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.

Labour was fully involved in dismantling the NHS and cannot escape blame. It began with NHS Trusts and the split from social services way back in the 90s. PPFI was Labour's baby and was a total rip-off, and now everything has been broken down into tiny trusts, all that is needed is the stroke of a pen to turn everything private - which could not have been done with the behemoth NHS prior to the late 1980s.

So now the defunding can happen in earnest.

All the changes have cost money in paperwork and admin. For example, when I began in the NHS, if there was a patient transfer between hospitals, it was arranged over the phone and was an easy process. As soon as NHS Trusts came into being, it was a bloody nightmare of who gets what funding, and so whole new jobs appeared to deal with it.

In the early 1980s, we constantly had visits from US insurance and management, because we ran things so cheaply. They wanted to copy it. But it was only possible because of the massive integration.

Trusts were never about improving things. They were always about breaking down the NHS so it could be privatised.

It's too late now - the chance to get it sorted was lost when Corbyn (who would have renationalised the NHS) failed to win the election, out of people believing what the media said about him. Doesn't matter who gets in now - the NHS is done because both Tory and Labour parliamentary parties want it that way.

@Changeau , I’m a Sister (a B6, who will not just sit in an office as I’m a nurse first and foremost) and am absolutely appalled at hearing what you’ve written (and what other OP have written about their poor experiences) with respect to your DD.

Can I get this right in my head…Your DD - a physio student on placement - was told to administer a suppository to a patient on the ward (and she did, why?)? And she witnessed a gentleman being incorrectly moved? Please do me (and those patients a favour). Please can you get her to report this immediately? She must stand her ground and refuse to do anything out of her remit. But also she must report any bad practice. I would want to know about it if it happened on my ward. And I would want to know who the hell deemed it ok for a physio student to administer medication like that (unless there’s something I don’t know about, I thought they can’t admin meds?!). Tell her to report it to her uni, and she should also be able to report it via a datix (can be done anonymously if she is worried). Tell her to report all of it. I’m furious reading about this.

Sorry, a complete diversion from the OP’s OP! X

This. I was stuck in hospital for four days in late 2019 and watched an elderly woman post thyroid surgery for cancer slowly slide down her bed over three days into a flat position. No one helped reposition her or get her up walking to change the sheets, she didn't speak english very well so she never got any food or drink from the meal rounds. I remember crutching past her bed thinking she's going to get pneumonia or something laying flat like that, she really needs to be up. Sure enough, collapsed in the toilet the last night I was there and eventually diagnosed with ta da! pneumonia. When I left her family were sitting around her bed more or less holding a vigil waiting to see if she was going to live or die, all for want of a little basic nursing care.

The nurses on that ward were terrible - I couldnt get my own water and I heard them bellowing down the hall complaining that I had asked for some. Never checked or adjusted that poor older woman. Never a kind word for anyone, had a screw up with my medication. Just terrible.

But, how much comes down to management and processes too - I spend a lot of time in another NHS hospital (much smaller trust) and the nurses there are all very proud of where they work and take pride in their patient treatment. Completely different experience - what bothers me a lot about the NHS is that for a supposedly socialised system, the treatment varies so widely and it really is a lottery about if you get care in the first place and then if that care is even decent. Shouldn't be like that at all but unless you go private, there isn't any consumer choice that would help drive improvement.

She was supervised when doing the suppository by a nurse

It was only a four day placement but yes, she was surprised not to have a senior physio to report to, the physio who did the rounds didn't even know she'd be there until she asked to shadow him.

She has a longer placement coming up in a physio dept in May which she's hoping will be better organised

It took me a while to get used to the idea of paying up front for medical care, but I’m completely used to it now as I understand most / all of it will be reimbursed.

medical practitioners, unless they work in public hospitals, are pretty much all private - midwives, physios, gps, gynaes, dermatologist, all specialists - as are the labs (for blood and other tests), imageries (for X-ray , MRIs, scans). They choose what they want to charge - some will charge more or less what the govt agrees to reimburse, others will charge a lot more (though having said that €70 is the most I’ve paid up front).

i agree with you though. My parents (in the UK) would rather wait a week for an urgent Dr appointment, or wait three years for a knee replacement, rather than pay up front - and they aren’t poor at all. People in the UK are so used to the idea of ‘free’ medical care.

She was supervised giving the suppository.

She has written everything down but will not report it apart from feeding back tonthe university that there was inadequate level of supervision. She isn't about to ruin her career over it and after all it's her word against theirs. Too much to expect a young physio student to whistleblow- I'm sure you can imagine how that would go.

She wanted to decline giving rhe suppository but was confused about what she should and shouldn't be doing and so keen to be helpful that she just did it. She said for a minute she thought it was some odd initiation ceremony! She is going to feed that back to her university actually.

@QueenCamilla I agree.

Like anywhere else in life I've experienced amazing people and dreadful within NHS but it doesn't help this attitude that they are some sort of hero's.

We need a culture change as well

"I agree. There is an endemic lack of empathy and care amongst the NHS staff (A&E and maternity wards are absolutely appalling in my experience)." I am ashamed to have to agree with this. I spent a very traumatic night in A&E, in excrutiating pain, and was horrendously bullied by a nurse practitioner. I don't want to give any outing details as I have shared story in RL. It's a grim tale. Junior staff looked in and walked past when I was vomiting like a whale. When I was transferred to a ward the next day the staff were lovely, but actual care still sadly lacking. I am a nurse of many years experience. I dread visiting relatives in hospital, seeing what I see and hearing what I hear. However, attitudes and behaviours in society as a whole have changed for the worse, on top of many other issues affecting the NHS.

