What’s the point in the NHS?

[younknow]

I fell over at work today. My ankle was immediately black and blue and swollen, so I hobbled off to urgent care in a taxi.

I waited for four hours, I was x-rayed and told there were no breaks and a severe sprain. The doctor told me I’ve likely torn ligaments in my ankle and will be sore for three months.

I asked what sort of follow up would be given and she all but laughed at me, saying that I could get myself a support on Amazon if I wanted. I said I couldn’t even weight bear and she said I could also pick up crutches if needed. She then said I could refer to physio but “ChatGPT would give me a plan”. I asked if I’d be scanned to find out how badly damaged it is and she said there was no chance.

What is the point? Genuinely, what are we paying for when even things like this are being directed to Amazon and A.I?! I can’t believe it.

I remember 15 years ago my mum tore ligaments in her ankle and she was scanned the same day it happened, put in a boot and on crutches for six weeks, had a course of physio and consultations with an orthopaedic surgeon to discuss a plan if it didn’t improve.

What’s going on?!

My friend did the same recently, severe sprain, torn ligaments and tendons, came home with boot for 6 weeks, 2 weeks with foot elevated, crutches & told physio would be in touch which they have, she was waiting 8 hours in a & e as they were at full capacity but can't fault the treatment.

The thing with how insurance works is that you don't pay for everything up front

Why look at US charges, we're in Europe

Google how much this would be if you had a private consultation! You’ve damaged some ligaments they heal in their own. Stop being dramatic or get private insurance.

If pain is caused by an infection, of course antibiotics will reduce the pain.

Really? Because it’s a good comparison of costs if you had to pay for them! The UK is free at the point of delivery!

OTOH, DH had his second stent in another blocked coronary artery seven years ago. The consultant who did it, commented that his first one was a short stent and it should have been a long one. He said

”We’ll have to keep an eye on that, as it could get blocked either end, and keep aggressively on top of your cholesterol!”

Have they? No! He went to his GPs a year ago, as his cholesterol was still high, despite being on the maximum dose of statins. They referred him to the Lipid clinic, as he needs another drug. The appointment is this November.

We both get the distinct impression that our local hospital (whose A & E has missed 4 fractures in 2 relatives), doesn’t bother with people over 65?

@BurntBroccoli You've quoted dollars. Those figures are wrong anyway. Most private initial appointments are at least £200 with a consultant and more like £250-£300, for up to an hour.

But that is not how insurance works. It's like house or car insurance- you pay your annual premium and it covers you for XYZ, if approved.

You pay an annual premium depending on your age and medical history- it can start at around £35 ish a month for some basic policies.

That covers any out patient appts up to a certain amount, and any treatment/ surgery if approved. The invoices are sent to the medical provider, or yourself to forward to them.

The NHS is actually supposed to be more for emergencies/serious conditions and it has just grown. When we have such an economic issue in the UK, actually your treatment was appropriate. They properly assessed you in a reasonable time given the lack of emergency. They ruled out something more serious. The only thing you can really do with your issue is to rest and take painkillers. Paracetamol is very very cheap to buy but costs the NHS more. I very much doubt a doctor told you to use chat gpt - sorry but that is very unbelievable and if they did you should flag that with pals. Otherwise I'm not really sure what else you reasonably expect. They told you how you can get crutches even. If you want anything more above and beyond the necessary, pay for it.

You come on here criticising the NHS but then what's the alternative? You want everyone to end up paying for private insurance which will cost you more and also mean poor people struggle to receive sufficient care? You want to pay more tax for the NHS and have less money yourself a month? You can voluntarily donate to the NHS if you want.

Of course it isn't a good comparison of costs. What a strange thing to say. Why not look at health systems that aren't thousands of miles away?

Unless you’re critically ill I really don’t think there is much point to the NHS anymore.

It’s brilliant in providing life saving treatment but useless at early diagnosis of cancer and particularly useless with anything minor like sprains and fractures.

Anyone else wondering if op is looking to make drama out of her injury as a precursor to sick leave and/or a claim?

Most cancers don't have lifestyle related causes.

My DH has an incurable cancer with no known lifestyle related causes - he was fit and healthy, never overweight, never smoked nor drank, played numerous sports, etc., before he was diagnosed (took nearly 2 years to get diagnosed due to useless GP's constantly fobbing him off).

My MIL died after waiting 48 hours on a trolley in A&E after being blue lighted in with double pneumonia, after a month of GP appointments who failed to notice, culminating in a GP appointment the day before she collapsed where the GP told us her lungs were clear!

