Let's turn the clock back to 1948

Can we agree to disagree M0nica?
I respect your views and you have had your own experience, particularly of the French system, but I have my own and that of my circle. 3 DiL work, or used to, in the NHS and for all of us as patients and as providers, it has been pretty good. Yes we have had to wait longer than we'd have liked for non life threatening care but we accept it.
I do get cross when the media bang on about the faults and forget the triumphs.

This is of course the Curate's egg argument, - bits are good, lets ignore the rest of it are bad.

Personally I prefer my eggs without bad bits.

M0nica

This is of course the Curate's egg argument, - bits are good, lets ignore the rest of it are bad.

Personally I prefer my eggs without bad bits.

So what do you suggest?

Grammaretto

Can we agree to disagree M0nica?
I respect your views and you have had your own experience, particularly of the French system, but I have my own and that of my circle. 3 DiL work, or used to, in the NHS and for all of us as patients and as providers, it has been pretty good. Yes we have had to wait longer than we'd have liked for non life threatening care but we accept it.
I do get cross when the media bang on about the faults and forget the triumphs.

I get cross when the media (and others) bang on about the faults of the NHS, but don't come up with any concrete suggestions to improve things for all (not just the few who could afford top-ups).

The main failings seem to be:

- GP waiting times
- waiting times for non-urgent procedures
- pressure on A & E and ambulances caused by difficulties in accessing primary care and bed flow (a knock-on effect of inadequate care in the community)
- staff shortages caused by staff retention problems and failure to train

There have been well-documented failures in a handful of individual hospitals, which should have been picked up earlier, but the majority of trusts are performing as well as they could.

Maybe somebody could come up with some solutions which wouldn't require extra resources and better planning from the top.

PS. I realise that we now have devolved healthcare systems and criticisms/solutions might very well be different in Wales, Scotland and NI.

M0nica

I can only speak from my fairly extensive experience of the NHS over the last 10 - 15 years. Not dramatic illnesses but the ordinary bread and butter of family health problems with a mix of more serious issues.

I quite agree that it is not statistically proven material, but it goes well beyond the odd anecdotal incident. I accept that the NHS is excellent in emergencies, and I have experienced those, but beyond that good treatment only seems to exist if you are prepared to pay for it.

Any patient accessing private health care, as funded by insurances, may find themselves thrown back onto the NHS, when they become terminally ill for example. The son of former neighbours suffered from a blood cancer. He had a regular checkup one August and was pronounced OK. A couple of months later he became ill - the cancer had returned. The private insurance would not cover him and he went to an NHS hospital where the care was exemplary but unfortunately he died.

Another example - a patient in a private hospital in Norfolk deteriorated and needed to go to the nearby NHS hospital because the private hospital did not have the staff to deal her.
Sadly there were delays with getting an ambulance and she died. This was on the news a one or two months ago.

Finally, a Scottish friend had prostate problems - not cancer. He was told that he could have a catheter inserted and the waiting list was at least 18 months. He could not bear the thought of living with a catheter and so paid for an operation in Harley Street. The cost - £8000.00. Time spent in London - 2 to 3 days. He didn't have private insurance but could afford to pay. Most people couldn't.

Which administrators dictated that you couldn't have tests MOnica? Doctors have to follow NHS guidelines (NICE), which are dictated by value. Spending more money would result in more diagnostic tests being available, even if they were clinically of limited value.

So how could it be more efficient? How do you define efficiency? You didn't have tests because they weren't deemed an efficient use of resources.

Did you take up the clerical errors with PALS or your local provider?

How has having a DEXA test changed your treatment? If it hasn't, what was the purpose?

Every single test I've had has had a purpose and treatment options have depended on the results. That's why I had them promptly and with no quibbling. No administrators ever stopped them.

I and my family were/are an unhealthy lot and have received good treatment from the NHS for serious health problems all our lives. However, sitting here in France I watch what is happening to the NHS with horror. Having moved permanently to France 15 years ago and being of a certain age, my DH and I have had several experiences of the French system which to my mind is excellent.

At the end of September I had an emergency op. Having gone to my GP I was told that I need to go to hospital now. He gave me a letter for the hospital and my DH drove me. Because I did not arrive by ambulance I had to wait my turn to be triaged. My GP had also telephoned the hospital. When I entered the triage ward I was given pain killers. Whilst there I was visited firstly by a junior doc who took all my details. Later by 2 others who tried to push my hernia back and finally by the surgeon who would operate. I had a room to myself which was lovely. There seemed to be 3 different shifts of nurses, so I assume they were working 8 hours. The only bad thing was the hospital food which was grim.

Sometimes one can wait a few months for an initial consultation with a specialist, depending upon the illness. It's never s long as a year. However, after the first consultation the waiting time is a lot less for follow ups.

We have a mutuelle insurance which costs around 230 euros per month (for both of us). Most of our English friends here came after retiring. Everyone will say how good the health system is, as do our French friends. I wish that the NHS could be as good in England.

