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Original poster

NHS is finished

146 replies

Tulipsroses · 02/12/2023 07:29

My experience with NHS is patchy. The maternity hospitals were good but some diagnostics I had to do were a nightmare. At one point I found it easier to fly abroad to do a biopsy because NHS would not do it and private clinic would charge a fortune.

I read about NHS horror stories and I can't stop thinking why on earth it's not abolished by now. It is clearly not sustainable. It's a black hole where you damp more money every year and the outcome is predictably worse.

If I was to design a health service I would have diagnostics and general health completely private with set maximum prices and no barrier to competition. I would subsidize medical degrees to make them free and remove the number limits on them so there are more doctors trained.
I would encourage people to have as many early diagnostics as possible.
What's your thoughts?

OP posts:
WhereIsBebèsChambre · 02/12/2023 07:36

So you're wealthy enough to fly abroad for private health care so you're alright paying in your new scenario? I suppose it'll be means tested do the only people who'll be affected and need to pay as ever will be those on paper who are assessed as just beyond threshold of benefits?
So squashed middle fucked over again, but you're alright Jack, and you can smugly pay for your own care, watch some get it for free?

Goatymum · 02/12/2023 07:42

i tend to agree it’s not fit for purpose, but many people would not afford private diagnostics so what happens then in your model?
I think there should be a nominal charge for GP appts - waived if you’re on benefits/disabled/under 18/student. Pharmacists can deal with ‘simple’ ailments - I’ve asked a pharmacist about a couple of things & they either say ‘use this’ or go to GP if it needs further examination.
As for a&e, disaster central. I waited 12 hours (9pm-9am approx) to see a doctor recently sitting in a hard chair in the waiting room ; it was a genuine emergency (ambulance was called but waiting time too long so dh took me in - they suspected a stroke, but it wasn’t). I don’t know what the answer is, but if I had something less worrying/more minor I would’ve walked out. (Quite a few people did).

Sparehair · 02/12/2023 07:45

The problem with increasing the number of medical students is limits to capacity within the clinical system to train them.

if general health ( you mean primary care?) and diagnostics are completely private, how would people who can’t afford to pay access healthcare. Where I live there are a fair few private GPs popping up so that’s already an option for those who can pay.

I agree that the NHS needs reform but personally I think there need to be some tough conversations about old age and how much we should seek to prolong life of people say, over 80, because older people do use the NHS much more and there are increasing numbers of them. There are also often QOL considerations. I’ll obviously be over 80 myself one day so it’s not like I’d escape this rationing but I’d accept it as the price of better healthcare throughout by earlier life.

MichelleScarn · 02/12/2023 07:47

I think there should be a nominal charge for GP appts - waived if you’re on benefits/disabled/under 18/student
So you only pay if you're working? After again being the only people in that group to pay already?

Ikeameatballs · 02/12/2023 07:47

I’m interested by what you mean by encouraging people to have as many early diagnostics as possible. X-rays, CTs etc mean radiation exposure, invasive diagnostics eg endoscopy and colonoscopy carry some, albeit small, risk. How would you manage this so that the risks/benefits were appropriate?

Original poster
Tulipsroses · 02/12/2023 07:48

WhereIsBebèsChambre · 02/12/2023 07:36

So you're wealthy enough to fly abroad for private health care so you're alright paying in your new scenario? I suppose it'll be means tested do the only people who'll be affected and need to pay as ever will be those on paper who are assessed as just beyond threshold of benefits?
So squashed middle fucked over again, but you're alright Jack, and you can smugly pay for your own care, watch some get it for free?

I flew to Vilnius for £60 and stayed in a hotel for another £40. I did a full check up, biopsy, all the blood tests, scans and consultations regarding my issue. All in all it came to around £500 for two days visit.
With NHS this level of service is unimaginable and in private just the biopsy was over £1000.

OP posts:
RunningAndSinging · 02/12/2023 07:51

But what would conversations about old age and how much we should seek to prolong life of people say, over 80 mean practically? No cancer treatment? No antibiotics for chest infections? What about pain relief? No inpatient admissions? Treating broken hips? Take away long term medication on the 80th birthday? It would be totally unethical.

WillowTit · 02/12/2023 07:53

it is marvellous
my dh gets masses of prescriptions - all for free - and he is not even particularly unwell
i also get some medications, i pay £11 a month
think about how much these actually cost,
cradle to grave.
long live nhs

LongTermLurker · 02/12/2023 07:53

I'm in Scotland and find the NHS to be absolutely fine! Same day in person GP appointments, free prescriptions, good NHS dentist.

