NHS now saying stuff is free.

[MixMaxChop]

Dear Mrs Chop

Welcome to NHS breast screening. We would like to invite you for your free mammograms. We have made you an appointment in a hospital that is not local to you in the arse end of a city that does not have any access from the railway station and parking is strictly limited and none of your previous mammograms have ever been in this city before but that’s not the point.

Free??

A) it isn’t free. My NHS contributions have paid for this many times over.

B) Surely “free” is the whole point of the NHS

C) are they craftily prepping us to have to start paying for services now in a stealth move to privatise the NHS?

Why are you or others cringing? A very highly paid individual, a clinician at directorate level, signed a letter claiming an NHS service was free. It is not. The NHS is funded by the people for the people and to misrepresent that is heinous in my opinion and serves only the gratitude narrative and that narrative feeds into the provision of sub-optimal services. It is a narrative that has provided Donna Ockenden with a very heavy workload.

Breast screening is an agreed preventative initiative and it is provided under the NHS contract as a service for which the public have paid, via taxation. It is not provided as a favour.

I agree with you it isn’t free but maybe they are trying to ensure everyone attends and it’s removing a perceived barrier that some people might think they need to pay?
On another note I live in a difference country and as a resident also receive ‘free’ healthcare as do my husband and children. My son needed surgery at 2 months old and when we left the hospital we had to pay a minor fee for the surgery and 2 nights stay in hospital (£57 in total)
When we left we received an itemised bill for every single thing he received (each medication, treatment, blood transfusion, 1 x night in NICU, 1 x night in standard room, etc) and these showed the exact price (going into the thousands for the total) and the cost to us - 0
if the NHS did this for every treatment and appointment I can’t help but think more people might think twice about wasting NHS time or turning up to a&e for a stubbed toe or cough!

i don’t think you should read too much into free mammograms, but I was shocked to have an nhs hospital consultant say I needed certain meds and wrote a request to my gp and the gp surgery refused the medication but said I could pay £300 per month for it. I now have had a wasted consultant appointment, no meds, I’m in pain and don’t know what to do.

Deoends on how you read and interperet this letter. Not very well written For the NHS to point out that thusctest s free sounds confusing snd a bit patronising tbh.

I think it may also send the opposite message to some people.That the test may be free but you have to oay for the treatment.

NHS also has many small private medical services providing tests etc
They work on a conveyor belt paid by patient numbers basis

Some are not that profesional.in my exoerience. It is the sorr of letter l would expect from one of them.

The problem is that if the UK started charging for thus type of NHS services, it would likely still not help the public purse because we'd manage to turn it into an extremely complex means tested system that cost more to administer than it raised.

We'd also likely fail to accurately determine who can and cannot pay so you'd have people with disposable income not paying and people having to pay but struggling to afford even relatively modest fees, and we'd also probably do it using an IT system that doesn't work properly despite us paying a private sector contractor billions to set it up and maintain.

Threads like these always make me wonder if there are any countries that do manage to run public services that work efficiently, not overly bureaucratic etc for service users, its employees and taxpayers? Basically is there a 'right' way to do it and is anybody actually doing it that way?

Wow you actually got a letter? I got a text reminder for mine. Thankfully I was available and it was within walking distance.

Results came in 2 weeks.

Maybe because they are using some private hospitals to help with waiting lists, some people are getting confused. Last year my mum was sent by the NHS to a Spire hospital as they could see her quicker.

For starters, have you contacted the Consultant's office? The Consultant might have some leverage with your GP or be able to suggest an alternative.

I do, however, sympathise and had a similar experience. My Rheumatologist recommended a drug for my osteoporosis after five rounds of the first line infusion and a couple more broken bones, yet whilst my dexa score warranted it, I didn't meet the threshold, according to Nice guidance, at that time due to my age. Fortunately I was able to pay the £2400 per annum for two years and it was effective.

Do you think there's a person in the whole country who doesn't know that the NHS is paid for from tax and borrowing and that "free" therefore can only mean "free at point of use" ?

I think that's irrelevant. The use of the word "free" is disingenuous. It is not free and should not be portrayed as free.

You sound more pompous with each post. The public have paid a small contribution in most cases towards their treatment, the majority will have paid in nothing like the amount they get back.

Frankly that's pathetic pedantry and anyone writing letters about it taking up NHS time to open, read and discard are even more pathetic.