Are you suggesting we each pay £200 pm for the NHS? Dinahmo?
I couldn't afford that.
Once on holiday in France, with our E111 cards, my MiL collapsed with what turned out to be anaphylactic shock from a hornet sting.
The emergency doctor arrived rapidly to administrator adrenaline but demanded payment up front before she had even seen the patient.
Is this the kind of health service we want and are heading towards?

The emergency doctor arrived rapidly to administrator adrenaline but demanded payment up front before she had even seen the patient.

It's no consolation knowing that payments to the French can (sorry, could, before Brexit) be claimed back, if you don't have the money available to pay up front. I'm clearly not saying that that was your situation, Grammaretto, I'm agreeing that it is not good. At least with the NHS we know that wouldn't happen to a visitor to the UK.

I think I can be fairly certain my mother would have died when I was a child without the NHS. In 1948 she was 26 years old, had had 3 children (one died) and numerous miscarriages. She was severely anaemic to the stage where oral iron was useless. After the NHS was launched she was given a daily injection by the district nurse, then, when she was strong enough , she had a hysterectomy. It was a pioneering operation which basically saved her life.

Grammaretto

Are you suggesting we each pay £200 pm for the NHS? Dinahmo?
I couldn't afford that.
Once on holiday in France, with our E111 cards, my MiL collapsed with what turned out to be anaphylactic shock from a hornet sting.
The emergency doctor arrived rapidly to administrator adrenaline but demanded payment up front before she had even seen the patient.
Is this the kind of health service we want and are heading towards?

I'm a severe asthmatic and as such (life threatening illness in my case) and as such don't pay anything towards my medication. It's all paid for by the state. Because I'm elderly I don't pay for visits to the doctor. We do not hand over any money for most prescription medicines - the pharmacie is automatically paid by the state and by our mutuelle. There are some things we have to pay for, such as special bandages to support wrists, and other joints.

I assume that your MiL was required to make a payment because she was not resident in France. Many people believe that visitors to the UK should be charged for any medical treatment.

Some years ago we thought my DH was having a heart attack and so I called the emergency service (after 11pm). Within 15 minutes a doctor arrived. Her ecg machine didn't show anything wrong with his heart so she called the SAMU who arrived after about 10 minutes. They had a bigger ecg machine and they couldn't find anything either. It was decided that he was seriously ill and so the pompiers came to take him to hospital. Eventually the hospital doctors decided that he had pericarditis. We did receive an invoice showing how this had all cost but we didn't have to pay it.

We are paying £100 each per month, not £200. The price is partly because of our age and partly because we have selected a high level so we are able to have a single room in hospital, if we so wish and access to opticians and dentists.
Younger people do not pay so much. The prices for a mutuelle start at 27 euros per month.

When we first arrived I considered not paying for the mutuelle because apart from my asthma we had been relatively healthy and I knew that treatment for terminal illness was covered by the state. However, someone pointed out that, until the nature of the illness was determined the tests had to be paid for and so we signed up.

I would rather be paying £100 per month each and getting a good service rather than face the problems that currently exist in the UK.

Dinahmo

Grammaretto

Are you suggesting we each pay £200 pm for the NHS? Dinahmo?
I couldn't afford that.
Once on holiday in France, with our E111 cards, my MiL collapsed with what turned out to be anaphylactic shock from a hornet sting.
The emergency doctor arrived rapidly to administrator adrenaline but demanded payment up front before she had even seen the patient.
Is this the kind of health service we want and are heading towards?

I'm a severe asthmatic and as such (life threatening illness in my case) and as such don't pay anything towards my medication. It's all paid for by the state. Because I'm elderly I don't pay for visits to the doctor. We do not hand over any money for most prescription medicines - the pharmacie is automatically paid by the state and by our mutuelle. There are some things we have to pay for, such as special bandages to support wrists, and other joints.

I assume that your MiL was required to make a payment because she was not resident in France. Many people believe that visitors to the UK should be charged for any medical treatment.

Some years ago we thought my DH was having a heart attack and so I called the emergency service (after 11pm). Within 15 minutes a doctor arrived. Her ecg machine didn't show anything wrong with his heart so she called the SAMU who arrived after about 10 minutes. They had a bigger ecg machine and they couldn't find anything either. It was decided that he was seriously ill and so the pompiers came to take him to hospital. Eventually the hospital doctors decided that he had pericarditis. We did receive an invoice showing how this had all cost but we didn't have to pay it.

We are paying £100 each per month, not £200. The price is partly because of our age and partly because we have selected a high level so we are able to have a single room in hospital, if we so wish and access to opticians and dentists.
Younger people do not pay so much. The prices for a mutuelle start at 27 euros per month.

When we first arrived I considered not paying for the mutuelle because apart from my asthma we had been relatively healthy and I knew that treatment for terminal illness was covered by the state. However, someone pointed out that, until the nature of the illness was determined the tests had to be paid for and so we signed up.

I would rather be paying £100 per month each and getting a good service rather than face the problems that currently exist in the UK.

