How would you fix the NHS?

[PinkFruitbat]

The Government is asking for ideas on how to fix the NHS.

https://change.nhs.uk/en-GB/

What would you do to fix it?

Stop the cruelty of extending the lives of the extremely elderly, with multiple painful and distressing health conditions for as long as possible.
I've seen the torture for poor elderly people too many times and am going to put a 'no vaccine and no antibiotics' rule in place for myself when I get to that state. Let 'the old man's friend' relieve the suffering.

Cigarettes and alcohol already carry high rates of tax, and at one stage (when more people smoked) the duty raised on tobacco covered the entire cost of the NHS. I agree that sugar and other sweeteners should be more highly taxed.

However, the wonderful advances in medical practice, pharmaceutical advances and everything else that has happened since 1948 -- extending life at both ends of the spectrum, including additional years for the elderly and giving very premature/ill babies a real shot at survival is proving a mixed, and costly, blessing.

Exactly this! Don’t reinvent the wheel and waste time and money. Go and see what works and emulate their system!

I can't find who quoted my post about PAs but if I got an appointment to see one I'd turn it down.

I've had really bad experiences with the same woman at my GPs surgery.

First time I went for Achilles tendinitis. I tried to explain that it red getting me down - I couldn't go to the gym, I couldn't walk, I was in agony and missed exercising. Explained that I had been losing weight and this had really stalled it. I was told I had to continue losing weight and if I couldn't go to the gym I should just stop eating!! I've never been more humiliated in my life.

Three months later I go to see her about a sinus infection and her first comment is that I need to lose weight to get rid of it!! I went to a private GP through my work and got prescribed some strong antibiotics.

They're not qualified, they think they're these amazing people but they're not. The fact they're working in doctors surgeries is a joke.

Provided that meets their wishes. My father made it very clear he wanted to live as long as possible, so withdrawing antibiotics and vaccines would be against his wishes.

I think we did used to be at the top of that list when the Labour Party last left office. I think we are still judged very highly for value for money by the WHO and the like.

There is no quality of life in patients like this. Have awful memories of various relatives just clinging on for months and months. I can't picture them before during their final illnesses.

Fine families who refuse to pick up their family members from hospitals and cause discharge delays. I presume you have never been a carer for an elderly family member.

And to the poster who suggested older people should be treated separately from younger patients - how does that work? We're individuals with our own medical needs, not one amorphous mass. But also with needs from being an older person, which simply aren't catered for in hospitals.

Quite.

Some of the ageism on here is shocking.

They are qualified aren't they? I mean I'm not saying they are good or useful but don't you have to train to be one?

I was using a child's illness as an example. The friend and her DP at the time had a 13 year old (who was well on the day) and has been used to being the last to leave in the morning since she started the academy. If you woke up on day of surgery and a DC was being sick, you don't attend surgery

@Thommasina trained as what though, they act like doctors when they certainly are not.

stop shit like this
https://www.mumsnet.com/talk/womens_health/4922271-hysteroscopy-injured-during-hysteroscopy-please-read?page=1

I think this is part of the problem. Anyone questioning the ethics of trying to keep somebody alive as long as possible despite spending the last three years of their lives screaming in terror because of dementia and suffering with multiple painful health conditions is denounced. And they act like they're the ones on the moral high ground.

Agree that we need to look at health systems around the world that are working very well (comparatively); Germany, France, Norway and strive towards that system. I think it would inevitably involve payment at the point of access. This is waived for those on lower incomes/benefits.

Also, a more accessible GP service and better systems and pathways for mental health.

Bring back geriatric hospitals. Most bed blockers are the elderly. We used to have large hospitals where people with long term illnesses or awaiting care could be looked after leaving hospital beds for surgical and acute patients.

Bring back same day clinics. I used to be able to go to my GP and just wait to be seen. It's better to give rapid treatment than make people wait while they get worse and therefore take up more facilities.

Have a specific area for rapid ambulances handover. No ambulances stuck outside the hospital.

Of course it's an ethical decision and needs to be discussed as such.

I'm sorry you had a traumatic time. This isn't about you though and how you felt. It's about the patient. It shouldn't be up to grieving relatives who decide they can't face any more misery.

Social insurance system

Charge for appointments missed, which cost the NHS £150 for each appt.

We have more comms options than ever before. There is no excuse for not showing up for an appt, and not cancelling that appt.

I've been treated for breast cancer over the past three years. My remaining appts are for annual mammograms. At my last one, I arrived an hour early and settled down in a waiting room to work until my appt but was called straight in because the previous FIVE patients just hadn't turned up. Unforgiveable!

I'd get people to make a contribution towards food and heating whilst they are in hospital especially for long stays. Older people still get exactly the same amount of pension, pension credit etc and would need to have bought food and paid for heating if they were at home. Also think you should have lived here and paid into the system for a number of years to et free healthcare. I see a lot of people who have lived here for a couple of years then require costly treatment- this could be covered by some kind of health insurance until you have lived here for ten years.

£5 deposit for a GP appointment that either gets taken off the cost of your prescription or refunded after you attend

I like the Danish? (sorry can't remember the country) system where you pay the equivalent of 20 to see a GP. That is capped at 100 a year. People on a low income don't pay.

What I can't understand (and I'm nearing retirement age myself so this isn't a younger person whinge), is why people who carry on working in the same job past state retirement age (66 at the moment), deferring their state pension, stop paying NI contributions?

According to a Which? survey, in 2018, 14000 people deferred their state pension when they reached retirement age. At that point they stopped paying NI contributions but, presumably, carried on working on the same salary.

Now I know that's probably a simplistic figure and some of those 14,000 may not have carried on working full time, may have relied on a company pension for a while. But, assuming 10,000 of them stayed in their current jobs and that the average salary of those people is £20K a year, that's nearly £600 per person in NI contributions gone. That's £6.0 million a year lost.

A friend has done this. The deferring has increasing her state pension and she's £600 plus a year better off because of the NI contribution stopping, but her outgoings didn't change when she hit 66 years old. They were the same the day after her birthday as they were the day before her birthday.

I totally agree with not paying increased taxes but this is a tax reduction without income being reduced - and I don't know why it's not been plugged with the money ring-fenced for the NHS.

What about all the missed appointments that aren't the patients fault?

Several.posts including my own, give many examples where it's either not possible to cancel, cancellation message is not noted, appointment letter doesn't arrive etc etc.

Oh yeah that’ll go down well with the Daily mail crowd.
@Thommasina what about those people on the cusp of paying much more or those with large outgoings like child care. I’d struggle to pay £200-300 insurance as well as NI which goes towards something different.