It goes all the way back to Thatcher. She prioritised reducing taxation over funding public services (no such thing as society). Now no one will vote for a party that talks about increasing taxation. A grown up conversation is needed about the relationship between decent public services and taxation.

Absolutely this.

@Changeau I’ve just mentored a student nurse through a placement on my ward. She told me about some awful experiences that one of her student colleagues had in a different Trust. The students reported the poor practice and the university immediately recalled the students having placements on that setting within that Trust, and the concerns were all escalated. They were sent to other placements and they had no bad repercussions.

This is really troubling me. I have reported bad practice in the past. Not just as a nurse (or student nurse) but also as a previous HCP. I’ve never been given any grief for it. If I see something wrong, I can’t keep quiet. Please tell her to report it. Even an urgent email to her university. Was administering a suppository even under her remit as a physio student?

I am qualified to do lot of things but if a doctor or someone told me to do something I wasn’t trained to do, then I don’t care who is telling me, I won’t do it. Because if something goes wrong, then a patient could suffer due my doing something beyond my remit and I would (very rightly) risk my registration.

I hear so much criticism of the NHS and it's hard because my personal experience is incredibly positive.
Suspected cancer in my 30s. Even though it was a one in a million chance for me to have that cancer as a woman in my 30s I was immediately referred. Ultra scan showed a suspicious lesion. CT scan the very next day to confirm. Saw the consultant 2 days later. Surgery a couple of weeks later. Excellent follow up care and scans for many years after to check for recurrence. I suffered anxiety so got very good post cancer counselling on the NHS. I also got to see a genetic counselled to explore why I got it so young.
I'm now in an online group for people who've had my cancer. I'm appalled by the care they receive in USA (richest country in the world!). So often their insurance companies just refuse to pay for cancer scans and treatments. It's often an exhausting battle.
I've also see members of my family receive excellent care. My dad in particular has been so well looked after.
My son has a problem so we took him to the doctor. Referral was immediate and he's now having surgery within weeks of us reporting it.
Of course I do believe all the horror stories I read in the press but the care I and so many others receive is second to none. You just never hear the positive stories!

She is not qualified, she has no experience (this is her first student placement) and she was unsure if she'd be unreasonable to say no. The issue is not with her, it is with the nurse who thought it was appropriate to ask her. She is going to feed this back to the university.

Well I work for the NHS in A and E and show extreme empathy for my patients...try not to generalise.
However, I don't get long with each person as over winter, there was literally a tsunami of patients needing care.

But the short time I do get, the patient has all my attention and care as I would with a member of my own family.

They run the NHS in Wales and it's the worst area of all. I would dread the whole of the UK beating managed as badly as Wales.

I didn't generalise. It was dds experience and even she said there was one really nice nurse and that all the specialist staff were caring and lovely.

Exactly. But people want to blame politics. Drakeford and co believe if you have the money pay for services including healthcare. This means that there is more money available for those that cannot afford to pay. It's all fallen down a bit dental wise though.

NHS Employers have provided a costed, evidenced workforce plan tracked to demographics and trends in population health in order to tackle future staffing shortages by training more staff today. Jeremy Hunt is trying to persuade them to change the data as it is unaffordable. The tories have been in power for 12 years and have created the workforce shortages today.

anyone not in the NHS posting negative views should try providing an efficient, friendly service in your line of work with 25% less staff and significant below base-rate pay increases.

The amount of money the Welsh government has to deliver public services is down to the UK government, and for geographic/demographic reasons it costs more per head to deliver public services in Wales than England.

I know she is not qualified, and I didn't say that the issue was with her! She was put in a really shit position - not just by the nurse, but also by the university if she wasn't clear on what she could/couldn't refuse to do. I'm glad that she is going to let the university know. I hope then that they make it clear to their students what they can and cannot do, how to report concerns and the importance of reporting any concerns.

Tell her from me though, never be afraid to report or voice concerns, or question something. Your DD and the student I mentored, these are our future nurses and HCPs. They're important and I would want them to feel confident and secure, not scared. I wish her loads of luck in her studies x

Our healthcare system is shit but people seem to have low expectations because it's "free". I had surgery in Lithuania it was me and one other person being looked after by 2 nurses. My pain was always controlled and I was given nutritious high protein food to eat like fish and eggs. I was very very well looked after.
I also had cervical treatment and endoscopy which here no pain relief was considered fine here. There I had sedation it's like a medieval torture chamber the nhs and no need for it.

Yep. I was around then and we went from crumbling old buildings to PFI . Which seemed great as they were new builds. But the rent was 10s of thousands a month. And I was working in MH care and everything we needed to equip the wards could only be purchased via the catalogue provided. You couldn't buy a fridge freezer from Argos, you had to buy a fridge freezer from the NHS contracted catalogue that was 2x or 3x the usual cost

@GPTec1 I didn't describe a situation with a spoon that may have been someone else. I have, from my own experience, ha awful treatment from NHS staff. And if you don't believe that can happen, then that's incredibly naive. Look at the police, firefighters - it's a culture. Of course, there are many incredibly caring and hardworking people in the NHS, some of my family members included. But that doesn't mean we can't point out where change needs to happen.

My friend was a midwife for the NHS. She was shattered, the ward wasn't even well equipped, short of beds, understaffed. She wasn't confident of the level of care at all.

She moved to Australia last year. Same job. Says its a fantastic job over there and the level of care is excellent for women. She actually has breaks too.

I think you'd have to be off your head to work for the NHS now when you consider the alternatives (especially if you are young and have no reason to stay in the UK). We aren't really attracting the best doctors, nurses and midwives with the current pay/working conditions.

It's so sad because in theory the NHS is a wonderful idea.