Why doesn't anyone have a proper plan for the NHS?

[letyouberight]

I say this as someone who works within the NHS as a registered professional. At work, it's total shit. We are so overwhelmed and stretched all the time, morale is in its boots, quality of service is naff and it's all just inefficient.

As a patient, I have recently been having an absolute nightmare trying to have a fairly minor procedure done which would actually relieve me of significant pain, reduce my time off work due to the issue and is literally a day-case procedure if that. I have seen 2 GPs who haven't listened so I have had to go back 3/4 times for the same problem. Then been told to see a specialist service whose waiting list is long.
I priced up going private and was told £2600, money I do not have.

I get it from the individual professionals' POV, as I also am medically trained and while I can see some aspects of care are individuals' faults, most of the problem is systemic.

Seriously, what are any of them proposing to do about it?! Reform, reform, reform- YES but HOW?!

Apologies if this is a bit ranty but I am honestly at breaking point with my work stress and health issues- both of which stem from the NHS.

Teresa May came up with insurance….

Because it needs root and branch reform, which would need cross party co-operation. And they don’t do that.🙄

Cos that would involve having to have some policies that are unpopular before a general election.

I do think we have to move to something like Germany where I understand people who are better off pay something towards it.

The NHS was founded at a time, which thankfully we have moved on from, when old people in poor health didn't live long, seriously disabled people didn't live for a long time or survive early birth etc. It's great that's no longer the case, but a free system is going to have difficulty managing the long term care or so many more people. Also, when it was founded it was more likely there was someone (let's face it, a woman) available at home to look after people as they recovered - a wife, mum, sister, maybe even a neighbour, who didn't do paid work outside the home and could help out. And that's just not the case anymore and because we can't afford for everyone to have time for everyone to fully recover with someone looking after them, that also creates costs and challenges for the NHS.

We have to accept that if we have an ageing society, we cannot keep up the NHS without those who could afford it (me being one of them) paying extra towards it.

I think nursing and medical degrees need to be subsidised heavily or outright free so that people will feel able to choose to take them if they want to. I'm sure the time and expense must rule them out for people who would otherwise do it.

We need a minimum fee for GP appointments £10 at the very least and everyone pays it. It needs reform and someone has to have the political gumption to do something about it…

Yeah but it’s worse to ignore the elephant in the room. The public want to know there is a plan in place…

Theresa May tried that about social care.

It didn't work

The one thing that this government has done, and isn't talking about, is set up a plan to massively increase training over the next 8 years, taking advantage of the relatively large age cohort about to enter uni.

It makes obvious sense, the restrictions on medical school places were always unnecessarily strict, but it will have problems (are there even enough teachers/trainers?), it'll cost a lot, and 8 years is a long time.
https://www.health.org.uk/publications/long-reads/how-feasible-are-the-nhs-long-term-workforce-plan-commitments-on-training

You would have to put the same charge for A&E. I could, kind of, agree, except, we have a really significant amount of people, including children, living in absolute poverty in the UK. Plenty of people just can't afford £10.

Also, if its not an 'everyone pays' thing, the majority of people children/elderly/benefits using the health service wouldn't pay anyway. This would add a layer of expensive bureaucracy and might lead to resentment in that the people paying for the service (through taxes) are the only people would don't get to access it for free.
I kind of agree with a small £10 max charge per use, but British people are just too poor to be able to afford even that.

Yes, the dementia tax - what the media called the prepayment for future ederly care that T May suggested. And then lost a load of gov seats in the election.

But how thick can people be - do all us oldies reaaaalllly think oh, it won't happen to me. I know of several young people ie in their 50s and 60s with dementia, and/or Parkinsons.
I suggest a scare tactic - lots of information leaflets showing the lives of people with dementia in care homes - I don't mean bad homes where they are not cared for but just people in care homes with severe dementia - that's scary enough. Then some statistics as to how many people will get it - eg the stats show that by the time they are 78 X number of people in your street could have dementia.
Lots of information on how much it costs per week for care home fees - spell it out.
Lots of information on the sale of your home, once you are gone, being used to fund your spouses care.

I can only think people are in total denial or ignorant.

This is true.
It seems to me that in quite a short space of time we've gone from a general attitude of:
"anyone who won't care for their elderly parents is selfish and wrong, they cared for you when you were a baby and so it's normal and right that you care for them when they are elderly and infirm"
To:
"Caring for the elderly and infirm is a huge and onerous task which should only be able to taken by professionals"
The plain truth is that not many people are willing to do this work and even fewer are willing to do it for the money that is on offer.

If people live in poverty they have a medical card or pay £100 per year, taken at source from their income or benefits.
The situation can’t continue and if we want a better health system everyone needs to contribute. It benefits everyone, therefore everyone must pay.

@Kendodd , there are people living a threadbare existence in the UK and far too many, but poverty is defined as less than two-thirds of the average. I am certain that living in that zone is grim but there are a lot of worse places to be impoverished, and many of them don't have a welfare state or an NHS to pick up the pieces either.

