The NHS. We need to fight to keep it.

[Differentforgirls]

My Mil is 87. Last year (around September) she was bleeding from her vagina and went to her GP.

The GP referred her to hospital for tests, which she got quickly.

It was cancerous polyps in her womb so she got further tests to ensure they hadn’t spread and was referred for surgery.

Tonight she has been discharged from hospital after numerous tests over the intervening months and a surgery yesterday (keyhole).

She’ll get follow up treatment too.

All NHS, where she has been treated with dignity, respect and kindness.

It might not be what it was due to cuts but it’s still something we should be proud of.

She’ll celebrate her 88th birthday next month, as an OAP in social housing with nothing but her pension, because of the NHS.

AIBU for thinking the NHS is something to be proud of and fight to keep?

The US isn't the only alternative though. Most other developed countries have a hybrid system between the NHS and the US systems, often with insurance backed schemes, which don't penalise the old and ill through higher premiums. We need to stop the obsession that the US system is the only option and we need to explore successful schemes throughout Europe, Canada and Australia. If we don't start to accept the NHS needs radical reform and continue sleep walking that it's like an untouchable national religion, we WILL end up with a US system of private insurance. We all need to wake up and smell the coffee.

Nice to hear you think so much about me. Bit sad though. Maybe you need some time away from mn if you’re targeting complete strangers?

Just a thought.

Take care.

Exactly! Well said. The NHS has been treated as a sacred cow for far too long. It needs to be totally rethought.

No bother. I’ve let mn know 👍

This , I’m afraid .
just paid to see a dermatologist after waiting for six months with no appointment in sight. I’ve been hospitalised and A&E, still can’t get an appt .
I don’t want to pay tax for it anymore. Especially as I’m now effectively paying twice in having to go private . The NHS is not salvageable sadly, it can’t cope with the demands of today’s society.

Anyway, back to the NHS. It’s obvious we all have different experiences of it. Some people have had horrendous ones.

My son now going for blood tests (Monday).

I think reading this thread has made me believe that I’m lucky to live where I live.

I don't think a single person on this thread has suggested we should look to the US model.

As for 'the rest of us can use the NHS', what if the NHS isn't good enough? Which it isn't.

Well, i don't agree the NHS does the bare minimum, not one iota, not my experience or that of my DD and her dept.

We have people languishing in AE or in Corridors for one very simple reason.. Capacity, well, 2 actually...& lack of social care.

Our local hospital opened in 1981, aside from a couple of small extensions, its the same now as it was then, trouble is the population it serves has doubled plus far more older people.

So not only don't we have enough wards, we don't have scanners, theaters, staff.... hell we don't even have a large enough car park for staff and patients, its a disaster zone!

...or perhaps my Gran would have explained it better to you "You can't put a quart into a pint pot"

No amount of insurance schemes or copying other countries, changes the fact we have under invested in healthcare for decades, it will take years and billions more to fix this... if we can even persuade young people to enter healthcare?

In our local hospital, there are at least 2 closed wards. So it's not always a problem of lack of space. When I was in the maternity unit to have our son, it was a three floor building and only two floors were in use. The health centre where I go for bloods is now a huge 3 story monstrosity - it replaced a small GP surgery with just 3 consulting rooms - the top floor remains empty and never used, despite it being 15 years old!

What you’ve written seems pretty inconsistent to me @Alexandra2001 - A&E is a war zone (agreed), not enough resources (agreed), insufficient investment and beds for the needs of the ageing and growing population (also agreed). We don’t exactly need McKinsey to tell us that these conditions inevitably result in organizations doing the bare minimum that they can get away with. Why else are they turfing a confused granny out at 3am? Why is the elderly parents board on here constantly advising not to leave granny’s house keys with her? (I would also add that any private sector organisation which treated people so abusively and with such contempt would be pilloried, but it’s the NHS, so they’re all saints, clap clap etc). 🙄

