NHS in a capitalist economy...

resilie

lostinrates wrote: »

The a and e and other basic equipment point is absolutely right. If it were not so I would be going exclusively private for the sort of thing I am having.

Low level /elective point has not been my experience...certainly not in the initial stages of my treatment ten years ago. In fact, far from it. I accept this is not the mainstream of uk private medical provision... Out in the 'provinces' I am finding it is less so, regretfully. The treatment I had back then was on a different level though.

I will be having one procedure nhs in a couple of weeks that I really wish was available privately, its not complicated (lumbar puncture) and a second investigative procedure, certainly not by choice to have it, will be done privately.


Lack of availability doesn't mean 'not better' it means non existent or not available for comparison.


I am genuinely sorry you have found the reading here depressing, I think we probably all do. Tbh though, many people's experiences of health provision are pretty depressing. My nhs experiences have driven me away from seeking help and find my trying to manage a complex health situation pretty much alone in frustration and 'fear' and dread. The difference in experience private to nhs IS often very real, sadly.

To put your mind at ease a lumbar puncture is a 10minute job and the experience you'll have soley depends on the technical ability of the doctor doing it. As its nearly June it should be ok (juniors swap over in august so at the moment they should be at their peak ;-)

The NHS was founded to keep the nation healthy anf alive- it was never meant to be anything but a budget health care option. We are also extremly good at delivering value for money- if you look at life expectancy and GDP outlay the UK outperforms alll other western countries ( we spend roughly 6.5%, most european countries spend between 10-12% and the US spend 14-16% of GDP)
Once basic care provision is reached you don't add a lot more in terms of life expectancy etc by piling in the pounds..... At work we always moan that People want a waitrose service for aldi prices.....
Privatising the NHS woukd make the overall health care bill much higher, most likely lead to a two tier system for rich and poor and would overall not improve outcomes (they might even get worse as access for the most needy could be limited)

The NHS has many flaws but it's still the best system that I know

lostinrates

resilie wrote: »

To put your mind at ease a lumbar puncture is a 10minute job and the experience you'll have soley depends on the technical ability of the doctor doing it. As its nearly June it should be ok (juniors swap over in august so at the moment they should be at their peak ;-)

The NHS was founded to keep the nation healthy anf alive- it was never meant to be anything but a budget health care option. We are also extremly good at delivering value for money- if you look at life expectancy and GDP outlay the UK outperforms alll other western countries ( we spend roughly 6.5%, most european countries spend between 10-12% and the US spend 14-16% of GDP)
Once basic care provision is reached you don't add a lot more in terms of life expectancy etc by piling in the pounds..... At work we always moan that People want a waitrose service for aldi prices.....
Privatising the NHS woukd make the overall health care bill much higher, most likely lead to a two tier system for rich and poor and would overall not improve outcomes (they might even get worse as access for the most needy could be limited)

The NHS has many flaws but it's still the best system that I know

I have been seen under lots of different healthcare systems, But most extensively here in uk. I'd defend the nhs value (especially if some changes were made) to society. But I wouldn't argue its the best treatment available. I think the latter is fine, so long as we are honest about the purpose of the nhs.

Thanks for the reassurance. June is a good time.....part of the reason last autumn didn't appeal much!:D. But I am doing as much as I can to aid the experience I get. E.g. I have a side effect that impacts on muscles, so I am taking diazepam that day. Hate that stuff, but soft muscles seem to sit better as an idea than rigid nervous ones!

resilie

lostinrates wrote: »

I have been seen under lots of different healthcare systems, But most extensively here in uk. I'd defend the nhs value (especially if some changes were made) to society. But I wouldn't argue its the best treatment available. I think the latter is fine, so long as we are honest about the purpose of the nhs.

Thanks for the reassurance. June is a good time.....part of the reason last autumn didn't appeal much!:D. But I am doing as much as I can to aid the experience I get. E.g. I have a side effect that impacts on muscles, so I am taking diazepam that day. Hate that stuff, but soft muscles seem to sit better as an idea than rigid nervous ones!

I think you are right that it's not necessarily the best treatment- but it's best value for money!!!

Diazepam helps with nearly anything!
Best thing is to just relax- makes it much easier... if you get a post LP headache have something with caffeine in it- the only thing that really works. Coke is best...
( a long time ago I was the LP queen you see )

lostinrates

resilie wrote: »

I think you are right that it's not necessarily the best treatment- but it's best value for money!!!

Diazepam helps with nearly anything!
Best thing is to just relax- makes it much easier... if you get a post LP headache have something with caffeine in it- the only thing that really works. Coke is best...
( a long time ago I was the LP queen you see )

I cannot drink anything carbonated (drug side effects) and am off coffee, but have a medicinal coffee planned. But, would a pro plus pill work? Hmm, thinking about it I could make some cola flat in advance....

As for best value for money, I am not in a position to know, but would not argue against that, especially with the caveat of not the best treatment. At what IMO its MeANT to do the nhs is formidable force for good. That said, the times where we have sat and commented on where savings could be made are staggering and must add up to considerable savings to be ploughed back into better employment conditions or more resource for service provision.

resilie

lostinrates wrote: »

I cannot drink anything carbonated (drug side effects) and am off coffee, but have a medicinal coffee planned. But, would a pro plus pill work? Hmm, thinking about it I could make some cola flat in advance....

