NHS treatment poor compared to some overseas countries?

[PSEnny]

I’m on holiday with a family member who developed an infection. This is linked to an ongoing issue but no sign or symptoms of infection before we left. We’re in the Canary Islands. At 8.30 this morning we had to go to a local medical centre. Saw a doctor within minutes of arriving. 30 minutes later the issue had been diagnosed and an injection given which was a combination of antibiotics to kill the infection. Doctor also checked urine. Not by using a dipstick but by putting the sample in an analysis machine. This revealed an additional infection. Over the next 2 days relative needs to go back for daily injections of the antibiotics. We were fully expecting to be given some oral antibiotics (family member has been given these before when the same issue arose). NHS have never checked urine for a potential other infection. We asked the doctor why we hadn’t just been given oral antibiotics. Doctor discussed how the UK gets it wrong in a lot of its treatment, that the injections are the best course of treatment and that the go to over the counter antibiotics wouldn’t have got to the root of the problem. Doctor spent 30 minutes completing a full examination. In the UK you’re lucky to get 5 minutes with a GP. I’m guessing there’s a cost issue in that oral antibiotics are cheaper? And the additional time needed to do a thorough consultation is also costly but if it meant that issues were actually treated properly would this actually save money overall?
This isn’t to bash the NHS more a thought about why the best treatment isn’t offered and why thorough consultations aren’t carried out when other countries can do it?

Did you pay for treatment?

We asked the doctor why we hadn’t just been given oral antibiotics. Doctor discussed how the UK gets it wrong in a lot of its treatment, that the injections are the best course of treatment and that the go to over the counter antibiotics wouldn’t have got to the root of the problem

As a kidney specialist, that is a load of rubbish, sorry. And we have one of those machines in our outpatient dept, it just reads the dipstick for you.

The NHS could do with more doctors and more time, but an uncomplicated UTI doesn’t require daily IV antibiotics. Sounds like they are rinsing you, or at least over-claiming on your medical insurance.

If it was through insurance, my experience is a lot of overseas health services will fleece you for what they can.

Ive got a filing cabinets worth of orthopaedic patients who have had ill advised, poorly done and even completely unecessary treatments overseas, on the basis (so far as i can tell) that the only reason to do it that way is they could charge an insurance company.

Yes actually and I’m guessing this is the difference. Will claim it back through insurance. So is it that it simply comes down to cost and that UK NHS services will go for the cheapest option, without a thorough examination even though it may not treat the issue fully?

I would imagine that having to go to the doctor for daily antibiotic injections would be wildly inconvenient for most people and they'd prefer tablets to take at home if possible.

Also, imagine how many additional nurse/pharmacy appointments would be needed to give everyone a course of injected antibiotics!

No, it’s that it’s completely unnecessary.

Sorry if it wasn’t clear the UTI was an additional infection. Male family member too and I know UTIs aren’t as common in males.

You do not need IV antibiotics for 99% of UTIs in men either….

Healthcare in the UK is very, very poor quality comparatively. I'm sorry but this is just a fact. It was not the case 20 years ago but it has deteriorated sharply during recent Tory rule. All of my friends with dual citizenship are constantly travelling to their home countries for medical and dental care. Others are considering moving back there specifically for healthcare. A relative had an injury while on holiday in a EU country and was seen in A&E and patched up within the hour, paid twenty euros. In the UK I would've been there for 10+ hours or paid hundreds for private care.

Reminds me of a monty python sketch about buying the hospital more machines that go ping.

I’ve worked in the NHS, in Germany and in Canada, and have many friends working in Ireland and the US. I am quite confident that IV antibiotics are not standard care for incidental, completely asymptomatic UTIs anywhere in the world. This GP is defrauding your insurance company.

My Dad is Canarian and we have lots of family across the islands. Canarian doctors are notorious for over dolling out antibiotic injections. My extended family seems to get injections for every little virus they have, it's crazy. The line about antibiotic injections versus oral antibiotics is simply not true either.

I'm a dual citizen and this is exactly what I do as well

Just to play devil's advocate. The NHS has a huge drive towards antibiotic stewardship, so trying to prevent over use and prevent further antibiotic resistance. So yes oral antibiotics could seem like the cheaper option, but often a weighted decision is made around is this beneficial/necessary and IV is often not routine because of that.

I had the misfortune to use private healthcare in the Canaries. Don't be fooled. It's a money making operation.
Also why travel insurance is so expensive.

You paid and they gave you a treatment that attracted maximum billing.

I once had the very sad experience of admitting a person who had become paralysed in the Med to a UK hospital after they were medevaced home.

The person was full of criticism for the NHS, how awful it had been in A+E, how the clinic abroad had been fabulous and only ever gave him painkillers by injection. I had to break the news to the person that this fabulous clinic with its injectable painkillers had done the wrong scans, they had cancer and would never walk again.

The shiny clinic with its injections didn't look so nice then.

Yep. I’m in the Middle East, in a country where private health insurance must be provided by your employer. I am grateful everyday for the ease of access this gives us.

Just this week, my two year old spiked a fever and was wheezing. Within 45 minutes of me phoning the clinic, she was seeing a pediatrician who diagnosed bronchiollitis. She was put on a nebuliser whilst we were there and the doctor assessed her again immediately afterwards as she had no other patients to rush off to. She was also swabbed for influenza, RSV etc and we were phoned with the results later that day.

I also started medication this week for ADHD. Between my therapist flagging ADHD as a possible diagnosis, to me undergoing hours’ worth of testing and assessment, to receiving my diagnosis, detailed report and prescription, was just 4 weeks.

Every time your relative is going back for an injection of antibiotics the clinic gets to charge the consult time and the higher cost of an iv injection of antibiotics. My cynical brain tells me the iv antibiotics are indeed better...for the clinic's finance books!

Even 20 or 30 years ago the NHS was comparatively poor on a global level, and I say that as my late husband was a heavy user of it from the mid nineties, but we travelled a lot and experienced heath services around Europe, Asia and the Americas. But people didnt notice in the U.K. as it was tolerable, whereas now it’s not just worse but much worse, and of course there’s much more viability of how bad it is

Was going to say the same thing as PP about the urinalysis machine. It dies exactly the same job as a conventional dip stick.

I am not questioning the judgment of professionals regarding OPs experience.

However in other ways I think she has a valid point. One example is the Shingles vaccine. Shingles is a terribly painful disease of mostly elderly who have had chicken pox. Occasionally it is quite serious. Until last year NHS England only offered the Zostervax vaccine to those over 70, for whom it is only 38% effective.

Now, many years behind other countries, we are finally offering the more expensive, more effective Shingrix vaccine to 65yos (the American Centers for Disease Control recommends age 50). But those who have had Zostervax are not eligible, where the CDC recommends they should also get Shingrix. Thinking of the needless suffering caused by this policy makes me furious

Obviously I don't have the notes but that sounds suspiciously like over treatment to fleece you or your insurance Company.

There isn’t really enough information in your post. Did the dr check urine when there weren’t actually symptoms of uti? Because asymptomatic bacteriuria does not routinely need treated in men. Or were the antibiotics to treat a different infection? It’s a bit confusing. Of course, when all consultations and treatment can be claimed from someone’s travel insurance, I’m sceptical. Antibiotic injections for someone who does not have a significant infection are unnecessary and will only contribute to their countries antibiotic resistance. But yes, the nhs has serious problems right now.

What would save money would be to offer up the chicken pox vaccination as part of the routine childhood immunisation programme.

No, wrong way round. Hospitals run for profit and payed for with insurance will go for the most expensive treatment. Bigger margins.