AIBU to think the NHS is already dead

I think there’s no chance that we’ll move to an insurance based system, but governments tinkering around the edges might happen. Mainly the NHS is rationed by governments, they provide not enough of what’s needed and prefer to make people wait. The doctor shortage for example, could easily be solved, although it would take time, because every single year many very well qualified students cannot get places at medical school because the government don’t want to pay for more places. That’s rationing. The government chooses to ration the number of medical school places which in turn rations the number of doctors available to practice, which in turn rations treatments. It’s a choice made by governments.

I could imagine an insurance based system might happen in the future. Here they add a tax on people who are able to afford insurance but don’t take it out. The trouble with private health insurance is that it doesn’t cover half the things you would want it to and you end up with a big debt when you leave hospital. The public health is free but you have to wait and wait . Private health insurance doesn’t cover normal GP visits, only hospital visits. You get some back for dental care and eye care but not all of it.

Baggs

Also, what services have been privatised exactly?

My DH is diabetic and was told he must arrange any treatment for his feet himself, all they provide is an annual touch test so he pays to see a podiatrist every few months. GP surgeries in our area will also not clear wax in the ears, our son had to pay to have his done at a local physiotherapy practice.

Would it be too pedantic if me to point out that the phrase is “free at the point of use” not “need”.

Jane43

Baggs

Also, what services have been privatised exactly?

My DH is diabetic and was told he must arrange any treatment for his feet himself, all they provide is an annual touch test so he pays to see a podiatrist every few months. GP surgeries in our area will also not clear wax in the ears, our son had to pay to have his done at a local physiotherapy practice.

This sort of tinkering makes such a difference. We are already being told that one of the issues with the cost of running our NHS is that we are always running hard to catch up and ending up with a service only for the very sick and disabled rather than one that keeps people well.

This is more about how it is run than how we pay, but that is also very relevant. It's obvious to most that catching problems early saves money in the long run. But we are making it more and more difficult for people to stay well enough. Often this is about staying well enough to work which we know has become a problem for the economy.

As well as people like Sunak not being able to understand that some people can't afford such things as professional foot care and ear syringing, we often also set test levels higher than other, similar countries, before we start treating people. I wonder if some of you feel currently cushioned by your income.

Our use of "technology" is poor, including the lack of imagination to understand that many do not have access to it.

I came across someone recently, who is on Pension Credit. She had just paid out £200 from her small savings, for physiotherapy. The GP pathway for treatment was closed to her as she has neither a smart phone nor a computer. She already uses a "walker", and has other conditions. She is well into her 80s.

With the walker she can walk to our local surgery and uses her bus pass, every day, to get out an about and keep herself busy. She has worked all her life in jobs that get people "service to the community" awards, but don't pay well. Her husband ran his own small "tradesman" business. She also has diabetes, and other conditions related to the culture she and many of us grew up in. Again the surgery are telling her a private company will monitor her diabetes electronically. She simply doesn't have the technology.

I am all for using technology and very keen to see it used more, but wonder if some of you who do not see a problem have a rather better income than this lady and rather more knowledge of technology, and therefore have an "I'm all right Jack" attitude at the moment.

GrannyRose15

Would it be too pedantic if me to point out that the phrase is “free at the point of use” not “need”.

It seems to be somewhat interchangeable. "Free at the point of delivery" is also used by those in this field.

In a government paper on Care (2019) - slightly different I know; they write.that they plan to :
be fair and accessible to all who need it, when they need it – ensuring that fees are more transparent, information and advice is user-friendly and easily accessible, and no one is subject to unpredictable and unlimited care costs

Admittedly this plan was underfunded an l'm not sure what got put into action - if anything. But it is an example of how words are swapped around.

I feel that whatever anyone says, you have this fixation and you won't be swayed by other people's ideas, arguments.

DaisyAnnReturns
The case of the lady in her 80’s at first glance seems to be having poor treatment.On second glance this is not NHS at fault it is her GP.Physiotherapy should be arranged by her surgery and if she has informed them that all she has at her disposal is a phone then they should give her a number to ring.My Mum, now 81 has physio now and then, she also has diabetes type2 which is managed by medication, an annual free eye test and an annual free foot check.
Your friend may have gone down the private appointment route to get physio more quickly, which is sometimes the case.
Just to add, it’s rude of you to dismiss other posters by saying they may have an ‘I’m alright Jack’ attitude. I see no evidence of this.

