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be met, over-diagnosis and medicalisation of some mental health conditions, a shortage of clinical staff, and outdated facilities all seem like far bigger problems.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

My wish is not to legalise euthanasia, but to ensure every person receives the dignity of excellent palliative care

That's not possible unless you can afford to pay privately. Haven't the government even said they can't afford assisted dying?

You are right as is another poster who mentioned Amazon, Uber ect, also COVID has not helped either I think it's turned a lot of people into worry warts and it's no surprise the way the media were.

They surely aren't obligatory though. Why does she go at all?

I would agree that there is unrealistic expectations on the NHS. It is not just the elderly who have these expectations.

Had this discussion with a group of medics who I graduated with.
The concensus was to stop funding;
gender reassignment
IVF
Charge people who have private procedures abroad that go wrong (such as boob jobs, tummytucks)
Charge insurance companies or private hospitals for procedures that the NHS have to fix
Plastic surgery should be for the disfigured or disabled or rectifying after cancer treat not for body dismorphia

They were unhappy with the trend in people demanding diagnosis, for ADHD or Autism in later life. Who then go on to want PIP.
I work with SEND children and questioned the leading psychiatrist response was we are all neurodiverse. We all learn in different ways!

Suggestion on things to do
Charge for non attendance of appointments
Use more IT to monitor chronic conditions
Bring back 8 hour shifts for nurses on the ward.

Better education for health conditions
Educate people on what is necessary for A and E and what is time wasting

Full time mental health staff in all medical and educational establishments

Basic lessons in school to cover what to do if you cut your finger! I remember teaching this years ago.

Be honest with people and relatives and spell out the chance of survival, the quality of life of certain procedures

For the profession to remember just because can do it doesn't mean you should.

It was a rather interesting reunion weekend. We all were in Halls together as students.

I can't remember all of what they agreed on as the red wine flowed!

I am not saying these are all my views but it was really interesting discussions.

Of course you can get free palliative care, please don't spread dangerous nonsense.

My DM died at home of pancreatic cancer and had a hospital bed provided and carers coming in four times a day plus a district nurse giving medication. There was never a question of having to pay for any of it or means testing. She died very peacefully.

Hmm, UK TFR fell below replacement in the 70s, ie when boomers were younger adults and teens.

https://www.statista.com/statistics/284042/fertility-rate-in-the-united-kingdom-uk/

After that it bounced around between fairly narrow parameters for about 40 years, until the mid 2010s. Birth rates dropping off a cliff happened in the last few years, and hasn't really had an impact on the health service yet because the relevant cohort are still children (this link only goes up to 2021 but we know what's happened since then).

What we are currently experiencing is something that we knew was coming decades ago. But yes, it would've been politically problematic to talk about this.

@spoonbillstretford free excellent palliative care?

One of my relatives wanted to die at home. The state provided carers were shocking, she was lucky she could afford private ones.

palliative care isn't just for those near the end of life...

And the last time I was in hospital visiting a relative I helped feed other patients as they were left with food in front of them but couldn't manipulate spoons etc.

The carers my mum had were private carers, with public funding.

@Teajenny7 how much would not spending on plastic surgery save? And what about spending on those who speed and cause accidents or those who take drugs?

@spoonbillstretford I'm still confused why you are extrapolating your experience to everyone. You seriously think everybody experiences excellent palliative care on the NHS? 😆

I’ve had pretty rubbish experiences on NHS and that’s wholly down to staff incomprtence - my expectations were 100% mainstream

But yes, it would've been politically problematic to talk about this.

still is

No I don't, I know there are definitely people who don't have someone to advocate for them and don't receive good care.

What I objected to was your statement that good care is only available if you go private, which is both misleading and incorrect. 🙄

"They were unhappy with the trend in people demanding diagnosis, for ADHD or Autism in later life. Who then go on to want PIP.
I work with SEND children and questioned the leading psychiatrist response was we are all neurodiverse. We all learn in different ways"

Would you say the same to people trying to get a diagnosis for a physical condition where there's no treatment or cure?

@spoonbillstretford you need to re read what I actually replied to and said...

I replied to a post that said they wanted every person to receive excellent palliative care. And I said that it's not possible to do that unless you can afford private because after all until you are ill you don't know what you will get.

I know there are definitely people who don't have someone to advocate for them and don't receive good care.

So you agree then 😆

I object to your lack of comprehension but it's pretty common on MNs these days.

What I objected to was your statement that good care is only available if you go private, which is both misleading and incorrect. 🙄

I didn't make that statement though 🙄

Yeah it’s all from their own healthcare systems but I can’t be asked to go back and source specifically to allay your question.

it can work and it does quite successfully in a lot of places. The negative multiple reasons is why we have a broken system - because there is always a reason why we can’t do something. What I’m saying is there are a lot of good solutions in a lot of the western world in universal healthcare that do work.

I’m going to assume that as someone who works with SEN children you know that most people with ADHD and or Autism don’t claim PIP?

And that you also know of the wider economic costs of not identifying and supporting people with neurodiversity, in terms of depression, addiction and other mental illness, along with a higher likelihood of being involved in criminal activities, spending less time in employment and struggling with relationships?

No and take a minute. Most other universal healthcare systems in the western world do this. They do charge for legitimate misses. I have feeling - I just don’t have the arrogance that the NHS system is the best having experienced other universal healthcare systems: it’s broken: it needs to be fixed and that means thinking differently.

Here’s some:

Quick Google if my experience isn’t enough….

In Canada, while many healthcare services, including most doctor's appointments, are covered by public health insurance, patients may be charged a fee for missed appointments, especially if they don't provide sufficient notice of cancellation. This fee is not covered by provincial health insurance and is intended to offset the cost to the clinic or physician for the missed time.

France will introduce a €5 penalty for people who fail to turn up to doctors' appointments, Prime Minister Gabriel Attal said Saturday, April 6. The fine was one of several measures
announced by Attal to boost a health service struggling to keep up with increasing demands from an aging and growing population.

Yes, in the Netherlands, you may be charged a no-show fee if you miss a doctor's appointment without canceling it in advance, typically within 24 hours or a full working day. This fee is not covered by your health insurance.

In Germany, doctors can charge patients for missed or cancelled appointments, but usually only in exceptional cases and if they can demonstrate financial loss. A common scenario where a fee might be charged is when an appointment is cancelled with less than 24 hours' notice, or if a patient has a pattern of missed appointments.

In Australia, patients may be charged a cancellation fee or a "no-show" fee for missed doctor's appointments, especially if they don't provide sufficient notice of cancellation. The specific fee amount can vary between clinics, but is typically between $50 and $100. If you repeatedly miss appointments or fail to cancel, the clinic may refuse to schedule future appointments.

This simply isn't true though is it? We all know that you can eat healthily and cheaply so I don't know how this figure was calculated. An apple costs the same as a chocolate bar. Lentils, frozen veg etc are all very affordable. You don't need that much meat in a healthy diet. Eggs are relatively affordable. I know it isn't true because I was fed and extremely healthy diet as a child and it would be extremely affordable by now.

I'm not saying it had lots of berries, expensive meat and expensive veggies. A pack of carrots is still pennies as are bananas. It is totally achievable to eat well still on a very limited budget.

The NHS are as bad at cancelling appts at the last minutes.