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.

I'm a HCP the problem is not enough staffing which leads to burnout , poor pay in comparison to other countries and increased costs. The NHS will not survive in its current format we have an aging population people are retiring at 60 then living until even 100 with very complex comorbidities which didn't used to happen in 1946. Most people had short illnesses before death we now have people living up to 10 years in poor health.

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

Sorry but I don't believe this unless the practice supervisor thought it was a student nurse which is no excuse. Everyone knows a physio wouldn't give a suppository...

Something else that’s totally normal in France is means testing - it applies to everything from medical reimbursement to the cost of school meals to, well everything. I don’t understand why it seeks to be such an issue in the UK. Here, everyone submits me a tax declaration yearly, and the household income is used create a ‘quotient familial’. If it’s high, you pay full price. If it’s low, you pay less. Eg my friend on a really low income pays €0,22 per school meal for her kids. I pay €4,25. I only know this because she told me: it’s all handled administratively, no one in school knows who’s paying what for school dinners, so no stigma.

for healthcare, people on low incomes qualify for cheap or free mutuelles and top up costs are paid by the govt. they don’t have the same choice that higher income people would have though.

Chronic underfunding plus the right wing press propaganda machine is creating the case for privatisation - significant numbers of Tory MPs have private shares in healthcare providers and we know the US is desperate to sweep in.
Labour will not privatise.

Well, you are totally at liberty to not believe anything you read on the internet of course. Sadly I can assure you that it's true.

And the NHS is still paying back the £80 billion it cost for their £13 billion PFI investment in the NHS. And will be doing so for decades.

It was also not in a ‘decent state’, if it were we would not be short of GPS and other staff now - their training needed to start when labour were in power.

The NHS was flawed from its set up due to the compromises needed to bring private doctors and hospitals on board.

What are these cosmetic procedures that are available on the NHS that people talk about? Not aware of any

Correct. I will add that it was the Thatcher govt that sold off social housing, leading us to the dire situation we have in the rented sector (alongside the massive house price inflation that has accompanied it).

It may be that a carefully-organised new system on the lines that operates well in some other countries might work here - but you will have to forgive my cynicism, having watched successive Tory governments allow privatised utilities to fleece the public (look at your energy bills), that we will get anything better in healthcare when we hand it over to the private sector who have to make profits.

I also need to hear where the extra doctors, nurses, etc will come from - we underpay them and do not train enough of our own, alongside shutting off a supply from the EU. Claiming this will all disappear if we privatise is astonishingly naive.

It goes all the way back to Thatcher.

If you ignore of the strikes in the 1970s, including the winter of discontent that bought down the labour government.

"It was also not in a ‘decent state’, if it were we would not be short of GPS and other staff now - their training needed to start when labour were in power."

Patient satisfaction was 70% in 2010. Where is it now?
We've got 150,000 NHS staff vacancies and you want to blame all of the on the Labour government 13 years ago? What rubbish.

Jeremy Hunt spent the last few years chairing the Health Select Conmittee and absolutely castigating the Government for failing to do any workforce planning.
Now they've produced a report and busy scrubbing about the target figures.

www.nhsconfed.org/news/nhs-confederation-writes-letter-chancellor-nhs-workforce-plan

I didn’t blame it all on the Labour government but neither are they blame free. Where do you think these qualified GPS come from? The Tories have been bad at workforce planning but so were Labour. NHS problems run deep - as I said, right back to the compromises that were required to set it up.

You certain did in your early post.

It takes approx 10 years to train a GP and 7 years to train a hospital Dr, so the Tories could have trained 1000s of Doctors over the last 13 years.

The Tories took away Nurse/AHP bursaries and froze nhs pay during their first 5 years in power, then limited it to 1% for much of the last 8 years.

We still do ok in comparison on Dr numbers (in hospitals) to the EU but are awful on Nurses, beds and Equipment.

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.

GP training takes around a decade.

There has been warnings over workforce planning for a decade. It's been ignored. Brexit exodus of staff was warned. Doctors going overseas was warned and ignored. Australia & Canada are both looking to recruit thousands and offering better terms.

As I say if you read any of the letters from the Health Select Committee over the last few years you'd see how much has been sidelined and ignored.