My father, only in his 60s died of cancer after literally spending months in hospital, being moved from ward to ward and over 3 different hospitals, waiting for scans, x-rays, and finally waiting months for an operation to remove a tumour, all over which time, he received no treatment, no chemo, but just abandoned on hospital beds whilst the succession of different doctors came to see him, ordered yet another test (often duplicates) never to be seen again, with the next doctor starting from scratch again. He, likewise was fit and healthy, never smoked, healthy weight, etc.

The NHS attitude of "victim blaming" needs to stop. It's not always the patient's fault, yet it seems to have become the ideal "cop out" for the NHS inefficiency and incompetence.

You ask what is the alternative. How about any of the European national health systems, or Canada, or Australia? The USA isn't the only alternative, yet it's the worse alternative which is why people are so keen to compare to it. The thing is we WILL end up with a USA style system if the NHS isn't reformed.

I’m talking in general, so not just for sprained ankles but also cancer treatment etc. It feels as though one person gets one level of care/treatment and the next has a totally different experience. Depending on the day or where you live. Just down to luck almost

saved my sons life many times when he’s been unable to breathe due to complications with asthma, he’s seen immediately, not allowed to leave until he’s 100% ok. Not to mention my c section care, which was a 3 night stay with round the clock care.
honestly, you’re fortunate all you’ve ever needed the nhs for is a sprain 🤣

Given that the rearrangement of deckchairs in the Lansley reorganisation cost the thick end of £2 billion with no discernible improvement, a complete restructure of the funding model would be extortionately expensive and take about a decade. I’d rather the time and money was spent on improving patient care than changing something that’s not perfect with no clarity that its replacement would be any better. Sometimes perfect is the enemy of good.

Most people would settle for "good", but we're not even close to that across the board. Some basic coherent and consistent competence and organisation would be "good".

Yes it would and is in many places. And changing the funding model would have no impact on that. I very much doubt that any healthcare system is consistent.

I have very mixed feelings about the NHS and I worked in it for a total of 14 years. Some of the care has been absolutely exceptional, highly effective treatment delivered by skilled and compassionate staff and some of it so appalling that I ended up having to have therapy for the PTSD it caused me. i have had some health problems recently after 7 years of not needing to see a doctor and I have noticed how bad it is now, I'd heard stories from friends and thought "surely not, it can't be that bad" but sadly they were correct. My lovely GP who really knew me and my history has retired, face to face appointments are very hard to get, and yes i agree that a phone call will often be sufficient but with my recent issues I have only seen one of the staff involved face to face and that is after almost a year. I get texts, have had three phone calls all from different people and I can't even recall their names. As much as possible is done online, my internet crashed last week when i needed to renew my prescription, They would not do it over the phone! It's the app, practice website or nothing, heaven only knows how some people cope. It's a combination of huge demand, cuts, when i worked in mental health we had massive cuts, for example our team of OTs were cut from 8 to 2. Imagine the impact of that on a busy psychiatric hospital. The purpose built art room was shut down and turned into an office, community "step down" accommodation for patients well enough to leave hospital but not ready to live independently were closed and sold off. The third sector picked up the pieces. I can only see it getting worse but private health care is not the way forward .Private providers would not touch complex mental health needs, it's not like hip and knee replacements and I think this would equally apply for chronic physical health problems

One change that would cost absolutely no money but would improve patient experience immeasurably is if all staff actually listened to the patients.

Some staff are excellent, but some still are appalling.

They don’t have money so doing the bare minimum.

15 years ago, they were in a better position than now.

Your missed appointment charge is cheap, where I live in Scotland it's £125.00

But the European style ones that are often held up as perfect alternatives also have issues. They cost more per capita than the NHS does. If we were prepared to pay more per capita (ie more tax) we could have a better service. Alternatively we could pay more per capita via insurance premiums but it works out the same (probably more expensive).

Some of the European countries listed would provide less care than the OP received, some would probably medicalise it a bit more. It's partly dependent on cultural attitudes towards pain/sickness. But whilst there are some genuine horror stories about the NHS which I think does shame us as a country, it's quite likely the treatment given to the OP was about right.

My GP surgery is brilliant and you can easily be seen. The one round the corner is larger and it is very hard to get a face to face appointment and you never see the same person twice.

My surgery is run by GPS as traditional. The one round the corner is run by private equity. People don't understand the involvement of private equity and how it is ruining go services. This is not an NHS issue.