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?

That’s a shame because my bloke loves it and it’s been a huge support throughout his ongoing cancer treatment.

I agree in principal with the NHS about free healthcare however the system as it stands is completely and utterly inefficient and not fit for purpose.

My 4 year old had a cough for well over a month. We had umpteen appointments with a nurse where we were told it was viral depsite asthma being rampant on both sides of the family. Eventually we get an appointment with the GP who after much consultation with another GP prescribes us a brown inhaler but not a blue one. We get a referral to Paediatrics who can't make any diagnosis but also give us prescription for the blue inhaler. Except for some unfathomable reason, the prescription needs to go to the GP for them to prescribe it wasting even more time. They were also meant to give us a wheeze plan which hasn't been done and to now get a wheeze plan, we now need to see a nurse at the GP surgery.

So four different professional and a ridiculous amount of appointments. Just complete and other beuracacy that wastes time for patients and money and time for the NHS.

Yup. Marked as no show, snotty letter sent to me and my doctor. I replied with call records and emails of the THREE times I had contacted them to cancel and their return call and return emails.

This is a very silly reply.

The discussion is about Advanced Practioners and Physician Associstes doing work they are actually qualified to do and the BMA throwing their toys out of their pram because some of their members jobs are threatened by it. Not about surgeons operating on people.

Oh and by the way the nurse was MALE.

Well “qualified to do” is debatable. Look up Dunning Kruger. And a male nurse is always a nice surprise in the NHS, although they’re usually quickly elevated to management. They were in my time, anyway. We are not going to agree. I think it’s tragic for patients, as well as a practice which is denied by government. We know the truth, though.

11% of nurses in the UK are male.

I have no need to look up what Dunning Kruger is (it's not clever to quote that, btw, though so many people think it is. ), and it bears no relation to the NHS training staff to do a particular job and then using them to do that job, which is what we are talking about.

Like previous posters state we need to move towards the European system not get all hysterical about the American system. My Mum went to the GP numerous times and got knocked back. I ended up in A and E with her for 10 plus hours where she finally got a diagnosis, tumour on the lung and brain.

@taxguru I agree with you, as I often do. But for one statement; the NHS is not free. It is free at the point of delivery. The people have been brainwashed for decades into thinking they receive NHS care "free". They do not. It's too often forgotten that the NHS bureacracy wastes our money, not the State's money. This concept of "free" has fed onto the gratitude line and I don't comprehend why any of us should be grateful for sub optimal NHS standards.

Then be prepared to spend an awful lot more....

• Average day-to-day health spending in the UK between 2010 and 2019 was £3,005 per person – 18% below the EU14 average of £3,655.
• If UK spending per person had matched the EU14 average, then the UK would have spent an average of £227bn a year on health between 2010 and 2019 – £40bn higher than actual average annual spending during this period (£187bn).
• Matching spending per head to France or Germany would have led to an additional £40bn and £73bn (21% to 39% increase respectively) of total health spending each year in the UK.

It's this underfunding that has lead to such poor outcomes.

Now that’s funny.

Please could you quote the evidence based research for what you have stated?

Thanks in advance.

FWIW what isn't costed in the UK is a fugure for wasted patient time. Apppintments where there are 45+ minute delays, cancelled appointments and ops, and the sheer, unrelenting frustration of trying to make contact or to achieve acceptable standards of information.it's an unquantified cost to the patient, beyond tax receipts.

Oh, and what are the figures, comparatively now, seven years after the quote you have provided?

@RosesAndHellebores

https://www.health.org.uk/features-and-opinion/features/how-does-uk-health-spending-compare-across-europe-over-the-past

Health spend in UK did increase greatly during Covid (obviously) before dropping back to historic averages.

Its an easy Google to show that what we spend, per capita, has been and still is lower than the vast majority of Europe.

People say that the NI increases on business have been negative, if we move to an insurance based model, business will have far more costs placed on them.

It needs root and branch reform. So much of it is broken now, despite the money poured into it.