So we need to spend a fucktonne more money. The tax burden is already insanely high, nobody who works for a living is going to vote for more taxes in a million years. A key difference now is that people increasingly do not want higher taxes even if it all goes to the NHS - we’ve seen the junior doctors coming back like Hungry Hippos after a 23% pay rise, we’ve gawped at the number of diversity coordinators and pointless non-clinical roles, there’s a good chance we’ve needed medical attention on holiday and been pleasantly surprised by how fast, clean, efficient and not-shit it is, and it’s also quite likely the NHS has mistreated (or worse) one of our friends or relatives. You can’t fool all of the people all of the time and the NHS really needs to learn this important PR lesson.

So what’s the solution? I favour a conscious decision to move to a state-backed insurance system, properly regulated, and nothing like the USA. I would and could happily pay for this - as would many others. I am never going to be willing to pay more tax to shore up a corrupt, self-serving wasteful monolith. I do think that everyone should pay something, even a notional contribution, because the narrative that healthcare is “free” when it’s actually insanely costly and worth investing in, both privately and publicly, is what got the UK into its current massive predicament. The change won’t be quick or straightforward or universally popular, but it absolutely needs to be done.

Can I just advise anybody who can afford it to look at Benenden health , we use it where possible before paying to go private as I have multiple diseases which would either not be covered or make an actual private policy ridiculously expensive . We’ve gone via Benenden for a few things now including cardiology for our adult daughter and dermatology for myself and IME you get seen really quickly . In our area it’s at least a 4 month wait for dermatology and I was approved , seen and treated within 3 weeks via Benenden and that 3 weeks included Christmas and NY .

The nhs is broken beyond repair. When i damaged my acl i had to go private to get physio. The nhs physio just kept bleeting about anxiety and she was abbrupt. At my gp surgery i can only get to see a gp face to face for something urgent. If it is not urgent i am lucky to get a phone appointment in 2 weeks time. I never got told if they are phoning in the morning or afternoon. Okay a phone call is all right for something simple like discussing the results of a blood test. However it is crap if something needs to be examined.

Why do you think that could conceivably be? Would it perhaps be underfunding? Over a period of 30 years the number of NHS beds reduced by more than 50%, there are fewer beds per capita than in virtually every comparable health system.

https://www.kingsfund.org.uk/insight-and-analysis/long-reads/nhs-hospital-bed-numbers

It's awful. Here in Wales, it operates just as an emergency service. It's even starting to impact private healthcare, as increasingly people are opting to pay for one-off treatment, which means that private healthcare plans no longer delivers instant access to healthcare providers.

I’m in Scotland and also experienced a wait when I gave in and went privately. Key difference there was that the people I spoke to at the private hospital were apologetic and seemed a little embarrassed about the delay unlike the NHS admin staff who give the impression that they couldn’t care less.

And yes, I took the delays in the private system as a sign that the public system is even more broken than I had realised. There is a limit to how long people are prepared to wait and when waiting times are measured in years rather than months, they are increasingly prepared/forced to pay. And I don’t know but suspect that increasingly these are people like me who don’t have private health plans but have decided to forgo something else, a holiday or other planned spending, to pay for private health care. Or have borrowed the money.

I don't think so.

I just believe that your Govt backed Insurance scheme would be no different than a tax in another name, which you say we cannot afford....

It would also add considerable costs to business, who would also be expected to pay in.

Why involve the private sector who have to make a profit?

There are huge staff shortages in the NHS and its getting worse, to make healthcare more attractive, the very first thing we need to do, requires more pay/cutting student debt, repaying those who have paid back loans....

10s of billions straight away plus would takes years before we would see any improvements.

Your comment "Hungry Hippos" in ref to Resident Doctors shows the issues, want more staff, but wont pay to attract/retain...

A charity set up to help provide dentistry in 3rd world countries, now spends more time working in the UK than it does overseas.....

