Who hates the NHS

Pammiel, my experience is that the nhs does provide effective treatment for cancer patients and for those of us with life limiting conditions.
Your dismissal of the benefits of fertility treatment etc don’t take account of the costs of not treating fertility needs or the mental health problems associated with body dysmorphia

Casdon

I’m amazed you would even consider that terminal care could be on the table ronib, it’s always been one of the fundamental things the NHS does.
Other treatments which are non life changing are always valid to consider for NHS funding, and there are already processes in place to do that, based on both political funding and clinical decisions.
Your point about A&E is erroneous. Of course, there is a level of abuse of the system - but A&E is not, and was never intended to be the gateway for hospital admission. The vast majority of admissions are organised between GPs and the relevant hospital clinical team. People who are involved in traumatic or emergency events go to A&E. you don’t need to be admitted to hospital if you have broken your wrist, or have a saucepan stuck on your head, or you’ve burned your arm on the iron, or whatever, you might if you have collapsed in the street, but after assessment you might not - that’s what A&E departments do, the clue is in the name.

How about if you’ve been seeing your GP for months because you suspect you have the symptoms of lung cancer, and are continually told your shoulder pain and breathlessness are because of a trapped nerve, and you are sent away with pain killers ? Until one day you collapse and are rushed to A&E with a severe chest infection and end up on a ventilator in ITU. A CT then reveals an inoperable lung tumour - which you have been trying to convince your GP of for months. This is what happened to my late husband. A&E may not have been intended as the gateway to hospital admission, but until GP’s improve their ability to recognise early cancer symptoms and refer accordingly, it’s inevitable that cancers will continue to be diagnosed as a result of emergency admission.

Iam64

Pammiel, my experience is that the nhs does provide effective treatment for cancer patients and for those of us with life limiting conditions.
Your dismissal of the benefits of fertility treatment etc don’t take account of the costs of not treating fertility needs or the mental health problems associated with body dysmorphia

My experience is that my late husband’s suspicion of lung cancer was dismissed by our GP until it was too late. By the time he collapsed and was admitted as an emergency it was too late. I have several examples of very similar events with family and friends. I don’t ‘dismiss’ anything - we all have our problems, but nothing anyone says will convince me that the treatment of conditions like infertility and body dysmorphia should take precedence over funding of life saving and life extending treatments. The UK has an appalling record when it comes to the early diagnosis of cancers - most are diagnosed when patients are admitted with other conditions. We have our priorities all wrong.

growstuff

Pammie1

ronib

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

I said much the same thing earlier on in the thread. I fail to see how gender reassignment surgery, fertility treatment and body dysmorphia treatments, to name but a few, can take up NHS resources while cancer patients and those with other life limiting conditions are denied effective treatment because of costs. We have our priorities all wrong.

How much does gender reassignment surgery, fertility treatment and treatment for body dysmorphia cost the NHS and as a percentage of the total budget?

No idea, but whatever it is, it’s too much, and not what the NHS was set up for. If we are all prepared to pay a lot more for the NHS and to elevate it to a world class service which caters for all comers, then yes, fine, let’s do it. But in reality we’;re not prepared to do that are we ? And what of successive governments who use NHS funding as a political brickbat ? There are failings in multiple areas of fundamental care that need to be addressed before we concern ourselves with wants rather than needs.

I have to agree with you Pammie1.

Pammie1

Casdon

I’m amazed you would even consider that terminal care could be on the table ronib, it’s always been one of the fundamental things the NHS does.
Other treatments which are non life changing are always valid to consider for NHS funding, and there are already processes in place to do that, based on both political funding and clinical decisions.
Your point about A&E is erroneous. Of course, there is a level of abuse of the system - but A&E is not, and was never intended to be the gateway for hospital admission. The vast majority of admissions are organised between GPs and the relevant hospital clinical team. People who are involved in traumatic or emergency events go to A&E. you don’t need to be admitted to hospital if you have broken your wrist, or have a saucepan stuck on your head, or you’ve burned your arm on the iron, or whatever, you might if you have collapsed in the street, but after assessment you might not - that’s what A&E departments do, the clue is in the name.

How about if you’ve been seeing your GP for months because you suspect you have the symptoms of lung cancer, and are continually told your shoulder pain and breathlessness are because of a trapped nerve, and you are sent away with pain killers ? Until one day you collapse and are rushed to A&E with a severe chest infection and end up on a ventilator in ITU. A CT then reveals an inoperable lung tumour - which you have been trying to convince your GP of for months. This is what happened to my late husband. A&E may not have been intended as the gateway to hospital admission, but until GP’s improve their ability to recognise early cancer symptoms and refer accordingly, it’s inevitable that cancers will continue to be diagnosed as a result of emergency admission.

