I was in England again this week. And yes, I was back in an emergency department, but this time with my cousin (who is English).
This is what happened.
My cousin loves high heels. As a former model she makes walking in the highest of heels look easy. However, cobblestone streets have challenges not found on catwalks and so she twisted her ankle very badly. Despite ice and elevation there was significant swelling and bruising and she couldn’t put any weight on her foot. I suggested we call her doctor and explain the situation. I was worried about a fracture. I hoped to arrange an x-ray. If it was broken we would arrange the needed care and if it wasn’t broken I could bandage it just as well at home.
“No,” she said. She’d have to ring for an appointment. It was Friday around 11 a.m. The chance of getting into her GP by the end of the day was apparently non-existent. She would have to wait until Monday. Even is she were lucky enough to be seen that day there was no x-ray in his office so it would be a trip to see him and then a trip to the hospital. She was shocked when I suggested she call and just ask if he could order the x-ray. Apparently, that’s not how it’s done. In person or nothing.
As a gynecologist I will admit feet are not my strong suit, but no medical degree was needed to say she needed an x-ray. She also has some health issues that could impact healing from a break or the timing of surgery (hopefully that wouldn’t be needed, but you never know), so a timely diagnosis was more important for her than it would be in the situation were reversed and it was my ankle.
“We’re going to the emergency department I said,” and off we went to Sunderland Hospital.
Getting to the actual emergency room (ER) from the parking area required a background in orienteering. There was loads of
construction and we had to go down hallway after hallway with Hogwarts’ worthy twists and turns. I managed to find a wheelchair, a unwieldily apparatus that only works in reverse. On purpose. This is to stop wheelchair theft, which is apparently a serious problem at Sunderland Hospital.
My cousin was triaged immediately. Within two minutes a nurse checked her ankle, gave her codeine, and then sent her off to an urgent care clinic. She wasn’t even registered in the ER. A porter wheeled her to the urgent care clinic in another building some distance away, which required a trip outside.
“What if it rains?” I asked the porter.
“We get wet. This is the North,” he said. “Of course it rains. Almost every day.”
Apparently no one complains.
The urgent care clinic had a few people ahead of us. It took about 10 minutes to check in and then no more than 15 minutes to be seen. A lovely nurse named Leslie triaged my cousin and agreed an x-ray was in order and made the arrangements. My cousin did not need to see a doctor or a nurse practitioner to get an x-ray. I’m not sure I’ve ever seen that happen in the U.S.
The x-ray and radiology report took 10 minutes. Then a nurse practitioner (also very nice) did an appropriate history and exam. The diagnosis was a torn ligament (sprain) and possibly a small fracture of the lateral malleolus (outside ankle bone). A orthopedics consult was needed. She could have a bit of a wait and be squeezed into fracture clinic that afternoon or she could have a cast and come back to Saturday fracture clinic. The clinic didn’t start until 2 p.m. and we were done in urgent care by 1 p.m. so she opted to wait. She was seen around 2:15 pm. An orthopedic consultant did an exam and recommended a tight support bandage and gave her exercises and guidelines about how to follow-up if she wasn’t meeting milestones.
My cousin was at the hospital for four hours, but over an hour was an unavoidable wait for fracture clinic and about 30 minutes of transport back and forth between the ER, urgent care, and fracture clinic. To receive this care all my cousin had to do was provide her name and birthdate. No copayments, no preauthorizations, no concerns about the radiologist or orthopedic surgeon being out of network. The nursing triage was wonderful and actually doing nursing (I hate seeing nurses relegated to charting). The nurse practitioner clearly knew what she was talking about and had reviewed the films with the radiologist. The surgeon only did the part of my cousin’s care that needed a specialist. It was a great use of resources.
Everyone I spoke with at the hospital loved the NHS, and honestly it showed. While the hospital was a veritable maze and in need of the updating that they appeared to be doing, the equipment was all fine and the people, i.e. the things that really matter, were great. Everyone from the porter to the orthopedic consultant was hard-working, knowledgeable, and friendly. What more could you ask for? I asked a few people what they would like to see changed? The only real issue was people who show up for care that is clearly not even semi urgent never mind emergent. Might a tiny user fee change that? Did we have user fees in the U.S.? Did they work?