After 14 years of Austerity, the NHS is in a total mess.

Any service with a single provider (ie a monopoly) is a recipe for poor outcomes and poor patient experience - again, we hardly need McKinsey to work that out. A key advantage of the French/German systems is the availability of choice for patients: elective procedures carried out publicly or privately using the same state-backed insurance. Premiums contributed to by taxpayers on a sliding scale for those of limited means, up to (in Germany at least) a salary level at which you pay it all yourself. The money follows the patient, magically meaning that all the hospitals - even the public ones - want your “custom” and will compete to obtain it, for example by not making you wait in a chair for 2 days before seeing a harried nurse or (as happened local to me last week) leaving you outside the hospital in an ambulance for 5 hours, where you die a preventable death without ever receiving medical attention.

In the context of an obvious crisis it’s surprising to me that you suggest refunding student loans and pay rises as an essential measure. Surely we need to find a way to stop people dying of neglect inside hospitals first? We weren’t struggling to fill medical schools last time I checked - quite the opposite - and doctors are amongst the highest paid professionals even though they are taxpayer funded. They just aren’t rich beyond the dreams of avarice, which unfortunately seems to be what they expect. It’s a travesty that so many doctors are being replaced by AHP’s but it’s also kind of inevitable in the context of spiraling pay demands. Interestingly, DH (consultant, originally from a developing country which still offers better healthcare than the NHS) has no truck whatsoever with the BMA or the ludicrous strikes insofar as they relate to pay. The non-pay points are more reasonable, but lost in all the noise,

i absolutely agree that change will take years, but we need to get on with it. The best indicator of the future for the NHS is its past performance, which is now absolutely fucking dire, and - taking into account budgets, demographics and medical advances - will almost certainly never improve.

Yes. It’s so depressing the contrast in how you’re spoken to and treated in the private sector. There’s an attempt at least at basic. courtesy. Weird since it’s at least in part the same staff!!

I see that @Vinvertebrate has answered my point above. If the paying patient has choice then they’ll exercise it where they are best treated.

The NHS is technically a monopsony rather than a monopoly. The advantage of this structure is that it has extraordinary buying power and is often able to negotiate a lower price for expensive drugs. More controversially, it's also able to keep staff costs relatively low by restricting salary increases and determining staff working conditions.

Yes you’re correct @EstoyRobandoSuCasa - I had forgotten that distinction, although it’s perhaps not how it works out in practice, particularly from a procurement pov. Drugs might be the exception.

One of the reasons why some other countries manage to pay doctors more is because the market, rather than a state body, determines the remuneration of an individual doctor. When you’re at the coal face, I imagine there is a perception that it’s only serving to keep working conditions and salaries low. NHS staff do benefit from collective bargaining though e.g. as a government employer, legislation around equal pay and working time is taken seriously. In law, I’ve never worked anywhere that I haven’t had to waive all the waive-able rights on day 1. You are also unlikely to be dismissed, receive generous sick pay and a pension which (still) knocks anything in the private sector into a cocked hat. Women wanting to work PT or flexibly are also accommodated whereas in many professional sectors (including mine) they are discouraged, to put it mildly. Pay for hcp’s is decent, not stellar, but it’s still only a small part of the big picture. I suspect that women, in particular, would be better served as employees under the current system, despite the current levels of dissatisfaction being expressed.

@Alexandra2001

After 14 years of Austerity, the NHS is in a total mess.

It was a total mess back in 2010 after 13 years of Labour too which was my experience. Killed two of our close relatives in 2008 and 2010 due gross medical negligence caused by doctors who hadn't a clue and being passed between hospitals to "reset" urgent waiting list times for cancer operations so they could hit their targets.

No doubt that austerity hasn't helped, but let's not pretend it was anywhere near perfect 15 years ago!!

Yes indeed. It's the NHS staff attitude of "you're not paying so we can treat you like shit".