Two tier health in uk today

[MrsHemswoth]

It struck me today just how bad our health system is in the UK - I’m not NHS bashing here (I’m ex long term NHS myself). I’m referring to specifically access to medicines such as injectable weight loss medication and also HRT.

I had a very early menopause - the GP at the time dismissed me initially (in her 10 min appointment) so ended up seeing a neurologist for vertigo/ dizziness then cardiology for palpitations and a 24 hour tape. All fine. I had joints so stiff and painful I was on the cusp of getting referred to a rheumatologist and
I had crippling anxiety and panic attacks so was referred to psychological services- so I had 14 sessions of CBT and a further 6 as it just wasn’t manageable.

Eventually I ended up on antidepressants and stacked on weight from them…. Had lots of other symptoms then eventually begged for HRT at 45 - without much support really. My symptoms improved a little but I still felt dreadful, despite max licensed dose and trying gels, spray then patches (as by now I had to seek support from a private menopause specialist) - eventually after 2 years of tweaking and monitoring and adding in testosterone, most if not all of my symptoms had cleared up!! Phew! But in order to get to this point, I have had to pay as I’m a poor absorber of oestrogen through skin so I need a higher dose. The GP will no longer prescribe this so I have no choice other than pay for it privately.( I already get the testosterone privately.)

Second scenario is that after years of thyroid issues and dietary struggles (and early meno) , I’m going to try Mounjaro - I’m desperate and really need help with this for my long term health. I already eat a healthy diet but just struggle to keep my weight in an acceptable range and am currently pretty overweight.

So my points are:

1. in order for me to be a functioning human being, I need the higher dose of HRT with testosterone that my GP doesn’t prescribe which costs a lot of money plus the private appointments and blood tests.

2. I’m at high risk of obesity related health problems at present so am also having to pay for Mounjaro.

3. I can just about manage to scrape the money together for this at the moment - but many can’t! It feels really wrong!! This feels very two tier not to mention short sighted!!

Also, the amount of NHS time and money wasted on tests and investigations and appointments when all some people need is the correct, personalised HRT / other menopause treatments to improve their symptoms or weight loss meds to support their weight loss journey alongside dietitians etc Surely cheaper than the £££££ spent on heart disease, diabetes treatments etc?

Pleaser excuse the rant!!! It just all feels very wrong…

They think it would cost the nhs 9 billion a year to give people wli op and they don’t have it, so private it is, yes it’s shit for those who can’t afford it, yes the nhs needs overhauling, but we all know this.

That sounds really rough. For the HRT, could it be worth trying a different gp or asking again if they will refer you to gynaecology within the NHS now you’ve got your dose sorted? I am also on a higher dose of oestrogen than normally permitted and my GP wanted reassurance it was ok and so contacted gynaecology who told her to refer me so now I’m under gynaecology with them overseeing the higher dose and the doctor I saw also gave me testosterone (she suggested it when a - different - GP had effectively not wanted to give me it when I’d asked). I think it’s really tough as it can be so variable what you get dependent on your GP. Our GP surgery is amazing and I feel very lucky. I’m just mentioning this in case you might be able to get it through the NHS, especially given the HRT certificate makes a big difference to the cost !

Thanks, that’s really good to know - I may push a bit further!

Nothing to do with menopause or weight loss injections but my DD went through three years of tests (ecg, eeg, blood tests) and different meds etc at one GP/hospital, and I paid myself for a chiropractor, physiotherapist, acupuncture and private MRI. It then took one visit to a different hospital for them to say within 24 hours what they thought it was (MS) and confirmed after tests a few weeks later. So I think there is a huge difference from one GP and hospital to another. The first just couldn’t see the bigger picture or think a teenager could have MS. Thank goodness for the expertise at the second one.

Or things become more obvious over time..