Everybody, literally everybody, knows that taxes pay for the NHS, they don't think it's funded by some benevolent quadrillionaire somewhere.

I haven't seen the reply to my question but I expect the service has been contracted to a private scanning centre and it was important to let people know there wouldn't be any charge.

And I expect making clear that a mammogram is free at the time increases the takeup wherever it's done, especially given how many people we have living in the country who are used to being asked to pay for medical services.

YABVU

Just proves you can't please everyone

Lots of other countries have better public services. Lots of European countries have far better healthcare at low/no cost because they have state backed insurance/copay systems. We could learn a lot from them. Likewise things like local council services, utilities,waste etc are far cheaper and better in some European countries. Also Canada and Australia have good systems. We need to stop thinking of a binary choice between the nhs or USA - most countries have systems between the two extremes often working far better.

We will never know how true that is unless there's more transparency about the cost of NHS care received.

There was a time when HMRC provided broken down tax statements setting out broadly the proportion of one's individual tax that contributed to: Defence, NHS, Welfare, etc. Around 2014/15 I think. Then ot stopped. It was helpful.

I suspect that people who always were able to afford healthcare prior to 1947, pay significantly more proportionately nowadays because they are subsidising everyone. And that's fine and as it should be but nobody should ever be made to feel grateful because the NHS likes to convey it is providing a free service.

How many times have posters on here laid into new mothers expressing upset over rude midwives, poorly managed labours sometimes with injury arising, and despicable post natal care, because they should be grateful for free midwifery services and having delivered a live baby and to have survived the ordeal.

@Imdunfer I meant to add that the letter I received was from the NHS and the mammogram was delivered at one of the hospitals in my NHS Trust. It was delivered extremely professionally, confidentially and with absolute dignity - far better than experiences in mobile units. I also gave a five star review to make that clear.

Sadly, I think in the UK we have ended up with the NHS we deserve because for generations people have put up with poor standards because they feel grateful or feel they need to be because the NHS is sold as "free".

I received an email a couple of days ago (I suspect a lot of people also received it), offering me an "immediate", "no waiting list" MRI scan, the fact that it was a private medical service you had to pay for was right at the bottom. Surely the first line should have read "if you've got a spare £500 we can give you a scan that you almost certainly don't need, it will really help us out because the CEO's bonus isn't looking to good at the moment".

Maybe they've found some people think they have to pay, and it's a barrier to use? It is free though, free at the point of use - you would get it even if you're not a taxpayer.

Nail on the head. It's a national religion that people aren't allowed to criticise however crap they/their loved ones are treated.

Reform aren't in yet. Then it will be fully privatised and a quarter of your wages will go on health insurance like in the USA.

“literally everybody” knows the NHS is paid for by their taxes but simultaneously women are so stupid they need to have the word “free” added to the unrequested mammogram appointment?
The same women who will also be criticised as time wasters if they don’t turn up at that unrequested appointment rather than being sent an invite with a link to make their own appointment?

That use of the word “free” does matter because it underpins the whole culture of “you must be grateful” for even shockingly bad care. That is bad for the NHS - if you want to retain it you should be encouraging patients to be willing to feedback on poor treatment and poor service, not promoting “its free, accept what you get and be grateful”. Women in particular have been very poorly served by the gratitude culture. Our maternity services are shocking in the UK.

This thread on what by any standards is a piss poor way to serve patients has endless posts telling the OP and other women that they should be “grateful” that her dignity and comfort is just too much hassle for the “free” NHS to trouble itself with:

https://www.mumsnet.com/talk/womenshealth/5503592-aibu-to-expect-a-gown-and-privacy-during-an-early-mammogram?

This wasn’t an unusual thread - it was the default response when anyone posts about a bad NHS experience. How can a service improve when such low expectations are set?

You are self important. Do you really want your taxes to pay for someone to answer your petty letter. I don't. I'd rather use the money for extra nurses.

You are the reason we will lose the NHS.

I want my taxes to deliver optimal services, affording every individual the dignity they deserve. I also expect a huge organosation such as the NHS to ensure that all communications are both correct and transparent. Which bit of the NHS not being a free service don't you understand.

Dear Lord!

PP is single-handedly causing the NHS to collapse with her letter?

The art of letter writing is clearly not lost!

You are making an almighty fuss about absolutely nothing. The time to complain is when the service is poor, not when a perfectly clear and polite communication is sent out in a timely fashion.