A&E is the gateway to the hospital for emergencies who need admission Pammiel, and your husband clearly was an emergency when he got there. It is a fact that the majority of admissions to hospital are not through A&E, they are known about and discussed between GPs and hospital doctors in advance. . I’m sorry to hear about the failure to diagnose your husband’s condition by your GP practice.

I seem to be getting an awful lot of adverts for private health insurance and doctors appointments that I can pay for. It did occur to me today that there are supporters of this government that wanted them to introduce a form of compulsory medical insurance and that they are now getting worried that it looks pretty certain that they will not be in power for much longer.

Pammie I'm really sorry to hear about your DH. My GP wouldn't believe I had a pain in my breast and missed my cancer, so it was more advanced than it should have been when it was treated, so I have some idea how you must feel.

I don't know how much gender reassignment and fertility treatment cost the NHS either, but I'd be willing to bet they're a tiny percentage of the NHS budget. The big costs to the NHS are heart problems, cancer, diabetes and dementia. The NHS is a victim of its own success because they tend to be diseases of older age and we're all living longer. Infectious diseases of childhood have almost been eradicated.

Most adults, unless they have a chronic condition, cost the NHS very little. More money is spent in the last few years of life, followed by the early years. Women of childbearing age cost more than men if they get pregnant.

That's why I wrote that if the accountants really want to save money, they should get rid of old people and not bother with sickly children. I wasn't serious, of course, because I think a civilised society should pay for people when they're more vulnerable, but I can foresee a time when people just look at a balance sheet and decide such people are too expensive. Getting rid of them would save billions and we'd be back to pre-1948 and I most certainly don't want that.

When I posted that people who hate the NHS could get private insurance, I was not suggesting that as a general alternative to our current system. I would hate a system that left a section of the community with no insurance because they could not afford to pay for it. Nor would I like a system which did not cover certain procedures that were deemed too expensive. Finally, I would not like a system which gave huge profits to both practitioners and insurance ompanirs.

The success of the NHS, Social Policy and the general improvement in standards of living mean that while in the past hospitals treated a lot of people under retirement age, now most people get through their working lives and into retirement, without having any serious medical problems that require long term treatment or periods in hospital.

However, all of us pay towards the NHS, whether we use it or not, so why should there be resentment when, after a lifetime of contributing to the NHS, and using it little, when we get old we then make more use of NHS resources?

M0nica

The success of the NHS, Social Policy and the general improvement in standards of living mean that while in the past hospitals treated a lot of people under retirement age, now most people get through their working lives and into retirement, without having any serious medical problems that require long term treatment or periods in hospital.

However, all of us pay towards the NHS, whether we use it or not, so why should there be resentment when, after a lifetime of contributing to the NHS, and using it little, when we get old we then make more use of NHS resources?

I tend to agree, except with unsaid bit of where NI money goes.

Money goes to a black hole.

It's not designated for health, pensions, etc. There is no NHS pot within. Thus reduce NI and make a separate health insurance - it's own pot

Assuming that we have been paying taxes all our lives, VAT, as well as income tax, then we have been paying towards all state expenditure. What parts we benefit from will vary as our lives progress. As children we make high demands on the education budget, but lower demands on the health budget. As we get towrads the end of our lives we make very little demand on education expenditure but more on health and welfare expenditure.

M0nica

The success of the NHS, Social Policy and the general improvement in standards of living mean that while in the past hospitals treated a lot of people under retirement age, now most people get through their working lives and into retirement, without having any serious medical problems that require long term treatment or periods in hospital.

However, all of us pay towards the NHS, whether we use it or not, so why should there be resentment when, after a lifetime of contributing to the NHS, and using it little, when we get old we then make more use of NHS resources?

Agreed, M0nica.

I have been having investigations lately, and the majority of people in the hospital corridors and waiting rooms are older (mostly general outpatients, including X rays and blood tests).

But most of those people will have paid in for decades, so I see no reason for resentment either. Also, if someone gets through life needing little or no treatment they are very lucky, and shouldn't begrudge those who are less fortunate.

Doodledog I have been having investigations lately, and the majority of people in the hospital corridors and waiting rooms are older (mostly general outpatients, including X rays and blood tests).

But most of those people will have paid in for decades, so I see no reason for resentment either. Also, if someone gets through life needing little or no treatment they are very lucky, and shouldn't begrudge those who are less fortunate.

Agreed 100x

However, it seems to me NI goes into a black hole, with NHS doing somewhat poorly, perhaps a designated tax/insurance for NHS (and lower NI) would work better, be more transparent.