Non-emergent care provided in the ER is obviously not the best use of health care funds, but in reality it’s a tiny drop in the health care bucket. Extra emergency room doctors and nurses and the not needed CT scans and other testing that may be generated are nothing in comparison to things like chemotherapy, or HIV medications, or bone marrow transplants. We do have user fees in the U.S. in the form of copayments. Even low copayments can cause some people to delay necessary care. They also don’t seem to deter people who don’t need the emergency room but want to go. I’ve sat in the ER with Oliver waiting for a bed while he struggled with pneumonia and overheard many examples. A man bragging that he tells the ER staff he has chest pain so he gets seen first. He was happy to pay his $100 copayment to be seen promptly at his convenience. He had nothing even remotely urgent. I’ve listened to a mother who waited hours for a diaper rash. Not a bleeding diaper rash, just a rash. Her physician had a free 24/7 pediatrics advice nurse that went unused (we had the same pediatrician, so I knew). She could have saved $40 and most of her Saturday, never mind the exposure to Oliver’s influenza, with a phone call. If you want to change ER utilization, and yes it’s a worthy goal even though it’s not the major cost driver, it’s education and outreach that are needed not penalties.
When I think of copayments I think of a 60-year-old woman with breast cancer three years post surgery and chemotherapy now in remission. She developed a cough and a fever so received a chest x-ray to look for pneumonia. The radiologist found something not quite right, a spot that was especially concerning given her breast cancer history. She needed a CT scan to see if this is a bit of scaring or if her cancer has metastasized to her lungs. When I asked her why she hasn’t yet had the CT scan she told me she couldn’t afford her $100 copayment. It will take her two months to save the $100 so she can get the CT scan to find out if her cancer has returned. She looked at me in the eyes for just a moment and then a mixture of embarrassment and fear that my eyes might tell her what she doesn’t want to know caused her to look away. And what if her CT scan is equivocal and she needs $100 (or more) for the copayment for a lung biopsy? If that’s not a circle of Hell I don’t know what it. You want to know what’s worse? I’ve heard a variation of this story more than once.
Dear U.K., the NHS is awesome. Try to treat it a little better. Maybe teach kids in school how to use the health care system (hey, why not NHS ed alongside drivers ed or sex ed?). Have safe sex. Stop smoking. Try to lose weight if you need to (obesity causes 30% of cancers). Wear lower heels for dancing. And for crying out loud stop stealing wheelchairs. The next time anyone mentions privatization or user fees tell them in America there are people trying to save enough money for the copayment for the CT scan that will tell them if their cancer has returned or not.
Thank you NHS for taking fantastic care of my cousin, of my son two years ago, and of everyone else.
To the British government, stop trying to mess it up.
Dr. Jen Gunter 
A [very sad] update on NHS charging: in OCT2017 the UK Conservative government changed the regulations to start charging “overseas visitors” for all non-ED (non-A&E or non-ER) NHS hospital treatment, with even privately insured patients required to pay up front or, in the case of clinician-determined urgent treatment, within 2 months of discharge (far too short to be reimbursed by most US insurance providers). Punishment for non-payment is deportation (“administrative removal”) or being reported to UK Immigration for future visa and entry denial together with engagement of debt collectors, who may or may not have mob connections.
Austerity sucks, conservatism sucks, market fundamentalist capitalism sucks! All must be crushed.
That’s the best comparative description of the two systems I’ve read, despite it opposing my previously held view. Thank you.
I think it’s another post to keep NHS. A lot of people complaining about NHS. It will be shut down anyway. Any of such a stories will not going to help to keep it. NHS is absolutely corrupt organization and should be shut down. Everything is very slow and huge discrimination going inside. It has lack of efficiency. It is just one story from million. You been lucky enough to solve everything fast and media picked your story to promote as good NHS practice, but in reality nothing happens like this. Everyone is very personal. If they will decide that they don’t like you because you are black, gay/not gay/put yours you will not going to receive proper service. If all doctors will be independent and private than they will have to work hard and only those who really deserve will be rewarded. Now rewarded those who have better relationships with management.
