To think people have inflated view of our healthcare system?

[Runaway0]

I've had treatment abroad twice and I wouldn't hesitate to get elective treatment abroad again this was the EU. The staff spoke perfect English there was an ICU in the hospital. I was offered pre op sedation because i was anxious ,I had my own private room , I was nursed with one other patient and there was 2 nurses on shift so 1:1 ratio my pain was perfectly managed. In comparison over here ive been expected to have gynaecological procedures with no pain relief. I had great protein filled meals with fish plenty of vegetables great for healing. (High carb slop offered here.)

I had dressings changed , post op care wirh docfor and I stayed 4 weeks to ensure everything was healing well. I keep hearing people say they would never get treatment abroad you will die etc they treat the UK as some holy grail of healthcare. People who go abroad are stupid etc.I have been left in pain multiple times in our health care system. My DD when she fell ill in Singapore had a team of doctors waiting for her at the hospital.
Preparing to be flamed but AIBU to think our healthcare system isn't that great? Many people haven't actually experienced care abroad so assume ours must naturally be the best?

Obviously we should be training more doctors - and paying them more so they don’t all sod off to Australia (ditto nurses), but IMO one of the major problems with the NHS is that ‘free at the point of use’ is such a sacred cow, no government of whatever colour will dare to tackle it.

In plenty of other countries, inc. in Europe, people do pay extra as needed, besides what’s taken in tax. A Swedish friend told me that everybody in Sweden pays something (albeit relatively small amounts) for prescriptions, with an annual cap for those who need a lot, and for GP and A&E visits, plus something for the ‘board’ element of hospital stays.

You can imagine the outcry if anything similar were introduced here - when at the same time there is so much complaining about poor standards.

The only other way is for income tax and Nat. Ins. to rise, plus of course a major crackdown on waste and inefficiency - both of which are often cited as part of the problem.

The scandinavian systems like this tend to be means tested too, so you aren't worrying that people aren't acccessing health care because they can't afford it.

I think a big contribution to this is doctors often reluctant to do diagnostic test (probably for cost reasons) unless you fit neatly into the typically presenting cancer patient.

Lots of cancers are missed because people are "too young" or aren't loosing any weight.

And while most people won't have cancer and the doctors dismissal will be correct ....we will be missing a lot of "too young" etc etc people that do in fact have cancer. So why not run the tests to catch those people ... Does it matter if the majority are actually clear of cancer ...it shouldn't do ...but wait it's costly so we don't and people get missed.

There’s some glorification of the US system on this thread, ignoring the role that insurance companies have to play.

The problem with having one national, cash strapped, service is that they then have a monopoly on deciding appropriate treatment. That’s not much of a problem when dealing with straightforward physical health issues but is when it comes to things like mental health where recovery is a very personal thing.

We have the glorification of CBT for everything from mild anxiety to complex trauma. CBT has its place but other very effective, relational therapies are often disregarded because they don’t fit an RCT model of evidence, and so the majority of NHS service don’t offer them, at least until you’ve done every other online process, a few rounds of CBT and are basically unable to function. It stifles innovation and reduces choice because trainees go into training with a view to employment at the end of their course so tend towards CBT, fewer practitioners of other modalities and less research into alternative effective treatments.

I was speaking to someone recently looking for therapy for a single traumatic incident that has left them struggling. Her NHS trust had nothing to offer her because she didn’t fit into one of their boxes. They have programmes for sexual abuse, domestic abuse, adult survivors etc etc but nothing for someone who needs support to recover from a single incident of traumatic accident. Relatively straightforward to work with therapeutically but computer says no.

That happened to a friend of mine in the US. She died after hitting her cap.
she was 34.

I get that people die here too when the NHS refuses them treatment, but I’d rather there be a nationwide policy decided by doctors that applies to everyone instead of what you have in the US where whether you get treatment is up to some insurance company employee who’s job security is literally based on how much money he/she can save the company.

But you do know that the choices aren't a faltering NHS OR a US private health care system right? There's an inbetween.

You have it backwards, the privatised bits have the biggest waste of money. Yeah they function ok in terms of performance but the price tag includes far too much profit.

Thank you howpo. These are the figures people need to see.

That's not different to what I am saying though. Yes they are inefficient economically, but they are there to plug holes, fix cracks, rather than actually addressing the full thing.

The country is being run by the rich who use private medical care.

They will let the nhs rot.

Turkey is going to do so well from nhs refugees in the years to come.

The treatment my father got in a shiny new hospital in Spain after a stroke was terrible. The treatment he got at a London hospital after we flew him home was exemplary.
My experience has generally been very positive. My family lives in America and paying for insurance is their main consideration when changing jobs, and the cost is unbelievable even with good insurance.
Other than Spain and US I have no other experience of healthcare, I think if you are paying then you will get better care.

The pay erosion suffered by doctors is the same pay erosion all workers have suffered due to the U.K. getting poorer as a country. When analysed by industry, the pay erosion suffered by NHS workers has been less than workers in other industries. I don’t think you’d get a pay boost under a private business model, or if you did it would not even offset the much higher out of pocket cost of professional liability insurance that would come with it.

Yes it is slightly different, you were saying the NHS is wasteful and inefficient and that the privatised bits fix that in pockets. They don’t the privatised bits fix low quality care in pockets, but they are the hugely wasteful and inefficient bits that are then dragging down the quality of care in the rest of the NHS.

