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be met, over-diagnosis and medicalisation of some mental health conditions, a shortage of clinical staff, and outdated facilities all seem like far bigger problems.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?

Fix social care, especially elderly social care and it will free up so much space in wards, thereby allowing A&E to transfer those patients who need it quicker and then manage to treat those who just need help and can go home.

Elderly care homes are woefully under resourced, under appreciated and prohibitively expensive for the majority. They don't like to take on patients with high care needs and those that are able to do so is just unaffordable. One in our area charges £2500 a week for dementia care residents.

Hospices as well need properly funding. The majority are funded through charity and grants, but they do amazing work in people's final days. Thereby freeing up hospital beds.

I would have no issue paying a nominal charge to see a GP.

This was about DNR specifically, resuscitation is physically traumatic and almost never successful in older people. By successful I mean, restored to their previous level of functioning without brain damage.

I'm 54 and I'm not even sure if I would want to be resuscitated in the event of a cardiac arrest.

Literally half the beds in the local hospital orthopedic surgical ward are taken up with dementia patients who've had falls and fairly serious injuries in care homes. They are at times, quite alarmingly distressed, screaming, shouting racist abuse at nursing staff, and threatening other patients.

DoNoTakeNo · Today 11:39

YABU because the biggest issue is the appalling IT structure.

Can you give more detail @DoNoTakeNo ?

NHS workers like yourselves need to familiarise yourselves with the Broken Plate 2025 survey. Ella Mills has managed to and she is more privileged than you so if she can there is really no excuse.

And i cant help noticing you didnt mention IVF Very telling

One of our regulars sells their GF bread/ suncream on FB marketplace! It's infuriating to see NHS money wasted and it's those people (not saying that's all patients!) who are also the first to talk to front line staff like shit and feel entitled to everything for free/ take no responsibility for their own health etc.

My Dad who is 76 has been badly affected by it, he is on a 30 week wait for a heart scan and refuses to chase it saying someone like his granddaughter needs it more
I'm sorry @Decoart , you must be worrying about them both.

To be honest, as a cancer patient I get sick to death of the "but the NHS needs more funding" and "aren't they all angels" crowd.

Yes, there are some good people, but there is far more nastiness, supercilious behaviour and bone-idleness than people realise.

People who only occasionally use the NHS for minor things simply won't realise this. They seem to treat the NHS like some kind of untouchable religion.

Once you actually access the right care, at the right time, in the right place, and hopefully with a polite/friendly member of staff, it's often fine.

But it can be a real battle getting there, and many people don't have the time, energy or ability to battle GPs who don't listen and NHS nurses who gaslight.

I wish you and your OH the best.

It's all of the above. I worked in the NHS for a number of years, as did all of my family.
But I know someone, now happily retired, who earned very good money training NHS managers to be 'the best version of themselves', and other such bollocks. Money is being wasted at every level of the service, but especially at the top.

So the secret message here is older people are a burden on the NHS (despite paying into it since it was founded), they should suck it up & die without treatment?
Well, many of us don’t want to die without being given an equal opportunity to live.
There is no other life, imo. I want to live as long as possible to see my children & grandchildren flourish.
Older people shouldn’t be blamed for previous government’s mistakes.
The current NHS is not fit for purpose due to the increased population since the 1950s. Additionally new expensive drug therapies haven’t helped.
How presumptuous of some posters thinking that they know how it feels to be over 60, 70, 80.
Lastly, re DNR I have several older friends who have been successfully resuscitated with no adverse effects whatsoever. They are still alive & enjoy their lives.

@DemelzaandRoss

Older people shouldn’t be blamed for previous government’s mistakes.

It's not "previous government's" mistakes though. Older people voted in those governments. I'm sure the politicians would have loved to campaign on higher taxes but the voters wouldn't have voted for them. Just look at all the fuss about WFA and now trying to reduce the disability benefits. Governments can only do what the voters will vote for them to do!