I've started HRT this year with absolutely no hassle. I've had two health problems in the last two weeks: firstly hip pain that hasn't resolved after many months (have been trying to sort it out with exercises etc). Got a GP same day appointment and they've referred me for a scan which I'll get in the next week or so.

Secondly acute flank pain, which required an out of hours appointment in the early hours of Saturday morning. The clinic was almost deserted (just me and one other). Was given good advice, and painkillers, and will be seeing a GP for further follow up on Monday.

Anyway I do sometimes wonder if there's some agenda with people sharing horror stories about the NHS. I am deeply appreciative of the NHS, and am happy to be paying extra tax in Scotland to help fund it.

Holidayhell22 · 02/12/2023 07:54

I do think sone people take the Mick. If I was in charge I would cut down the number of treatments which are free.
Unpopular opinion but I would also insist patients took steps to help themselves before offering free treatment. Examples include; if you are an alcoholic then you actively look at helping yourself before treatment. You have to sign up to start reducing/stopping your addiction.
If you smoke then you sign up to quit smoking and prove this before you are given free treatment for smoking related diseases.
If you don’t do this fine, but no free treatment.
I’d also make it compulsory that doctor’s surgeries reserve appointments for those who are working and actually paying NI contributions.
So, unlike the idiots who run my surgery and reserve Saturday appointments for jabs for the over 75s, I’d ensure these appointments are fit those who have to work full time. I’d also reserve lunch time appointments for the working population.
Again unlike my surgery who Dave these appointments for the doctor to visit the elderly, who don’t need to be seen then!

IrresponsiblyCertainAboutSexualDimorphism · 02/12/2023 07:59

In your totally privatised price-capped model, how will people pay for their care?

How will this cost less or the same overall than the NHS does currently? Where will the profit come from?

tokesqueen · 02/12/2023 08:00

Goatymum · 02/12/2023 07:42

i tend to agree it’s not fit for purpose, but many people would not afford private diagnostics so what happens then in your model?
I think there should be a nominal charge for GP appts - waived if you’re on benefits/disabled/under 18/student. Pharmacists can deal with ‘simple’ ailments - I’ve asked a pharmacist about a couple of things & they either say ‘use this’ or go to GP if it needs further examination.
As for a&e, disaster central. I waited 12 hours (9pm-9am approx) to see a doctor recently sitting in a hard chair in the waiting room ; it was a genuine emergency (ambulance was called but waiting time too long so dh took me in - they suspected a stroke, but it wasn’t). I don’t know what the answer is, but if I had something less worrying/more minor I would’ve walked out. (Quite a few people did).

What about the over 65's? By far the biggest users of the health service and most often the most financially comfortable. Would they pay?
There's uproar when we ask them to pay for paracetamol.

Swirlyyyy · 02/12/2023 08:02

Sparehair · 02/12/2023 07:45

The problem with increasing the number of medical students is limits to capacity within the clinical system to train them.

if general health ( you mean primary care?) and diagnostics are completely private, how would people who can’t afford to pay access healthcare. Where I live there are a fair few private GPs popping up so that’s already an option for those who can pay.

I agree that the NHS needs reform but personally I think there need to be some tough conversations about old age and how much we should seek to prolong life of people say, over 80, because older people do use the NHS much more and there are increasing numbers of them. There are also often QOL considerations. I’ll obviously be over 80 myself one day so it’s not like I’d escape this rationing but I’d accept it as the price of better healthcare throughout by earlier life.

The over 80s thing is difficult. I've got family members who had expensive treatment/surgery in their 80s who went on to live another 10 good years. I've also had family members kept alive for years with dementia even when they were saying "just let me die". So perhaps what we need are more options around euthanasia / not giving any treatment such as antibiotics etc. This of course would have to be done at a much earlier stage when people still have capacity etc.. I don't know how much money it would save in the long run but it would also give people the chance to make their own decisions.

PictureFrameWindow · 02/12/2023 08:05

One basic reason that it costs more to run each year is our ageing population. Obviously it costs more to treat over 80s vs 20-30 year olds. It's just our government knew this but totally failed to plan.

WrongSwanson · 02/12/2023 08:05

I get amazing care for my condition.

And I am on a group for my condition with lots of people in the US in it and my goodness no I do not want to switch to their system. Even high earners with very good insurance end up totally sunk by it.