IMMIGRANTINBRITAIN ? You may be an immigrant bu I think you may be being paid to write this by the very unsavoury UK Taxpayers Alliance, a very nasty lobby indeed, or by the equally nasty Conservative Party.
Would have been fair if you had included how much specialists make in NHS vs what you earn in the US as a specialist! A large part of our high costs is all the high earning professionals in our system who would not give up their plush life too easily.. and are highly organized (AMA) with well-paid lobbying efforts. Be honest, are you willing to give up your lifestyle to be in a system like the NHS?
Yes, I am aware there are other highly paid professionals as well.. pharma executives, hospital owners and executives, PBM executives.. but you are one of them. Please tell us how US could be more like UK once you have done something to push your own AMA to allow that!
A few weeks ago I had three tonic-clonic seizures in succession, was rushed to an NHS hospital, triaged and apparently seen immediately (awareness is a bit of an issue in such circumstances so I go by what I am told) and had a head CT immediately. I spent 5 days in hospital during which I had a further chest CT, 3 12 lead ECGs, EEG, contrast brain MRI, a liver scan, many blood tests and consultations with a neurology specialist. Having ruled out anything more serious which might have exacerbated my epilepsy of many years I was put on a transition to Keppra from my previous AED. My seizures seem back under control. As usual I paid absolutely nothing beyond my taxes, my prescriptions are free and I am back at work. The question I have for people from the US is how many people there would be fearful of the financial harm of such an adventure, let alone the stress such an intense situation carries already? Yes, many people with less threatening issues wait a few hours in A&E and that night I probably contributed to some of them having to hang around a bit in that hospital as did the people with heart attacks and other life-threatening emergencies but, having worked around the world including the US, I can assure everyone the same is true everywhere.
Oh go eat a bag of dicks.
I’d love to see how awesome you think it is when it takes 20 years of pestering to diagnose you with PCOS. Or when you’re waiting over a YEAR for psychological assessment and that’s before the inevitable waiting list for treatment, which will only be for 6 sessions and if you’re not cured, too fucking bad. Or when every complaint you have is related back to said mental health problems (including what turned out to be fucking tendon damage).
This is why I have a big problem with UHC. They set it up to work reasonably well for the average patient. All too many people aren’t the average patient and the system fails them badly. Not to mention the excessive waits for quality-of-life issues.
Jen, I have read your post a few times since you posted it, just about everything that has been said in your post is true as are many of the statements made by others. My third son Loz married a wonderful girl Lisa from San Francisco, they both lived in the UK and she has citizen status after a few years of marriage they had a wonderful baby called Huck, who has many ailments. The first three years of his life in the U.K. all of his conditions treated by the NHS without question (he has dual nationality)
The pull from Lisa’s family to return to the US was understandably huge and the inevitable has happened and the have moved out in the early part of this year(not enough room here to explain how much we miss them all). However for me the most shocking thing is that this small defenceless child who obviously cannot earn his own money yet needs health insurance – at a cost of some 300 dollars a month plus copayments. This is crazy, we all know you need medical care mostly when you are young and as you approach the end of life.
It will always be impossible to change your health system for reasons which we are all aware, however I consider it my duty as a citizen to protect the imperfect NHS, I pay a lot of tax and i’m happy to do so, I am not a church goer but do believe that you should treat others as you would wish to be treated yourself, simple motor which has taken me a long way in my life.
Thank you for your kind words about our health system, in my mind it is the best in the world; simply because it has always been free at point of use, if we lose that then we are much poorer as a nation.
Love health and happiness
Thank you for the insight on healthcare that is so different than what we have in the U.S. I’m glad its not my decision to determine how care should be delivered. As a nurse I recognize that there are advantages and disadvantages. I am thankful that I have reasonably good health insurance with reasonably low co pays. I am thankful that I have never had to push off treatment due to cost concern. I am thankful that I live near quality hospitals. I am thankful that my family is usually healthy and do not need specialists. Thank you for the hard work that you do for your patients.