As for best value for money, I am not in a position to know, but would not argue against that, especially with the caveat of not the best treatment. At what IMO its MeANT to do the nhs is formidable force for good. That said, the times where we have sat and commented on where savings could be made are staggering and must add up to considerable savings to be ploughed back into better employment conditions or more resource for service provision.

Go with flat coke...
The NHS is a beast and there are huge opportunities to improve, streamline and make it more efficient..... completely agree with this.... but we must also recognise that it has done an enormous amount of good and private doesn't always mean better value or service (I'm thinking G4S during the olympics) running the whole health service privately (warts and all- by that I mean emergencies, acute medical admissions, not just cherry picked outpatient appointments and elective surgery) would almost certainly be more expensive than it is now or lead to worse service (case in point privately run out of hours GP services- massively expensive and really not working very well)

lostinrates

resilie wrote: »

Go with flat coke...
The NHS is a beast and there are huge opportunities to improve, streamline and make it more efficient..... completely agree with this.... but we must also recognise that it has done an enormous amount of good and private doesn't always mean better value or service (I'm thinking G4S during the olympics) running the whole health service privately (warts and all- by that I mean emergencies, acute medical admissions, not just cherry picked outpatient appointments and elective surgery) would almost certainly be more expensive than it is now or lead to worse service (case in point privately run out of hours GP services- massively expensive and really not working very well)

That is again, flat coke it is.


My best experience of nhs in recent years IS a privately run NHS treatment and minor ops centre. My mother had two knee replacements there and the care was absolutely fantastic. As good as most private and better than some. The surgeon was both proficient and compassionate. They seem to manage well on the budget. People's complaints about the unit locally are ideological rather than practical, in fact, people are making a point of choosing over nhs proper comparisons.


Out of hours situation is separate again. Our GP is open only one Saturday morning clinic a month at a satellite, and not at all at the main place (which is newly overhauled and fantastic building). A commercial enterprise without the back up of a system should realise this would yield low customer satisfaction with working patients.

resilie

lostinrates wrote: »

That is again, flat coke it is.


My best experience of nhs in recent years IS a privately run NHS treatment and minor ops centre. My mother had two knee replacements there and the care was absolutely fantastic. As good as most private and better than some. The surgeon was both proficient and compassionate. They seem to manage well on the budget. People's complaints about the unit locally are ideological rather than practical, in fact, people are making a point of choosing over nhs proper comparisons.


Out of hours situation is separate again. Our GP is open only one Saturday morning clinic a month at a satellite, and not at all at the main place (which is newly overhauled and fantastic building). A commercial enterprise without the back up of a system should realise this would yield low customer satisfaction with working patients.

As you probably know GP surgeries are privately run businesses contracted by the NHS. However the way renumeration works does not really take customer satisfaction into account. Over the last 25 years there has been a lot of talk of re-naming patients as customers- something I have always refused to do. I think health care is different to other industries asnin the age old rule of "the customer is always right" and should always get what they want just isn't applicable or fundable. When a surgeon says know to doing an op as the patient is too frail and woukd likely die on the table but pt insists for example. The pt might not be satisfied but that doesn't make it the wrong decision....

grizzly1911

resilie wrote: »

I think health care is different to other industries asnin the age old rule of "the customer is always right" and should always get what they want just isn't applicable or fundable. When a surgeon says know to doing an op as the patient is too frail and woukd likely die on the table but pt insists for example. The pt might not be satisfied but that doesn't make it the wrong decision....

Thanks for the insight.

I agree.

In some cases treatment simply will not actually achieve much difference in outcome. In the case of surgery it could make things worse or give rise to other issues. Particularly things like lower back problems that come from degeneration.

In some cases the remedy is in the patients own remit but they will not help themselves. My MIL has benefited from actually walking and taking exercise after succumbing to back and leg pain previously where medication had no real effect.

I do think we live in a society where all demands are expected to be delivered instantaneously - not just healthcare but many services and products. By actually handing over our own money we think this gives us the power to demand it even when it isn't actually possible to deliver on the demand.

resilie

grizzly1911 wrote: »

I do think we live in a society where all demands are expected to be delivered instantaneously - not just healthcare but many services and products. By actually handing over our own money we think this gives us the power to demand it even when it isn't actually possible to deliver on the demand.

Thanks grizzly. Wise words indeed...

lostinrates

It's possible to both be a patient and a customer. But I feel the name change would place the emphasis wrongly too.


A patient (or customer) can be neither right nor wrong if they do not get to a doctor because while the problem is small the pressure not to take time off work is not prioritised. Of course their is patient responsibility, but those same working patients often feel workplace or family responsibility too.

I happen to like out of ours doctors more than my own GPs be a use I am odd like that, but when not too busy they give a fresh vantage and insight and often give me good questions for my consultants. If I had a more continuous relationship with a gp I am sure I would feel differently.

I am also a big fan of telephone appts. For managing existing conditions or those with no visible symptoms they are really, really useful.