To think the NHS’s biggest problems aren’t management but an ageing population, unrealistic expectations and over-medicalisation?

[NaiceBlueSquid]

People often blame NHS management for its ongoing crises but isn’t the real issue much deeper? An ageing population, increasing patient expectations that can’t realistically be met, over-diagnosis and medicalisation of some mental health conditions, a shortage of clinical staff, and outdated facilities all seem like far bigger problems.

AIBU to think that while NHS management could probably be improved, it’s nowhere near the biggest problem the system faces?

I agree, I’ve worked for the nhs for nearly 25 years and patient expectations has increased year on year.

Some people think the nhs is there to solve absolutely every problem in their lives.

That said there are some areas that could be run more efficiently and with a lot less bureaucracy.

The nhs also needs a national records system , so that it doesn’t matter where in the country you are any dr you see can access your patients records. At the moment the system is very disjointed which creates confusion and delays.

Yes, a jolly good idea! Let all over 75s remain untreated. Great for those waiting for their inheritances.
My cousin recently attended ten age 80 birthday celebrations. Sorry, they weren’t all lying about waiting to die. Some had treatable cancers, some arthritic issues, some completely well. Still alive & kicking.
Cutting out care for those of a certain age is not the answer.
I would advocate setting boundaries for under 75s, after all you haven’t paid in as
much, have you?!

I work in adult social care and find myself increasingly exasperated at the amounts of medications prescribed to (very) elderly clients just to 'keep them going' regardless of their quality of life. This is not to say that I think treatment should be withheld on account of a person's age and medications should always be given to relieve pain, but at some point there needs to be some common sense applied. Also, the amount of medications that are prescribed and not taken because the client thinks it's pointless, doesn't like it, and the meds just end up being sent back to the pharmacy for destruction. Such a complete waste of money.

See if you feel the same when you’re ‘elderly’! It’s easy to offer opinions when you have no idea what it’s like to be ‘elderly’
Many of our relations are no longer willing to have NHS appointments constantly postponed or cancelled. Neither do they wish their quality of life to suffer with long waiting lists.
They quite happily pay for private treatment. The ‘elderly’ are still treated if they have funds to pay. Not good for inheritance seekers of course.

Why are you rattling on about 'inheritance seekers'?
My dad died at 89, my mil at 89. Neither had a fantastic quality of live for the last five years of their lives.
My FIL is 94 in a home. His quality of life is pretty poor too and some of his fellow residents literally don't know where they are. Are these lives worth saving? I think probably not. And inheritance does not come into it.

Sometimes when I hear about some people's mental health problems, I think 'you don't have a mental illness, you are having a legitimate reaction to a really shit circumstance or difficult life'.

I spent many years thinking I was a neurotic mess until I realised that just about anyone with the caring responsibilities I have would start to crack. So, I definitely agree with the over medicalisation of some mental health issues.

Aren’t there quite a few services that used to be more easily available e.g. dentistry, ivf, ear syringing? Haven’t thresholds increased to access treatments too?

The more you spend on Private Health the less there is to pass on. A close relative has paid £20,000 for 2 hip replacements. Others thousands on knee replacements & cataract surgery.

Nothing wrong with that - better to have quality of life rather than languishing on waiting lists if you have the money.

I am English, but I live in Scotland. The hospitals up here are SO much better than down South. I've never had an issue.

But the English hospitals I've experienced have been dire :

I was hospitalised for a miscarriage and stayed in overnight. Didn't get fed once.

When I had my babies mistakes were made - a pair of scissors swaddled in with my daughter, for eg.

My uncle had a brain haemorrhage and was temporarily blind - they would put his food next to him and not tell him it was there - so my Dad had to go in at every meal time to feed him.

My Dad is always in and out of hospital with infections (he's elderly now) - his notes say which antibiotics he is resistant to, but they never read the notes and give him the wrong meds - EVERY SINGLE TIME.

Simple, common sense things, that a non medical person (like me) can see are wrong, and could so easily be rectified.

Also the system is so clunky, with Departments not talking to each other - for example, the Discharge team are supposed to connect with the Carers when my Dad goes home (to reinstate the care) - they never remember to do it. And then when the Ambulance driver delivers him home, they see there's no care and just dump him anyway - no water or phone given - just dumped in a chair and left.

In fairness, they have brought my Dad back from the brink many times, so there is that, but that really reinforces the ageing population theory, as he would be dead by now without medical intervention. Add to that, that his quality of life is rubbish, and you have to wonder whether that's a good thing. He would say so (of course), but my sibling and I are run ragged (and have been for 5 years now), with spinning all of the plates that are required to care for a fully grown man of 22 stone, who behaves like a toddler most of the time.

Or possibly an overweight/obese population who are unable to regulate their own diets and are developing poor health as a result.

Roughly 25% of adults and 10% of chlldren are obese, which together is a larger number than the over 70s.

Perhaps we should blame the fat rather than the elderly. At least the elderly cannot help getting old !!!

Do we differ between people who are fat with medical conditions and medications at our cutoff points for access to treatment?
So we have fat people, elderly, maybe disabled people too? FFS

It’s a tad ironic that with the millions already with deteriorating health due to covid infections, with pressures on nhs due to viral infections added to with covid, that some bright spark thought I know, let’s make it worse and ensure we don’t acknowledge airborne spread and also let our staff spread them around the hospital too!