@Alexandra2001 thanks for the link. I'll look in greater detail later.

Businesses are paying a lot presently, as indeed is the state, because people are waiting so long for care they can't work.

If the nhs were to get more money there would have to be a complete reset about spending it well and provision of a service to the people who fund it.

It’s not just about the spend per capita (although that is important ofc - and I assume the figures above exclude any patient co-pay contribution, so the difference may be even more stark).

We need a system that incentivises treating patients rather than them being a cost, which incentivises inaction and delay, with often horrible consequences for patients). Historic funding increases for the NHS have led to bumper pay increases, with no productivity improvements. I’d like to see a choice of providers for the patient, not those commissioning services.

It’s a mess and needs sorting. We need the European mode

@Alexandra2001 also, on the cost to business point, it would cost businesses less if doctors signed off fewer people and for shorter periods. I'd love to know if GP's ever refuse a sick note. Let me give you a few examples:

1990 sub-total thyroidectomy - signed off for 6 weeks. Signed back on after three when I was fine (GP said "these set periods are based on manual work);
2015: badly wedged vertebrae - GP handed me a note for one month. I handed it back and asked for one week and if I felt unable to work I'd ask for an extension.
2024: I had to attend a three day court hearing in a professional capacity. I had a chest infection. Saw GP who prescribed AB's but told me I should not go to work/court of sick - zero cognizance of the fact that some things, if you can get up, get dressed and keep down a cup tea, you can't not attend.

If the above extrapolates across the population, and I am persuaded it does from what I see at work, no wonder we have a benefit culture.

I don't dispute in any way your figures on higher spending by the state. But in countries with partly insurance based systems people presumably aren't paying to go private thats all inluded in the calculation?

So I wonder how those figures stack up if you add in all the money people spend on private health care in the UK to get at your "spend per head" figure? Including the tranches of people with workplace insurance.

And when those people are removed from the headcount (except for A&E of course), what then is the "spend per head" of the NHS ?

That figure really needs to be known before "spend per head" in different countries can be compared.

The best figure i can find is that around 15% of the population are covered by private medical insurance. There will be more who are self funding. The population needs to be reduced by this number before the cost of a large part of the NHS is calculated.

It's this underfunding that has lead to such poor outcomes.

Partly, but it's very hard for people to go through being asked to pay more money into the system when they see the levels of inefficiency and waste when they use the service. Even people within the NHS talk about it. Both need to be addressed.

I have very high hopes of AI in respect to both.

It's also ignoring the amounts people pay for private health insurance, private treatments etc. That's growing in the UK. I don't know about the rest of Europe, but if their residents have a better "national" health service via co-payment, insurance backed, or whatever system is in place, they're probably not going private as much and not paying private as much.

I'd love to see figures comparing the average individual TOTAL healthcare spend in the UK against TOTAL in European countries.

Things like paying for private dental care, private physiotherapy, private MRIs and Xrays, private operations, private consultations, private hearing aids, etc where people in the UK are paying "extra" for things they should be getting on the NHS due to long waiting lists, etc, which those in Europe are getting as part of whatever national health service scheme is in place in their country.

100% @Badbadbunny - I’ve lived in France, Switzerland and the ME albeit not in the last decade. ME was entirely private, so I could choose my provider (and just rock up with my insurance card).

On the continent, there was always a co-pay involved (which was refundable by the mutuelle iirc) but it encouraged the idea that healthcare came at a cost. I do think there is a psychological element in the UK: patients don't pay out of pocket, so we don’t ascribe any value to the service (it’s “free”). Staff don’t charge, so they treat the patients like supplicants who should be grateful.

I may be an unreconstructed capitalist, but I’d prefer to be holding the purse strings, choosing my hcp and understanding exactly what service I can expect, in any exchange involving my health. I don’t know how else we can ensure that a decent standard of care is provided, because it’s currently an absolute lottery and getting worse. Even die-hard NHS supporters must now admit that our standards are way too low relative to those of our European neighbours.

@Vinvertebrate 100%