My cousin's are wealthy and live in the US and some of them are doctors and they think their private system is terrible.

Let's not go all rose tinted glasses on this.

Wealthy people might think they will be ok but it only takes one suprise diagnosis where the insurance doesn't do what you need it to do and you can be totally sunk.

Beautifulsunflowers · 02/12/2023 08:07

I’ve said this before on similar threads

the community services need to be sorted out before the acute settings can even begin.
theres no flow through hospitals because there are no community beds/carers.
A&E is backed up because of this and because people struggle to get gp appointments. People call ambulances because they don’t know what else to do, where to find help.
yes it’s a mess. Yes it needs a complete overhaul.

where I work there are plenty of doctors and medical students- there are also plenty of management with clipboards. There’s groups of physios and OT’s. It’s HCAS and nurses we struggle with. We’ve recruiters from abroad- relocation packages worth millions - these junior nurses are given 3 mins free accommodation and go in at the top of the pay band creating unrest with the nurses who have trained here and have student debt, who are working their way up the pay scale.

AgnesX · 02/12/2023 08:07

Jesus wept. Yet another thread about how shocking the NHS is. Are you the Daily Mail or a Tory party media team.

booksandbrews · 02/12/2023 08:08

It’s definitely in dire straits. I was told by my GP to pay for a private consultation - I’ve been urgently referred to orthopaedics and the wait is 80 weeks. It’s madness. We can afford a private consultation but probably not further treatment.

olderbutwiser · 02/12/2023 08:09

For the most part, round here the nhs is pretty good. But to me the three challenges are

  • good clinical care but poor management. It’s tough to recruit good non clinical staff into an organisation where there is relatively poor pay and poor status for them
  • focus on quantity of life vs quality, especially for the elderly frail
  • obesity - mincing around the realities, public attitudes and research that’s well behind the curve, not enough tough love
WrongSwanson · 02/12/2023 08:10

Tulipsroses · 02/12/2023 07:48

I flew to Vilnius for £60 and stayed in a hotel for another £40. I did a full check up, biopsy, all the blood tests, scans and consultations regarding my issue. All in all it came to around £500 for two days visit.
With NHS this level of service is unimaginable and in private just the biopsy was over £1000.

Show quote history

Sounds like just what the planet needs, everyone jetting off abroad every time they need a Dr appointment. Great plan!

Badbadbunny · 02/12/2023 08:11

@Goatymum

I think there should be a nominal charge for GP appts - waived if you’re on benefits/disabled/under 18/student.

So just another tax on the squeezed middle then!

Badbadbunny · 02/12/2023 08:13

@Holidayhell22

I’d also make it compulsory that doctor’s surgeries reserve appointments for those who are working and actually paying NI contributions.

Yep, good idea.

PinkflowersWhiteBerries · 02/12/2023 08:13

@LongTermLurker where are you ?? I am in Aberdeenshire and the service is dire. Same day appointment only for emergencies and you have to phone every morning at 8am to try to get on the list. Seriously, who has time to do that ?

Well actually, to that point, my very elderly, now dead MIL, got same day appointments each time she called, home visits, off-plan drugs. Home visits for a cold…when SIL queried what good all this was doing she was told that the Drs must do what they cab to preserve life .

I do think we need to talk about quality of life at all ages, but particularly as we get older. I am in my 60s, and have an advance directive in place ( hopefully they will heed it) so they can switch me off.

WrongSwanson · 02/12/2023 08:14

olderbutwiser · 02/12/2023 08:09

For the most part, round here the nhs is pretty good. But to me the three challenges are

  • good clinical care but poor management. It’s tough to recruit good non clinical staff into an organisation where there is relatively poor pay and poor status for them
  • focus on quantity of life vs quality, especially for the elderly frail
  • obesity - mincing around the realities, public attitudes and research that’s well behind the curve, not enough tough love

why tough love on obesity but sympathy and therapy if you are anorexic? both eating disorders but such different reactions to them?

(I was anorexic for a chunk of my 20s, never understand the different responses to different eating disorders)

MrsMorseEndeavour · 02/12/2023 08:14

I think there need to be some tough conversations about old age and how much we should seek to prolong life of people say, over 80, because older people do use the NHS much more

Rubbish. My DM is 80 and rarely bothers the doctor and is only on blood pressure medication. My 30yo DD is on multiple medications including controlled drugs. So you would let my DM die if she happened to have a blip and something suddenly happened to her but be ok with my DD getting a bag of medication each week for years?