That is fine, Dinahmo, but the problem in England is not really about how the health service is financed, but about the government refusing to finance it. State funding is a perfectly reasonable economic model if you look at the flows back to the Treasury from the money they are putting into the economy via procurement from private enterprise and the state paid personnel spending their money into the economy. Economists estimate that state investment in the NHS has a multiplier of 2.5 when it comes to economic activity generated as a result.

I'd be interested to know, though, is the ,mutuelle' paid to the state or is it a privately managed insurance?

I have discovered I am not alone in thinking the NHS needs root and branch reform.

Wes Sweeting, Labour Shadow Minister of Health is in agreement with me. bbc.co.uk/news/uk-politics-64002936

Maizie The mutuelles are non profit organisations and differ from private health insurance companies in that you don't pay extra for pre-existing health conditions and they must continue to keep paying. As I mentioned above when you have a life threatening illness the state pays 100% of the costs.

Since 2016 private companies have required to provide employees with a mutuelle collective and they have to pay a minimum pf 50% of the cost.

After care is also good. After my op a nurse came to my home every day to change my dressing and to check on me. On the last day my staples were removed by the nurse.

A friend who is in his early 80s and who suffers from severe COPD ( he has an oxygen supply at home) was recently in hospital with covid. He went home yesterday and he will be assessed as to his needs. A nurse will come in. A heart specialist will go to his home to see him as they discovered other problems whilst in ICU.

I agree that the NHS could be funded properly and that to do so is opposed by the current govt. However, we are generally living longer and the aging population is placing a greater burden upon the state.

The benefits system needs to be completely overhauled. In the 21st century no one should be living in poverty and unable to heat their homes or feed their families or to go without treatment because of long waiting lists.

My mother was born in 1930 (sadly missed now) and when she was about 7 or 8 (just before the second world war) she contracted scarlet fever and was in bed for 6 months. After she recovered, she caught it again and so was in bed for the best of a year and missed a whole years schooling. This was before the NHS. She died in 2021 at the age of 90 y.o.

After care is also good. After my op a nurse came to my home every day to change my dressing and to check on me. On the last day my staples were removed by the nurse.

This is one area where I think the NHS (in England at any rate) falls down badly. It's a result of a policy shift away from the community (despite rhetoric) and funding.

M0nica

I have discovered I am not alone in thinking the NHS needs root and branch reform.

Wes Sweeting, Labour Shadow Minister of Health is in agreement with me. bbc.co.uk/news/uk-politics-64002936

I follow Wes Streeting on Twitter. I disagree that he thinks "root and branch" reform is needed.

He's calling for more funding and more strategic thinking about training. At the same time, he wants the NHS to be accountable for better investment.

One area where the NHS needs to invest is in IT. That will change the relationship between medics and patients, but I don't think it's root and branch reform. I would go further and abandon commissioning (which would also save money), but apart from that, I don't agree that massive organisational changes are needed.

Of course the NHS isn't perfect - no healthcare system is or ever will be, but it's far better than any alternative. As I said before, we must protect it and resist any attempts to privatise it. A quick read through here shows that many of us - myself included - would not be here without it. The NHS has in many ways been a victim of its own success. We are living longer - thereby requiring more healthcare for longer. Babies now live who would have died either before, at, or shortly after birth. Treatments for many diseases have advanced to the point where people now survive who otherwise would have died. I could go on and go.

growstuff we will have to agree to differ.

Can I just point out once again that top-up insurance does not need to be paid by those below a certain income threshold. Our income is above the threshold so we pay it, but everyone is entitled to the same treatment and serious illness is funded at 100% for everyone.
It is expensive, but as I said before, there is no road tax and our annual council tax is 600€ a year, so we gain in some other areas.

M0nica

growstuff we will have to agree to differ.

I'm not going to agree to differ about what Wes Streeting actually said. He didn't claim that the NHS needs root and branch reform.

*BlondieScot,^Of course the NHS isn't perfect - no healthcare system is or ever will be, but it's far better than any alternative.^

Try looking at these links. Almost every ranking i could find placed us 10th on the list en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare

www.william-russell.com/blog/countries-worlds-best-healthcare-systems/

All the medical systems in developed countries had systems that were inclusive of everyone. Not the same as ours, but quite effective and often delivering better outcomes.

The exception was the USA which delivered worse outcomes at greater expense and was not inclusive. It showed what an exception it was to the general trend. When comparing systems we would be better off ignoring the US and looking at how the many countries in Europe work. The answer it seems is better than us with better outcomes.

Gabrielle56

I find it interesting that you think social care would be improve if it was put in the hands of local authorities. In fact it is, and that is part of the problem. Many care homes have gone bust in recent years because local authorities have refused to pay what it costs to look after the people in them. People supposedly paid for by the local authority have routinely been subsidised by other fee paying patients. And those fee paying patients got exactly the same poor level of care as those who had their fees paid for them. It has been a travesty for years.

I suggest improvements would begin if local authorities started to pay the true cost of care.