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?

I have lived in 4 different countries so far... none of them have a prefect medical system. Where we are currently, there are tiers of medical insurance. Base level of insurance gives you cover in public hospitals and for 50% more, you can have cover in private hospitals where the same operation can cost more than double the amount. It is insane. You can get an MRI for a pain in the butt and can quickly run up costs that far exceed your annual premiums while those on 'basic' insurance are queried for everything. I remember listening to a talk by a UK trained doctor who worked here, who said that in the UK, they are trained to prescribe based on clinical presentation whereas here, they rely much more on testing.. which of course.. has a cost associated with it..

No where is perfect!!!

Absolutely agree with this^
I think injections are red herring here. The point is much wider - UK healthcare is at a really low point.

NHS is underfunded. Used to work in Switzerland and medical care was excellent. However, medical insurance used to cost about £600 per month for 2 of us. If we want better health care we will need to pay more for it.

Hi,@Runningbird43

These are great questions. Only people who have had chicken pox are vulnerable to shingles. So a routine childhood chicken pox vaccine would eventually largely eliminate the need for a shingles vaccine, together with the other good it would do.

The shingles vaccine is offered routinely, but rigidly. I think you had a couple of chances to get the old vaccine in your 70s -you were not offered it every year if you missed your first chance, you had to wait.
Now the better vaccine, Shingrix, is supposed to be offered to those turning 65 from last autumn. But my friend who should have been eligible heard nothing from our otherwise excellent surgery, and I don’t know how 66-70 yos will be vaccinated.

The real travesty in my view is that older people have no opportunity to get Shingrix on the NHS. They’ve been vaccinated with something having less than 40% efficacy.

NICE must cheese pare as the NHS is broken. But I have seen up close how incredibly painful shingles is and this seems cruel. I suppose if the money goes into reducing cancer waiting times we must be happy. But one has a feeling it is just as likely to go into the pockets of Tory donors for providing dubious, expensive services

It'll increase shingles to begin with (which could be mitigated by the shingles vaccine being given at an earlier age, like 50) but in time most people will be vaccinated against chickenpox and so shingles will decrease hugely.

You know the current news stories about vets bills?

private medicine. They’re profit making businesses. The more they can charge for, the more profit.

Sounds like care more convenient and shiny but not necessarily better. The NHS also does lots to try and improve health on a population level e.g. considering overuse of antibiotics, smoking cessation, chasing people up for things etc, while trying not to cost individuals too much. That said I do think there is much to be improved (alongside the fantastic work already done) e.g. reducing waiting times, more time for professionals to give care and availability of diagnostics etc, plus it would be great if more was invested in the NHS to do this. However I don’t think this is the best example of how care could be better

Over the last year I've spent almost £1000 to access care more promptly - the first time for breast pain and the second time be fitted with a pessary for prolapse. I've been lucky I have a bit of rainy day money to cover it.
Meanwhile, after speaking to a spinal surgeon we've agreed I'll try physiotherapy as a last option before a spinal fusion. I've got an open follow up, but there's no sign that physio are doing anything at all - I haven't heard from them, and suspect my open follow up will run out before I do. 🤷🏻‍♀️

I live abroad and get private medical care. I am now pregnant and in many ways, my care has been amazing. But about half the stuff, tests and screenings are totally fucking useless. They literally throw every single possible screening at me and the doctors are so pushy, I can't say no. The whole process is overmedicalized. And the midwives are useless because the obgyns do everything. So you have doctors with 20 years of education and experience doing the work of midwives and midwives just changing nappies, helping you right after birth and giving antenatal parenting classes. They're not even trained to help with breastfeeding.

All well and good but a waste of valuable resources if you ask me and I don't think this is better than the NHS.

I'm in Finland and my experience of the health system here has been pretty good in my area until now (won't be any more, as they've shut the out of hours service in my town and now we'll have to travel 50+km if we get ill or have an accident outside of office hours), with yearly health checks for children (so preventative care), GP system that functioned, and a really good out of hours (last time I went with vague chest pains, I arrived and was immediately given a bed and had an ECG within 15 minutes of arriving, doctor half an hour after that. When DS had a seizure the ambulance arrived almost before I hung up the phone, taken there and bed and tests straight away) but now they're ruining the system by underfunding it (must have learnt from the UK...) and I expect we'll have it just as bad, if not worse, soon enough.

Not my experience in UK. I had a nasty wrist fracture waited less than 10 min be seen, was treated, there was a remote consultation with an orthopod to confirm diagnosis & treatment, was treated, cast put on & out the door in 2 hours.
The NHS has many problem (esp in handling patient flow effectively) but clinical treatment is not one of them.