DaisyAnneReturns

Witzend

It was very much not dead when I was ill back in March - 3 weeks of excellent care in hospital.

As for contracted-out services, an ex colleague had both his really bad cataracts done at a specialist ‘private’ clinic - for free. The fact that they were so bad was nothing to do with the NHS - he just hadn’t bothered to see an optician let alone a GP, for many years,

I don't doubt the care but what if you had to pay for it?

That was not the original question, though.

I’m well aware that the cost would be crippling if I had to pay and didn’t have adequate insurance. Despite paying a very hefty whack in monthly premiums, my sister in the US still had to shell out ‘merely’ for a badly cut finger.

And in my ignorance I’d actually said, ‘Well, at least you’re insured, to which she’d replied, ‘You’re joking - there was a $2000 excess.’

Well said Freya and others. OP doesn’t seem to like the answers she’s received. Most of us will know ‘someone’ who hasn’t had perfect NHS care, but on investigation it’s often an anomaly/misinformation/misunderstanding. My DD can’t wait for her promised podiatry - we’ll gladly pay for it. So many want a service, but how many actually need it? My MinL (fairly well off) would wait weeks for chiropody rather than pay for it. Nose and face.

I’ve probably mentioned this before, but IMO some people do so take ‘free’ for granted, that it virtually amounts to abuse.

A friend of ours stockpiled a mass of free prescription items - I once counted over 60 of 5 or 6 preparations in his bathroom. More than once they were all thrown away by a visiting friend who was an ex nurse, and yet again after he eventually died.

Dh was an executor so I do know that he left over £1m in cash and two houses long paid for. But he was notoriously tight with money so I’m quite sure that if he’d had to pay even £2-3 for prescription items, he’d never have taken so many that he just didn’t need.

I doubt very much that he’s the only one who takes free items they don’t need. Among his items were packs of paracetamol, which anyone can buy for pennies in supermarkets. And I read somewhere that each prescription costs the NHS £7+ just in admin, never mind the cost of the item.

I wish they’d take paracetamol away from being prescribed.
It’d be a start.

Years ago (not sure now) men could have a vasectomy on the NHS then, years down the line if wishing they hadn’t had that op, could have a reversal done on the NHS. What a cheek for ‘a lifestyle choice’.

I used to type the letters from the surgeons to the relevant GPs and I used to think it wasn’t right. It ought to have been spelled out ‘yep, the NHS will do your vasectomy Sir, but sign here please because if you change your mind you have to fund a reversal yourself’.

In my opinion the NHS lost their way. It couldn’t decide FULLY whether it was providing a service or running a business.

Witzend

DaisyAnneReturns

Witzend

It was very much not dead when I was ill back in March - 3 weeks of excellent care in hospital.

As for contracted-out services, an ex colleague had both his really bad cataracts done at a specialist ‘private’ clinic - for free. The fact that they were so bad was nothing to do with the NHS - he just hadn’t bothered to see an optician let alone a GP, for many years,

I don't doubt the care but what if you had to pay for it?

That was not the original question, though.

I’m well aware that the cost would be crippling if I had to pay and didn’t have adequate insurance. Despite paying a very hefty whack in monthly premiums, my sister in the US still had to shell out ‘merely’ for a badly cut finger.

And in my ignorance I’d actually said, ‘Well, at least you’re insured, to which she’d replied, ‘You’re joking - there was a $2000 excess.’

I didn't know there were rules about not developing a conversation and train of thought Witzend.

Interesting to hear about your sister's experience.

I agree with you Urmston.

Georgesgran

Well said Freya and others. OP doesn’t seem to like the answers she’s received. Most of us will know ‘someone’ who hasn’t had perfect NHS care, but on investigation it’s often an anomaly/misinformation/misunderstanding. My DD can’t wait for her promised podiatry - we’ll gladly pay for it. So many want a service, but how many actually need it? My MinL (fairly well off) would wait weeks for chiropody rather than pay for it. Nose and face.

