NHS is finished

[Tulipsroses]

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?

Your argument is fundamentally flawed, being based on the oft repeated tory mantra that it's a money pit with no bottom.

We spend a smaller proportion of our gdp per head of population than virtually every comparable economy, that we are throwing money at it is a lie perpetrated by the 1% who have been systematically sucking the economy dry and want to hold on to their vast wealth.

Tax wealth, narrow the wage gap, fund public services properly.

Maybe think a bit more about the scale of what any health service represents before using your thread title.

I hope the results of your tests were helpful.

I agree there are lots of frustrations and bottlenecks in the NHS. My view is that there are problems in every health system and it is hard to change things without having knock on effects. Add a charge to GP visits and you're going to add a huge volume to 111, 999 and A&E. Do you want to make 111 a premium number? Who's going to administer the charge and pay those staff?

None if this is to say that I think everything in the NHS is fine. It's not. And nor do I think we should be 'thankful' for it like a charity. We should have high expectations of our health service.

Nice to see tory party HQ busy on a Saturday morning

absolutely!

if you can afford it @Tulipsroses
you go private, leave it for us who cannot

Quite. there are chat boards all over the US stuffed with people in dire circumstances because of the private system (often wealthy "Mumsnet approved" professional types).

These OPs are so imbalanced because they seem to assume the alternative is some perfect wonderful system where everyone gets amazing care (or at least, I actually suspect,.where they think they would get amazing care and thats all that matters to them)

My cousin's are wealthy high earners in the US and even the ones without children are constantly stressing about various medical costs

All my family are in Scotland, and while they don’t have quite as rosy an experience as you, it’s certainly nothing like the situation that seems to be common in busier parts of England now.

so what would it cost in tax to provide the Scottish level of service across the whole of the UK? It would mean a massive expansion of healthcare facilities and the staff to work in them for sure, given the different population densities.

It's not rubbish. Statistically they do.

I’m not sure what the answer is but I was surprised the other day when chatting to my most left-wing friends who also happen to be NHS workers and they said similar. Sad times but something needs to be done I guess because I was quite horrified listening to their experiences.

In your model, what happens if you don’t have the funds to pay?

My DH is just coming out of a couple of years of cancer treatment.
The 14 hour op and 2 weeks in hospital, the radio and chemo therapy, the physiotherapist, the MRI and CT scans, the speech therapy, the dietician and nutritionist, the psychiatrist, the ENT team, the hearing aids he's been given, the meds he's been on for pain relief and other things, and the specialist diet he now has to follow - all that has been free.
The cost to the NHS must have been at least £1m.
I think the NHS has been fab. The consultant or his team have responded to requests for support 24/7 when we've needed them and we couldn't have got better treatment if we'd gone privately.

And yet I have lots of traditionally Tory voting family members who work in the NHS and still have lots of non* horrifying (indeed very positive ) stories to tell and still think it is a great model that needs tweaking.

*They would never vote for the current shit show however

It hasn't been abolished because it is brilliant.

I was diagnosed with bc under routine screening, recalled within 2 days, saw my surgeon within 19 days and out of surgery in another 23 days. Chemo & radio were complete within 6 months. During Covid. Free.

I managed to work throughout, although probably not to my normal standard.

But I don't moan about noisy maternity care, I don't go to the gp every five minutes for things I can sort myself. I take the trouble to eat healthily, limit alcohol & sugar, don't smoke or do drugs, I exercise four times a week. I always attend appts, I always go for routine screening no matter how uncomfortable. I ensure my ds does the same.

My expectation is that the NHS is for essentials only and I treat it with respect.

During Covid, the A&E departments were quiet because there were no drunks and no brawlers. Perhaps if people showed a modicum of common sense, we wouldn't have the problems we have.

You say it’s a bottomless pit but when you look what we spend per head against other nations, we are 17th. Most other developed nations spend at least a thousand more and if we move away to an American model they spend $7000 more per head and they are shockingly bad at treating the poor.

serial underfunding by a Tory government that wants to bring in an insurance model because large corporations pay big political donations to governments that make them lots of money.

