The NHS disaster

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Okay, so the NHS is supposed to be free-at-the point of entry. I like this notion. For a socioecomically deprived individual, this is great!

What is not great is being told that you cannot see a psychiatrist because you are not suicidal enough and then end up paying for private care. True story.

Share yours!

To pay, or not to pay, to pay, or not to pay.

Ah, f**k it. I'll carry on with this knife I got in my hand - this girl ain't got no other option.

https://www.thesun.co.uk/news/7119305/gp-apologises-suicidal-teen-carry-on-cutting-no-help-under-18/

no institution is perfect, if you want to find fault you easily can but if you want to find good I'm pretty sure in the case of the NHS it will far outweigh the bad by many multiples

your stories here!

I agree that the good of the NHS outweighs the bad. The idea that criticising parts of the NHS is tantamount to being anti-NHS, is the reason why improvements cannot effectively be made, to the NHS.

If no-one challenges what is wrong with the state of things in the NHS, then nothing can improve, in a nutshell.

I think the biggest problem with the NHS is underfunding. They just don't have the resources for anything that's not deemed important. It's much the same with the police these days. The gov is about to put more into the NHS, but it'll be funded by a tax that's not as progressive as it might be, so it'll be another financial burden on struggling households. Food prices are going up, energy prices are set to double. And healthcare isn't exactly free. First, like I said, it's rationed. Second, working people have to pay for prescriptions. Third, they've closed the small, local hospitals so now you've often got miles to travel, and when you get there they charge you for parking. And the pay for ordinary NHS workers is pretty low, and the hours are long. Waiting times can be ridiculous, both waiting for appointments and then waiting for them to actually deal with you when you get there. The pandemic has burned out a lot of the staff. Then there's the problem of government gradually privatising the service.

I remember when it was a much better service back in the 1960s, and once you're used to that, looking at the apology for a service you get now is heartbreaking.

Still, it's a lot better than the American healthcare system where the insurance premiums are so steep that you can only get decent cover if you've got an employer who pays it for you. So if you lose your job, there goes your healthcare too. And the forms and decisions about which plan to buy are a nightmare. They might for example limit cover to a certain number of days in hospital, after that you're paying around $1000 a day, but if you can discharge yourself for a couple of days and then go back, you might be able to reset the clock. Great dilemma for somebody who's ill. You get tons of letters from the insurance company about bureaucratic stuff that should be their problem not yours. There's this crazy thing going on where you can be prescribed medication and then when you get to the pharmacy they tell you the insurance company hasn't okayed it. I don't know how ordinary Americans stand it. Twice as expensive and half as effective as the UK. And although you're paying for it, they still treat you like they're doing you a favour a lot of the time. Whatever happened to the principle of the customer being always right?

So the NHS leaves a lot to be desired, but I wouldn't swap it for a private deal. End of rant.

^ The American health insurance model also features things called 'deductibles' and 'co-payments', which essentially means that you still have to pay towards your medications even though you're fully 'covered'. Supporters of a private insurance based health system over here talk a lot about 'top up' payments - I wonder if that's something similar to what I described in the first sentence?

Yes, there are a number of words for what I just call watered-down health insurance benefits. As far as I'm concerned, healthcare is too important to allow it to depend on the individual's ability to pay or to understand complex bureaucracy.

It isn't a problem of underfunding in my opinion - but one of utilising existing resources & organisational structure. You can keep throwing money at a thing, or you can change how a thing works. That goes for anything, including organisations.

The NHS has already been improved a lot over the past decade, but it'll probably take another couple of decades to fix - even if nothing else goes wrong.

It used to be incredibly wasteful. I remember a time when you could get paracetamol on the NHS which cost about 20 times on the NHS what it did from the shop (not a myth, either, all factors considered). You could get creams, lotions and even gluten free bread on the NHS and people were just abusing it like crazy.

As someone who is gluten free and has very little income - I would rather buy gluten free bread from a shop if it costs £3 rather than have the NHS be charged £9 for every loaf.

Capitalism works, it is essential, as a balance on the scales with socialism.

The problem with psychiatric services is that we have no idea how to limit how much a person gets.

In theory every person could have 40 hours of week worth of therapy which would require every other person becoming a psychologist.

If we only get 4 hours of care per week, we need 10% of the population to work those jobs.

Realistically it'd probably closer to 1 hour per week, but that's still radically more than we can support.

There's no DSM that can pinpoint how much is too much and how much is not enough.

My guess is there's far more people needing service than there are people that could give it.

It would be a lot easier to change society to a place where people are not mentally ill, rather than try to manage the fallout from everybody losing their minds in a horrific, nightmare-zone of reality, don't you think?

Encouraging more medical treatment for mentally ill folk without addressing the root causes, is akin to putting a plaster on a shotgun wound.

You can still get paracetamol on prescription. This is generally only given to people who are on long-term paracetamol for chronic pain, who need high volumes of tablets. Even then, most people will find it cheaper to buy their tablets over the counter than pay the prescription fees. People who don’t need to take large volumes are encouraged to buy their own.

You can still get gluten-free bread on prescription. In 2017 they stopped prescribing gluten-free cakes, pastries, and breakfast cereals. However, I’m not sure that there’s evidence people were “abusing it like crazy”.

As for lotions and creams - yes, those are often available on prescription because “lotions and creams” is a very broad category that includes large amounts of medicine. It’s one step away from complaining that “pills and tablets” are available on prescription.

Paracetamol = Tylenol, by the way.

It depends on what NHS CCG a person is under, based on their geographical location.

40% of NHS CCG's in England do not prescribe gluten free products at all.

I have looked at the statistics on this matter a long time ago & yes, the system was being abused and that is why the criteria for eligbility was tightened and in some places, provision of services has been cancelled altogether for gluten free products on the NHS.

I don't think it is a step away from making people pay for pills - they are completely different categories. Pills are necessary for many people, crucial to economic productivity, even.

A tube of dermatitis cream might be essential for a persons self esteem to go to work, in the instance of skin problems, but when it can be bought for a couple of £'s, it is a difficult argument to make that the NHS needs to pay for it, with their cumbersome purchasing systems.

https://www.coeliac.org.uk/information-and-support/coeliac-disease/once-diagnosed/prescriptions/

Also, no doctor in their right mind would prescribe paracetamol on the NHS, as it affects their job performance stats (being wasteful is a negative).

One solution to the problem of a drug costing the patient more as a prescription than it does from a supermarket would be to go back to free prescriptions for all. If the NHS is paying over the odds for paracetamol, I don't understand why. Normally their bargaining power with the drug firms is relatively good because they're a big customer. I don't know of any per se reason why free prescriptions would lead to overprescribing. If making something free of charge increases the demand for it, a doctor can always say no if they're not convinced the patient needs what they're demanding. Trying to price the demand out of existence isn't a very good way of fixing the supposed problem, because it doesn't take into account the actual need for the drug or the patient's ability to pay. I'd much rather people didn't have to worry about cost of treatment when they were ill.

Because there's 30 different ways to make an anti epilepsy drug.

And if the government will pay for anything, pharmies will just start making up new drugs for the hell of it.