I may not agree with the answers but "like"? I'm not two! I have opinions of my own and didn't realise we are not allowed to discuss on GN these days.

Is this a Mumsnet thing? Or has GNHQ changed the rules? Or have a little group of you decided you run GN?

As I said Georgesgran, had you bothered to actually read, this is nothing to do with the care recieved which is generally outstanding, but the way this far-right government is killing the essence of the NHS by destroying "free at the point of need".

Jane43

Baggs

Also, what services have been privatised exactly?

My DH is diabetic and was told he must arrange any treatment for his feet himself, all they provide is an annual touch test so he pays to see a podiatrist every few months. GP surgeries in our area will also not clear wax in the ears, our son had to pay to have his done at a local physiotherapy practice.

The ear wax thing, as I understand it, is because ear syringeing is not regarded as good practice. About thirty years ago my GP told me that the risk of causing infection is one of the reasons the approach changed.

I don't know anything about diabetes and foot touch tests but wonder if it could have something to do with what is regarded as actually necessary?

It is not really about where treatments take place, it is about the wait to get said treatment if you are not paying yourself.

Baggs

Jane43

Baggs

Also, what services have been privatised exactly?

My DH is diabetic and was told he must arrange any treatment for his feet himself, all they provide is an annual touch test so he pays to see a podiatrist every few months. GP surgeries in our area will also not clear wax in the ears, our son had to pay to have his done at a local physiotherapy practice.

The ear wax thing, as I understand it, is because ear syringeing is not regarded as good practice. About thirty years ago my GP told me that the risk of causing infection is one of the reasons the approach changed.

I don't know anything about diabetes and foot touch tests but wonder if it could have something to do with what is regarded as actually necessary?

I suspect you're right. I have an annual diabetic foot test, carried out by a nurse. I'm given advice about looking after my feet and don't know what else a podiatrist could do at this stage.

That's interesting, gs. Thanks for that. I hope your feet do not trouble you too much

Luckygirl3

It is not really about where treatments take place, it is about the wait to get said treatment if you are not paying yourself.

Quite!

I feel extremely fortunate with my experiences with the NHS.
DH received excellent care from paramedics and hospital last year when he was very ill with sepsis.
This year I have had prompt referral to Cardiology/ Treadmill test for chest pains, three physio sessions for knee injury
( meniscus) and three massage treatments for a trapped nerve affecting shoulder/arm.
( Yes I'm falling apart at the seams..)
Face to face appointments are available at my GP surgery. We are in Scotland. 🏴󠁧󠁢󠁳󠁣󠁴󠁿

I wish they’d take paracetamol away from being prescribed.
It’d be a start.

The problem is Urms if you need the drug on a regular basis, you will have to shop for it frequently or traipse around various pharmacies to buy the limited quantity that you are allowed to purchase in any one transaction.

After surgery, which led to a long rather painful recovery, I was advised to take Paracetamol by my consultant. I was too poorly to keep going out every 3 days or so to buy them in the limited quantity available - couldn't drive and had to rely on someone to transport me to the chemist.

My GP put them on prescription - because he could prescribe 100 at a time. And he knew I wasn't well enough to keep trudging around various outlets to buy the quantities needed.

If Paracetamol are to be taken off the prescription list - and I think they should be - then we have got to be allowed to purchase them in larger quantities. It's unrealistic to expect people in pain to continually have to go out to buy them so frequently - especially if there's no local pharmacy.

I asked my GP to authenticate my need with a 'note' so I could buy them myself in the quantities needed. He couldn't do it - there's no 'system' for it!

Baggs

That's interesting, gs. Thanks for that. I hope your feet do not trouble you too much

Thanks Baggs. I have diabetic neuropathy in my feet, but there's not much a podiatrist can do yet, although I know further complications can develop, when treatment by a podiatrist would be useful. I just have to keep my blood sugar as near normal as possible to try and prevent the condition getting worse and I take painkillers, which isn't the responsibility of a podiatrist. NICE has guidelines for referral to a podiatrist and I don't meet the criteria.

Interesting, Dickens. My mother had paracetamol on prescription. I can imagine it was for similar reasons as she was housebound.