There's a failure at every level to fund public services in the name of austerity. We don’t train enough doctors because we don’t have the spaces in hospitals to give those doctors Jobs and the doctors we do train have to work in awful conditions for low pay so they bugger off to Canada, Australia and New Zealand. We are then short of doctors and the Troy solution was to spend less time training them so no one else would want to employ them.

If you want to see what medical care was like pre nhs read the citadel by AJ Cronin.

The nhs faces a long fight to get back to where it was prior to the Tory government’s attempt to crash it but it can improve, throw open the university doors to anyone sufficiently qualified to get through training. Bring spending per head to the international median and tell the insurance companies that political donations are banned.

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

Many countries do have a fee, some small. But I’d be interested in how many would pay given the size of pension age.

Plus I’m not sure anyone would vote for it

I don’t mind the NHS, I know it’s patchy but we’ve had really good service actually (and don’t bother with private generally even though work pays), but I do think the projections are eye watering and that needs to be talked about realistically.

The complex care needs of the elderly are very high, and in some ways testament to the success of healthcare

That's a dreadful idea. Have a think about how that might work.

@PinkflowersWhiteBerries I'm in Midlothian. And yes I do phone at 8am for a same day appointment (they're not called/intended as emergency appointments in my surgery). Although I think there's some leeway... Pretty sure I've phoned later in the morning and still managed to get a same day appt. And if they don't have a same day appointment (and the problem isn't urgent) I can get an appointment within a week or so.

Here's a sample from a US chat board (shared with permission and with lots of redactions)

"I was diagnosed by an {specialist} in June , and had various testing done. Referred to a {specialist} affiliated with with {other specialist } billed together.

Got a big bill, my insurance said out of network. Then they said in network, they would re-bill.

Got a call yesterday afternoon from the insurance company, they are both out of network !!

I can't afford the {urgent essential surgery}

Our medical system is screwy!"

@MrsMorseEndeavour "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"

Firstly, it's not your conversation to have. Doctors take a Hypocratic oath that requires them to treat everyone equally, to save life where possible. Do you imagine they will calmly sit by and watch a patient they have known for 20 years die, because they've just clocked up their 80th birthday. Of course not !

And do you mean all those 80yos who staff the local food bank, the charity shops, the ones who organise much of village life? My dm was still working in a charity shop at 86. Still knitting prem baby clothes for the local unit.

To be honest, you sound foolish & entitled.

It’s always very all-or-nothing in these discussions. Either the totally free at point of care NHS or massively expensive US style healthcare. Many countries, including many in Europe, have somewhere between the two.

We are in France. If we want to go private, we are still reimbursed by the government for most of the costs. and the costs of private care are so much lower compared to the UK - because there is some competition and government reimbursement. The public healthcare system is struggling here too, for similar reasons as in the UK, but I personally haven’t experienced any of that.

Well in this utopia pensioners (who may be well off) and people on benefits will get it free.
The people paying NI and fund the NHS will just have to get a second job or more shifts I'd assume.
But to think that's not #bekind to point out apparently, to all the 'I'd happily pay 10 times over for everything, Increase my taxes!' crew. Surprisingly they never take up the advice from others you can already pay more tax if you want!

Doctors don't take any oaths. However, it is true that no doctor is allowed in this country to give a treatment that is intended to cause death, and they can be struck off if they do.

It is up to us to make clear our wishes to refuse types of treatment past a certain age, if we want to do that. I've done it- there's a detailed Advanced Refusal of Treatment in my GP notes. It's in fact based on my son's age, not mine.

People who need appointments would get them? Or do you think people in work shouldn't get appointments?

(I know it's an automated message)

Referred for something in February last year and still waiting. Had a text recently asking if I still want to be seen or could I go private? No idea how long the wait will be.

Don't be silly. In your model people who dont work, who are most likely to have poor health wouldn't get them. This would be divisive and cost the NHS mote in the long term. Treatment has to be allocated on medical need not anything else.

I agree, the NHS is a black hole for our tax. It spends far too much time playing politics with the whole trans issue and others. It is currently recruiting well paid diversity consultants instead of medical staff.

No other country in the world has gone for free at the point of use, they offer far better service linked to insurance, France, Germany etc. it will have to change, even Sir Starmer has admitted that.