Nice article, thank you.
The NHS is not a free service, we all pay for it via NHS contributions. It’s amazing how many people think the NHS is great, ‘considering its free’.
If you stop to think that you’re actually paying for that service, is it still so great?
This article only tells us that they received the right kind of care for their circumstances – I wouldn’t expect anything less!
Myself and my family have experienced some awful care in A&E departments since moving to the North East of England from Scotland. There clearly is a problem with NHS England, I’ve never seen anything like it. On one visit, we waited 10 hours to be seen with our 4 year old and it was a further 2 hours before we left the hospital.
NHS is unfortunately hanging on by just a thread
Pity really !
I’m a med student. This is an ophthalmology series I just started. Feel free to share and follow to stay updated 🙂 https://paulchronicles.wordpress.com/2017/01/09/ophthalmology-series-case-4/
It takes an outsider to make us realise what we have!
There is a system in place that we use called Nhs 111 you call them they triage you over the phone and tell you how you should proceed with care it ranges from take over the counter medicine to them sending out an ambulance. That is the perfect system to avoid wasted trips and resources
Couldn’t agree more, we hear all the bad sides of the NHS but non of the good sides. I got diagnosed with cancer at aged 30 and was treated immediately. I could not fault any one I was in contact with. After reading a simular article as I was in the middle of treatment the thought of going through all of the treatment and then being left with a bill to worry about, (if yoy had no unsurance or the fees to pay,) while trying to recover would have been agony. The only thing I can think of that would be good to be changed is more help for NHS staff aso they work such long hours while doing an amazing job!
My daughter has a mental illness: can you imagine needing treatment for such a condition and having to worry every time a new bill comes through the letter box?
I just wanted to say I loved reading this. And i will be looking at your previous/future posts as well.
Why burden Sunderland ER with a minor injury such as this, there are four Walk in centres around Sunderland where she could have received the exact same care. Why not educate yourself before lecturing British people how to appreciate our NHS, we already know dude.
Yes people like most of us here who are earning pays taxes and NI contributions. However, people who are unemployed never paid taxes and contributed to the NI still receives treatment from the NHS for free. Unlike in America, those who have no medical insurance won’t get the treatment they needed.
All my children grew up under the care of orthodontics through NHS. Dental braces were fitted on them and i never paid anything. My wife goes on dialysis 3x a week she is being picked up by ambulance at home and returned on ambulance every session again I paid nothing. My daughter has special needs but I never paid anything for the medical investigations done on her. Her educational needs are provided for free by the government. She gets school transport for free also. That is why my family and I are very grateful to our NHS and to our Government. For me, NHS is perfect healthcare. We love NHS!!
So you love the NHS because the UK government made.someone else pay for your expensive family needs. Well yes, there are always some “winners” who are net beneficiaries of the subsidies. By definition though most are not like that. They pay more than they receive in service.
Frank it’s medical needs of my family not our personal needs. Regardless of the economic status and race of the patient the NHS treat patients accordingly and equally. FYI, my wife and I works for the NHS. We pay taxes and contributes to the NI but we never complain about NHS treating patient who never paid taxes and contributed to the NI. All I say is we love NHS because it is perfect!!
@Mike, “my wife and I works for the NHS […] it is perfect”
Please forgive me for taking your assessment with boulder of salt or two then.
Our NHS isn’t free as we pay for it in our wages that’s what our national insurence is.. so it may seem free to people who live abroad but it’s not. Each country has differnt ways of paying for their hospitals. Our government are cutting back on this service which is wrong as we still pay never the less its as important as education.
I’m proud of our NHS. It is the best in the world. People complain about it because they have never experienced other countries health care systems. Where else in the world can you be seen for just about any ailment in a single day. Then treat accordingly no matter what the cost and for free! Some of us here in the UK are complacent about the health care we receive. Often these are the ones that abuse it and take it for granted.