People are willing to pay for GLP1 privately and are doing so in great numbers, so there’s little incentive for the NHS to invest in it so much as they’ll see the benefit anyway. It’s rather like dentistry. We’ve all sort of accepted that the NHS can’t afford to fund this like it used to, and tens of millions of people now go private - either paying out-of-pocket or taking out dental insurance. The effective privatisation of dentistry was been completely accepted, and it’s barely even talked about now.

The average person pays nowhere near enough tax for the healthcare services that they want to consume.

No country on the planet bar Cuba and North Korea operate on a single-payer state model because it always descends into the shit show that we have in the UK.

People need to pay in more for their own healthcare. As they do in European countries, which work a lot better than the UK.

I read somewhere that the weight loss drugs are about to come out of patent and the market will be flooded with cheaper generic versions.

Only semaglutide will be out of patent in 2026.

Tirzepatide has patent protection till 2032 IIRC.

What’s the difference between the two? Is one more effective than the other?

In any case, 2032 is only 6 years away. It’s incredible that the market could open up in just a few years.

Semaglutide is Wegovy
Tirzepatide is Mounjaro

On average, Mounjaro is a bit more effective (21% of weight lost in trials vs 15% for Wegovy) but you still see decent results with Semaglutide.

Once it goes off patent this year it will become cheaper and more accesible (via generics) so you will likely see higher take up privately and NHS-wise.

Go and see your MP to complain if you get no joy

That’s what I do, push, push, push.

In terms of your GP care I do think if people are unhappy, they should just swap practice to see other doctors . I am not yet near perimenopause and menopause, but I know lots of people have had difficulties with HRT etc & their GP. If you google my local area and HRT doctors there is a GP female specialist who does lots of this. As soon as I start having symptoms, I’m going to change GP practice and see her.

If you aren’t happy with your GP, there is such a wide range of opinion that I say just change practice until you get someone who understands you.

My GP was very receptive to HRT and it’s taken a few tweaks but I’m pretty happy with where I am now. However they have been absolutely abysmal with my chronic low ferritin levels with the latest advice being to eat more iron rich foods to improve my current ferritin level of 5.

I’m absolutely knackered and barely functioning. My weight has gone up because I’m too exhausted to do much more than get through my working day and chuck a pizza in the oven for dinner. No hope of exercising as I’m out of breath just walking very slowly.

Fortunately I have private health care via work and was amazed to find they would fund an iron infusion for me. If That hadn’t been available though, I’d have spent the next goodness knows how long getting more and more unwell and probably ending up costing the NHS more money than an iron infusion would have done in the first place. It seems that you have to be practically on your last legs to get any help now.

I think in years to come we will pay for all treatments, we pay for some now , but like the NHS wont exist.

I estimate I’ve had far in excess of £100000 worth of treatment on the NHS in the past year. I wouldn’t be alive without it, and am expecting more expensive treatment this year. I’m grateful for the NHS we have and use my vote to best support the service.

Sucks to pay for HRT or WLIs but I’d rather do that than have to find 100k+ for life saving treatment.

Why can’t you just take an oral iron supplement which are available over the counter? Every time people say their low iron/ high ferritin isn’t being taken seriously by their GP I always wonder why they don’t just do that.

This, this, this. Virtually none of us will ever pay in anywhere near what we take out. Where do we think the money will come from for our ever increasing expectations?!
We simply do have to pay in more either as higher taxes or like the european model of additional contributions for specific services, or accept a much more limited range of services!!

Because I can’t tolerate oral iron @Shrinkhole which is extremely common. My GPs response to this was tough luck. Plus the haematologist I spoke to, said it would take over two years to restore my levels with supplements. I’m not prepared to spend two years with excruciating stomach pain and vomiting in addition to the horrific anaemia symptoms. An infusion will work within a few weeks with no gastric problems.

Also @Iheartmysmart being anemic is dangerous for women. Compromised immune system, heart and lung problems, multi organ failure. Not to add very heavy periods that are a vicious cycle.

Can you ask to be referred to a Menopause clinic? The do exist on the NHS, My GP referred me to one; the appointment was a phone consultation but it made a difference and my HRT was changed.

thanks for your replies and ideas x