I'm not opposed to change. But Conservatives have received huge donations from private medical firms. Heaven knows the billionaire owners of the media will have their sticky fingers in private healthcare. The Conservatives aren't the right people to direct a national conversation about our options.

I also need to hear where the extra doctors, nurses, etc will come from - we underpay them and do not train enough of our own, alongside shutting off a supply from the EU. Claiming this will all disappear if we privatise is astonishingly naive

This where i take issue with Labour, they are not being honest.

They say they will train 10,000 extra nurses per year and AHPs, where are 10k young people with 2 or more A levels wanting to work in the NHS ?

These A level students are working in other sectors, if we got them to work in the NHS, they d just be shortages in other work sectors.

As you say, we lost many EU staff, esp in social care and EU workers don't want to come here, RoW dev country HCPs are often not very well trained, certainly not to our standards.

The first thing the Govt needs to do is pay NHS staff better wages & make shifts & working hours more flexible and family friendly so that the NHS isn't paying extra through the Bank system for nurses to work.
Recruitment and Renton of staff would make a huge difference!

I have just been through treatment after an accident.
Friday 14:30 to 17:30 A&E - X-ray wound washed & dressed home with antibiotics.
Saturday - phone call from plastic surgery to book appointment for Sunday
Sunday local anaesthetic dead shin cut away wound washed & dressed home.
Tuesday - wound checked & dressed
Saturday as per instructions emailed plastic surgeon a photo - he called me back on his day off!
Sunday - phone call to go to day surgery Monday
Monday - skin graft under general anaesthetic - back in my own bed at home by 13:00.

I had an on-call number I could ring at any time if I had any issues.

Every member of staff i had contact with was kind sympathetic & professional.

I cannot fault the treatment I received, I feel so grateful and I realise this is not everyone's experience!
And of course I am lucky as I live 10 mins from the hospital!

Agree. It needs to change. It was never designed to provide the level of care that many in society now need, therefore it’s obviously creaking at the seams. Unfortunately (and I’ll get my hard hat on here for the lefties…) a form of statutory public life insurance and top up fees is the only way. Austria, Singapore and Italy do this very well. The NHS as a system has never been copied by another country…. Or certainly never on a lasting basis . There’s a reason and that’s because it doesn’t work. The sooner people open their minds to an alternate idea the better.

@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 dont think it's Stockholm syndrome

I think its, thankfully, that most people are aware of the chronic underfunding and misuse of the nhs.

And that despite its failings they are still grateful for the free at point of use total healthcare they receive

If they're not then there's always private health care.

No one is stopping you using it if you cant access the healthcare you feel you need via the nhs

The staff, on the whole are caring, compassionate and highly skilled. Doing their best in very difficult circumstances

The NHS is in an appalling state. The service provided falling way short of adequate for many people. Unfortunately we have been trained since 2020 to have a very low bar, to think ourselves lucky if we're kept alive, and to never ever forget that there are people worse off and that's the reason our own needs are not met. Who would be churlish enough to complain about only being left in agony for hours, when others are dying?
We also find it difficult to separate the institution from the front line staff. The latter are at best excellent and at worst doing the best they can with what they have. Our gratitude and empathy for them blows a smokescreen over what should be our outrage at a system that is badly letting us down.

The OP sounds like a troll for privatisation.
I live in Europe and regularly use two other country healthcare systems. One largely private, one national (cross border healthcare agreement). The NHS is more efficient, cost-effective and has the potential to be much better on preventative care - there is no cost at point of use. This is infinitely better than any fee paying system or quasi private system.

The NHS is failing due to lack of investment. This means ALL areas are affected; staff training, equipment, availability of staff and follow up care. I totally agree that the care provided is sub standard; it is due to inadequate resourcing staffing and management. I don't agree that staff are inherently rude; this is a training issue.

There is enough money in the UK to make the NHS serve the population FAR better. People like the OP are advocating to divert the few doctors we have into an elitist tiered system. This must not happen.

More investment, train more healthcare staff, nationalise the GP system.

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

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

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’

Westminster clawed back from the Welsh government £125 million recently given to the Welsh government re covid management. Because it was still sitting there Westminster decided that it wasn't needed. That should have been distributed!!