@0sm0nthus I think that’s a bit unfair. Thousands if not millions of people help elderly relatives stay in their homes but dementia is entirely different. We have a diminished workforce due to caring duties. When the elderly are extremely frail, they simply cannot cop at home. They fall and life is on the edge of a cliff.

Other Families need to work and if someone needs 24 hour care it’s impossible to do that amount of care in the home. What if you don’t live close by? If people are retired and are happy with caring duties in retirement, so be it. I’ve certainly known this. Others need greater fulfilment or they get ill too.

@TizerorFizz
I'm sorry I must have not expressed myself very well in my post.
I completely agree with you that in many if not most cases it's not feasible to care for elderly parents it's a full-time job and you already have a full-time job as well as various other commitments!
Not to mention being in your 60s or older yourself and just not up to it.
We don't have any solutions to the change in age profile of the population.

@0sm0nthus Thats ok! I think the only way out is insurance as proposed by Teresa May. She introduced it at election time which was a huge mistake. She considered the Dilnot Report and projections for dementia deaths and came to the conclusion we need a different approach. Difficult to get people on board though and look what happened to the con majority in that election. We always went something but won’t pay for it.

I agree with all that. People always want better state services, but when it comes to paying, they all want "someone else" to pay for it.

Teresa May had it absolutely right with her proposals, but the voters stuck their fingers in their ears and didn't want to hear it. That's meant that those who'd have benefitted from it (the beneficiaries) risk losing their inheritances once the savings have gone for the care home fees and the council put a charge on the property when the savings run out.

Too many people are too ignorant (or just don't care), to do the research to understand how the current system works. It's a bit like the Waspi women who claim they didn't know. Lots of people don't understand that care home fees cost thousands per month and don't understand the criteria as to when the state pays (health reasons) or the person themselves pays (care reasons), and don't understand how councils can put legal charges on homes which means they get the money eventually once the home has been sold out of the estate.

As you say, we need better education. Better education as to how elderly care works and is paid for, better education about healthy lifestyles to help avoid the need for care homes, etc. Something like public information films about dementia would be a brilliant idea to start to get the message across.

Not sure what TM solution was but I think the Lib Dems had the best plan. All care is free, but everybody who dies after retirement age pays a 3% tax on their estate, whether they had care or not. This covers it. Again, met with howls of "it's not fair" and binned.

The Tories have a detailed plan for the NHS. It just isn't very public, is it. Taking shape, unfortunately.

There's not enough staff to provide the services. But in specific areas the services (in yermsof numbers) aren't being cut. There are countless threads on here about poor maternity care in NHS hospitals. There's a massive shortage of midwives and maternity care assistants. It's not just about the money, who wants to go into a job where no matter how hard you try your work will be slated and belittled, and "those nasty midwives" etc? And you get to miss out on your evening/weekends/nights out and special occasions for the pleasure of it?

The services can't be cut, all women need to be seen to as they present. There's no "oh, we only have capacity for 20 today". So each midwife is spread a little bit thinner, and things are missed, resulting in very unhappy service users, court costs and payouts when the inevitable happens, unhappy staff then leaving the profession, and a service then coping with fewer staff and less money. And although the birth rate is decreasing, the complexity of many pregnancies has exploded! How do you recruit and retain staff into that environment/culture?

The Tories have always destroyed the NHS, it took Blair a decade to get it back on a its feet.

Unfortunately the Tories have done so much harm that I doubt the next labour government will have the time or the money to do anything.

The only way we can sort it out is to have an adult conversation about costs and tax. We need to set out how much of our tax is set aside for health. At the moment it's too low.

I'll give you a good example...a inlay treatment privately will cost about 1000 privately. So two molars at a private dentist will cost over 2000 pounds. My point is that healthcare is expensive and most likely will use more than they pay for ...which is why we are in this mess. We need to be paying at least 400 pounds a month into healthcare during our working lives to get decent health care....this is not happening.

I worked in Norway for a bit and you paid a lot out but the system worked very well. So not matter what system you choose the bill must be met....if you have private healthcare you'll pay monthly or all at once but reality is the more treatment you need the bills get bigger. So health care insurance sounds great until you need lots of treatment because the insurance company will simply increase your premiums. In America where it's purely private insurance many people find themselves unable to keep up with the premiums.

Simple answer is the NHS is a good system but we need a sensible debate on how we fund it

You're saying that the v nice Labour party will have to hugely put up our taxes to cover the 400 pounds a months that we should be paying - do you really think they'll do that? Unlike the nasty Tories who didn't.

Nurses and midwives have always worked shifts. Luckily the birth rate is going down!

We simply don’t have the resources to keep the behemoth NHS going. We do need to accept change. Norway is a rich country with a sovereign wealth fund and much smaller than us. We are not Norway. Therefore we need to decide what we can do to change what we do and how we pay for it.

Thing is, if we want that sort of health service, it costs a huge amount of money. I heard on the radio the other day that NICE had recently approved a drug that costs £1.3 million per patient.