@AutumnFoxe or you could have been advised to go online or to your local pharmacy and buy a pack of iron tablets for less than a fiver for 3 months supply.... it would have saved numerous letters, time taken to type, send and process on the receivers end, time taken to write a prescription, the dispensing fee paid to the pharmacy.... getting that pack of iron tablets to you after your diagnosis probably cost the NHS well over £50... but people (this is not aimed at you personally, I making a general statement) don't see why they should pay when the NHS is 'free'.

The State.................keep your weight down dont smoke dont drink. get plenty of excercise work full time.
Also The State..............run yourself ragged caring for your elderly parents. What do you mean you dont have time. Your parent is blocking a bed. How selfish of you!

MAKE YOUR FUCKING MINDS UP

We once received a letter asking we hadn't attended a paediatric appointment in Devon ( with a consultant from Bristol Children's Hospital, because Plymouth didn't have paediatrics at the time) we'd received no appointment letter. On phoning the consultant's secretary, it transpired that nobody had received appointments for the clinic. Plymouth blamed Bristol and Bristol blamed Plymouth, and we had to drive to Bristol from Cornwall for a 10 minute consultation.

I agree healthcare is far better in France and Germany.

Sadly the main parties are all too aware that many people feel we are lucky to have free healthcare (which it isn't) and now free at the point of service is being sold to the public (constantly mentioned by Wes Streeting) as to why the NHS is worth keeping it absolutely isn't we deserve better

The NHS has to change culture from within, dealing with poor staff, money wasted and too many senior management wasting money and time on projects that then need another project to fix previous project is standard. The money and time I see wasted while other areas its understaffed, lacking in investment is visible everyday at work

Depends where you live. You could vote Tory for ever & a day where I live & they would still get in. Also it’s not always the same political party that has made stupid decisions. Don’t blame the voters.

I understand that and personally I would agree for myself but I dislike intensely people who believe they have the right to say what others should do when they are not in that situation. People over 80 should have the same rights and ability to choose for themselves as anyone else.

No - the message should be focus on outcomes. By all means aid people to live long and healthy lives. But dont scan, test and prescribe when patients are too frail to undergo treatment. We are living longer - but not healthier.

Yeah that isn’t right either. Unfortunately people who work I. The NHS are also users so it perpetuates. It does suggest when it’s free all the time for everything that people dont always value it in the same way.

My sincere best wishes to you and your husband for successful treatment and outcome.

I disagree with you. Many investigations can help to diagnose quite simple ailments.
Being older myself I am speaking from personal experience plus with friends who are even older. They are happy to have tests.
My own father had a double hip operation in his 80s & went on to live pain free until his late 90s.
Please don’t generalise.

Well im sure the posters on here who think that patients should pay for missed appointments also think it should work the other way.

I don’t think we can actually blame people for living longer, just recognise it’s a factor in the NHS’ decline.

in other countries GPs aren’t gateways to hospitals and you can book directly with consultants (even in China where most GP work is now automated) as GPs don’t get paid for referrals. They are a seperate service and GP salaries (and working hours) are usually lower as a result. It is absolutely mind boggling how some UK GPs can earn many multiples more than that a specialist consultant. It would save so much money.

Yeah no it really isn’t. Many many many other countries have universal healthcare which works a lot better. I speak to close family in three other counties and doctor appointments are faster, consultants are easier to come by, treatment is leading, etc. It’s such a narrow view that the UK has about their healthcare.

I should add my parents live two hours outside a major Canadian city and there are two new hospitals being built within an hour of them (in different directions). When my father needed specialist treatment he was given a choice of three hospitals and given dates at each and what would suit him.

I don’t disagree. I think the NHS is almost inaccessible now for working people. I end up using private, even for GP appointments now and it’s frustrating. Must be much worse for people who actually need to access the service to manage a health condition like you. Sorry for your experience.