But your experience is increasingly uncommon nowadays, average waiting times tell you that much! DC3 broke a wrist last May (aged 3), and we were in A&E for something like 4 hours in total. What's more telling is that I was relieved we hadn't had to wait that long, the visit before that was 7 hours despite DC3 being triaged amber on arrival....

Similarly some people may be seen fast but even for cancer now 38% of people now don't start treatment within 2 months of an urgent referral. (The target is that should be 'only' 15% who don't, data from https://www.rcr.ac.uk/news-policy/latest-updates/diagnostic-and-cancer-waiting-times-data-for-january-2024/ ). I have family abroad and haven't heard of anywhere else that has anything like the number of people languishing on waiting lists!

Thank you, @Natsku One presumes that this is why the American Centers for Disease Control recommends Shingrix at age 50.

My husband saw a doctor in Germany for what ended up being a voice box infection. The doctor was very thorough, did a blood sample with the results straight away and wrote a script. It was only 80 euro which wasn’t worth even enough to make a travel claim. Prob would be similar price in Australia if we had to pay full price, but they wouldn’t have done the blood test that would have been separate and return for the results.

Shingles is the same virus as chicken pox, you only develop shingles if you have previously had chicken pox. The virus lays dormant in your nervous system, it is an opportunist which in a healthy individual is unable to reinfect their body. As you get older your immune system weakens and the virus takes the opportunity to reinfect.
The vaccine helps to prevent the virus reinfecting. The infection is from within rather than due to exposure to someone with chicken pox. The vaccine boosts the immunity.

Crabby cat you are missing my point. Clinical treatment is good. Patient flow, e.g., things like waiting times is not. Lots wrong with NHS but not the actual treatment.

I wish people would stop focussing on the US system. I have never heard anybody say the US system is better.
Europe though is way better (France, Spain, Switzerland, to name a few countries)

1. they do preventive medicine instead of waiting for issues to be bad before treating
2. if you want to go private, the cost is reasonable unlike in the UK where the choice is free or £££
3. even without going private, you receive better treatment as not so cost-driven than here

Similarly to a PP, all dual citizens I know (including me) will see specialists in their home country as seing a GP about something that is not critical is pointless.
Latest example: my legs felt heavy recently, I have family history of DVT. GP gave me advice (sleep with legs up, etc, nothing I didn’t know already). French GP prescribed compression socks (based on my leg measurements, not generic size) and a scan.
I’m sure in the UK I would be treated if I had DVT again, but why not avoid it in the first place?

Sorry, as your post was in reply to someone complaining about long wait times to say that hadn't been your experience, it wasn't clear that actually you were agreeing wait times are normally awful.

I'd agree the NICE recommendations in the UK are very solid evidence based treatment guidelines. However, in my experience for conditions where treatment requires follow up the inability of the NHS to actually do that means treatment ends up being poor. As an example, one of my DC has constipation problems. NICE guidelines are that there should be follow up within a week after starting disimpaction, you often need to further adjust doses / add in extra medication. GPs are so busy this doesn't happen at all, either in my personal experience or on what I've heard from others in support groups. Instead, you end up with huge Facebook groups of parents as each other's only source of medical guidance....

What the NHS needs is wholesale report and recruiting some managers who are not glorified and over promoted clerks!

In addition, the Consultant contract needs totally overhauling. The amount of non clinical time in our trust is simply outrageous and if the public were more aware of what some Consultants actually do clinically they would be shocked

I just happen to know US CDC regs for shingles vaccination. That’s not a huge focus on American health or a reason to moan. I did say Shingrix is usef by many countries.

When I lived in America we belonged to an HMO, a kind of hybrid healthcare system more similar to many continental healthcare systems than to traditional American insurance or to the NHS. It was brilliant. And when President Obama’s team was researching the Affordable Care Act, they looked to France for a model, though they ended up with something far from what they started with

The US system is only good if you are covered and that is immoral. If you are, it is much much better than the NHS and that’s been said a lot here.

From what I've heard from uk expats who now live overseas, the main difference between the NHS and health care the user pays for ( either as needed or through insurance) is that the NHS will consider the ailment to be less serious first , whereas overseas tend to eliminate a more serious cause in the first place .

Different trusts will have different hospitals and budgets. I'm a dual national and my free public healthcare is miles better than the NHS.

All is true: private hospitals will give you unnecessary treatment, and also the NHS is appalling compared to other countries’ public healthcare. It’s not just bad, it’s scary.

Agree, but it's also cheaper.

The great british public have got what they've voted for.

In my country (Finland) its also recommended for people age 18+ if they have weakened immune systems making them more prone to shingles (my brother for instance had shingles 3 times under the age of 40!) but its not part of the national programme yet so you have to pay for it. But now chickenpox is part of the national programme I expect the shingles vaccine will be soon too, its currently being investigated in any case.