Yes. But given that the NHS was the #1 healthcare system in the world for decades prior to being sucked dry by the Tory government who’s goal is to privatise it and line their pockets, it’s not the system that is the issue. There is no need to overhaul and switch to another system. All that is needed is to properly fund the system we have.

The NHS, when it works, is a treasure everyone should fight tooth and nail for. Having experienced the absolute shitshow that is the US healthcare system it's obvious that any country with asperations to true social equality has to have a system where anyone and everyone can access healthcare without having to worry about the cost of it.

The problem is, of course, that we have had 13 years of the tories fucking the NHS up just as they have fucked everything else up.

Like any organisation, if its properly staffed, tends to be run more efficiently.

I asked my DD what makes your ward run smoothly, she replied when fully staffed but thats a rarity, so things get missed, people don't get the care required, patients come back in & so it goes on.

Private companies are there to make profit, they will exploit the NHS to make more money... look at the report into the Priory Group published recently.

And switching systems costs money. Billions of £££. I’d rather any extra billions go to delivering healthcare, not think tank reports and then a slew of government contracts to de-nationalise some or all of our healthcare.

We are terrible at it anyway. Denationalisation has failed on every service we have privatised- our rail system is utter shit and expensive, our water system is aging and pumping sewage so we literally have rivers and oceans of poo, our gas/electric is a third higher than in mainland Europe and the war in Ukraine affected them too plus the whole system is aging due to no investment into upkeep, our telecommunications - 4/5G sucks anywhere outside London again down to private companies prioritising profit over network maintenance and upgrades.

I have had a breast issue for some time. No lump that I can find but the texture inside is completely different to my other breast.
I called the gp and was asked by the receptionist if I needed to be seen or would a telephone appointment suffice. I said surely they can't examine my breast over the phone so why take up a telephone appointment when I'll ultimately need to be examined anyway.
So they gave me an appointment with a nurse who did not robustly examine my breast, she just felt it lightly and prescribed ibuprofen gel which I questioned because there isn't pain so much as a sensation. She insisted I use it for 7 days, so I did.
No change.
So I called again, same attempts to avoid a face to face appointment by reception and eventually convinced them I needed to be seen.
Another appointment with same nurse who didn't recall seeing me. Same half hearted examination. Agreed to refer me to breast clinic.
I've now had a letter several weeks later, and I could cry. Its next week but it's a hospital telephone appointment. This will be the 3rd appointment and there is no way I don't need a mammogram. That cannot be done over the phone.
All these attempts to fob me off could actually kill me.

The funding issue won't be solved with more money if the NHS continues to be run by idiots.
My breast feels worse and is bigger. I'm scared but nobody gives a shit.

Haven't rtft just got up to the cancer stats and I can quite believe it.

My dad was diagnosed with cancer in an awkward place (somewhere in his sinuses, so hard to reach), had radiotherapy (and maybe chemo I can't remember my memory is terrible) about 3 years ago. When he had finished the treatment plan they signed him off saying he's now fine, but they never bothered to rescan him.

Of course he wasn't fine, cancer wasn't completely gone and about 18 months ago they found out it had grown back, because it's come back in a fairly short space of time they said his options are limited. He's had all the chemo they're willing to give for now and that's it, that's his lot.

It's not gone, but it's shrunk again, they say if it comes back (as it's sinuses he gets symptomatic at a certain point) within 9 months there's nothing they will do, if it's after that point they will consider more chemo. They won't consider surgery because of the placement though I'm sure it's not impossible, we can do microscopic surgery now!

I think a big contribution to this is doctors often reluctant to do diagnostic test (probably for cost reasons) unless you fit neatly into the typically presenting cancer patient.

Also poor awareness among GPs leading to mis- or delayed diagnosis. Primary care needs a complete overhaul with a much greater focus on continuing education for GPs.

No, that's not what I am saying. I am saying a lot of the NHS is wasteful and inefficient. And in an attempt to plaster over the cracks they are bringing in inefficient privatised services which doesn't fix anything because the root cause is not being addressed.

Perhaps if hospital departments were accountable for their own budgets which were directly linked to KPIs and performance (including patient feedback stats), the poorly managed ones might show some improvement.

The NHS is a beast, inevitably some hospitals, some departments, some trusts will be run badly. But that can only change, surely, if they are held accountable and people are rewarded for good performance (and sacked for poor performance)?

To add to the anecdotes on this thread, I had every major milestone and test missed by the maternity team that cared for me. The response was to get someone senior to help me out, which was nice, but doesn't resolve the issue of administrative or performance related incompetence. That team just carries on treating other patients who risk the same issues.

I guess what I'm asking, as someone who is admittedly a total layman, is would a privatised business culture, without the privatisation, at least improve things to a basic level more consistently?

I have received excellent emergency NHS care, not flawless but still excellent and long term too. Top of the class for that kind of care. I appreciate primary care is struggling in the UK. However I don't see how you can compare the care I had from the NHS with elective care in another country. I would never choose elective care in another country that did not have access to an ITU - even in the UK I would ensure there was adequate local provision.

As others have said it's not the staff that are the problem. It's the structure and consistency of management and funding.