I don't care what it's called, really. The point is that most of us pay in at the rate that is set by the government of the day, yet when they don't deliver the service they have taken our money to fund, they say that we can't afford it. It is the government who should ensure that we do pay enough, however they go about that. An increase in income tax, a 'poll tax' system where everyone between 18 and state retirement age pays in whether they earn or not, a death tax, a wealth tax on unearned income, ring-fencing the sugar tax and taxes on alcohol and tobacco - all those things and others should be on the table for discussion.

I think the NHS should first get its act in order and give us some evidence that the money is being used effectively and well.

Constantly pouring more and more money into a black hole that demands more and more money, using a very basic form of emotional blackmail to get it, yet fails to show that the money is being well managed and we are getting good value for our money, is almost a guarantee of inefficiency.

My extensive experience of the NHS in recent years doesn’t lead me to believe we aren’t getting value for money, or surrounded by inefficiency

I wish fervently that we had it here. We have a version of it but nothing like as good. You’re lucky.

We are indeed nanna8.
I was waiting at our specialist cancer hospital, for my husband who was having thousands of pounds worth of treatment to try and prolong his life.
A man next to me started moaning because there’d been an hours delay in his wife’s treatment. I reminded him that would be down to another patient reacting dangerously to their treatment so everything stops till the patient is stabilised. He continued to moan and grumble.
He believed the tax and insurance he’d paid entitled him to have his every need met instantly. It was clear he’d no idea of the financial cost of every infusion treatment. His wife, like my husband had extensive stage 4 metastasised cancer. The infusions were part of a palliative care package.
We need to value and fight for our nhs. Of course it needs constant review and oversight, like any other huge organisation.

Doodledog

I don't care what it's called, really. The point is that most of us pay in at the rate that is set by the government of the day, yet when they don't deliver the service they have taken our money to fund, they say that we can't afford it. It is the government who should ensure that we do pay enough, however they go about that. An increase in income tax, a 'poll tax' system where everyone between 18 and state retirement age pays in whether they earn or not, a death tax, a wealth tax on unearned income, ring-fencing the sugar tax and taxes on alcohol and tobacco - all those things and others should be on the table for discussion.

It's rather like road tax, it all goes into a pot and very little of it goes into repairing our dreadful roads.

Yes, I know none of our tax goes into paying for services ...........
In which case, why not just call it a loan repayment?
And stop sending us those nice pie charts?

M0nica

I think the NHS should first get its act in order and give us some evidence that the money is being used effectively and well.

Constantly pouring more and more money into a black hole that demands more and more money, using a very basic form of emotional blackmail to get it, yet fails to show that the money is being well managed and we are getting good value for our money, is almost a guarantee of inefficiency.

MOnica, you keep reverting to this assertion.

Do you have any clear, incontrovertible, researched based, evidence (no anecdotes please) that 'our' money isn't being used effectively in the NHS?

Which bit of 'our money' is disappearing into a black hole, never to be seen again? Good God, even some of the £millions Michelle Mone scammed for useless PPE during the crisis phase of the covid pandemic was seen again in the form of a lovely sailing yacht...

And stop sending us those nice pie charts?

You're right, Callistemon. We don't need those silly pie charts, we need a Sankey Diagram.

Money circulates, it doesn't stop in its portion of 'pie'. Or disappear down a black hole.

gimms.org.uk/2022/11/26/spending-chains-sankey-diagrams/

(If the full text doesn't open on this page click on 'Read more' )

Maizie Where is the evidence that the NHS is being run efficiently and well. This is the [problem we do not know because no one is looking at it.

Any company that has been running for 75 years would more than once in that period had major upheavals when it looked at its organisation, and how it is run and emasured its efficiency and effectiveness. When has the NHS done this?

Frequently

Iam64

My extensive experience of the NHS in recent years doesn’t lead me to believe we aren’t getting value for money, or surrounded by inefficiency

My recent experience hasn't been great. The staff I have seen have all been caring and skilled, but there has been little communication between departments (specifically between the GP and hospital, and between different consultants), and systems such as getting bloods and other tests ready before clinic appointments, and having to have different appointments on different days to get blood taken and sent to (presumably) the same lab for analysis and then the results to different people have been inefficient. More than once I have had an appointment with a consultant who has had to call me back after seeing the results of tests that were run too recently to be ready in time. I also get letters, texts and emails repeating the same information, which also appears on the NHS app and is followed up by telephone reminders.

I realise that I am lucky to be seen at all as others are on very long waiting lists, and that the numerous tests I've had have all been free when I've needed them, but I can't pretend that the system is efficient. I can get lifts to appointments and don't need to take time off work to go, but for many of those who work full-time it would be costly in transport and missed working days.