I live up the road from sunderland in newcastle. Here we have the RVI. One the the best hospitals in the world. Alone with the research labs, Newcastle is pioneering some of the most significant medical advancements in history. Recent cures for some cancers and also the most important developmemt in the cure for HIV to name a few. Im certainly proud and thankful for what we have in the UK. Thank you for a great post. A superb reminder of how luck we are here. And next time you are over, come to Newcastle. Far better than Sunderland lol
Love & Peace xx
My experience with the NHS has been quite extreme: In 2 occasions I went to see my GP for severe pain in the abdomen and colic episodes, he said he had no idea what was going on, that it was probably something from “digestion issues” to “bowl cancer” (I’m quoting) and sent me back home with painkillers until new tests could be arranged (never happened). The colics kept on happening, the days the pain was too much to handle my flatmates had to call an ambulance (twice), which never came, so, covered in sweat and feverish I had to crawl to Whitechapel hospital feeling like dying, to wait in a room with dry blood stains on the walls. After waiting for my turn I got my belly explored, no doctor asked me any question regarding my health, no X-Ray, no CAT scan, no ecography, nothing at all. Just painkillers and a “good luck”, this while routine happened twice. Something was going terribly wrong, the pain of these episodes were rising dramatically, so I had to do something. The day I had enough I filled a suitcase, told my boss I was out, called the landlord to say my goodbyes and took a flight to Madrid, Spain (my hometown) where I was rushed to ER, diagnosed Gangrenose chronic appendicits through a CAT scan in just a couple hours, went through surgery on the spot (4 hours cleaning the mess), got a good 15 cm of my intestine removed, got a remarkable amount of stitches in my body, spent 14 days at the Ramón y Cajal Hospital recovering, lost 9 kg (I’m pretty skinny by nature) and saved my life, because I was very close to sepsis according to chief surgeon. So, my thoughts on NHS? It doesn’t treat immigrants or lower classes as well as natives or the wealthy ones, and I’d rather have a Spanish butcher than an English doctor to treat me (I mean…come on, appendicitis…a VET could see that coming!), which is surprising considering Spain is a way poorer country than the U.K.
I considered suing the NHS, but I felt sorry for them. I hope someday the Government will take it seriously so everybody in the UK could benefit from a real health care system, whatever class, race, age or economic situation they live through
My experience with the NHS has been quite extreme: In 2 occasions I went to see my GP for severe pain in the abdomen and colic episodes, he said he had no idea what was going on, that it was probably something from “digestion issues” to “bowl cancer” (I’m quoting) and sent me back home with painkillers until new tests could be arranged (never happened). The colics kept on happening, the days the pain was too much to handle my flatmates had to call an ambulance (twice), which never came, so, covered in sweat and feverish I had to crawl to Whitechapel hospital feeling like dying, to wait in a room with dry blood stains on the walls. After waiting for my turn I got my belly explored, no doctor asked me any question regarding my health, no X-Ray, no CAT scan, no ecography, nothing at all. Just painkillers and a “good luck”, this while routine happened twice. Something was going terribly wrong, the pain of these episodes were rising dramatically, so I had to do something. The day I had enough I filled a suitcase, told my boss I was out, called the landlord to say my goodbyes and took a flight to Madrid, Spain (my hometown) where I was rushed to ER, diagnosed Gangrenose chronic appendicits through a CAT scan in just a couple hours, went through surgery on the spot (4 hours cleaning the mess), got a good 15 cm of my intestine removed, got a remarkable amount of stitches in my body, spent 14 days at the Ramón y Cajal Hospital recovering, lost 9 kg (I’m pretty skinny by nature) and saved my life, because I was very close to sepsis according to chief surgeon. So, my thoughts on NHS? It doesn’t treat immigrants or lower classes as well as natives or the wealthy ones, and I’d rather have a Spanish butcher than an English doctor to treat me (I mean…come on, appendicitis…a VET could see that coming!), which is surprising considering Spain is a way poorer country than the U.K.
I considered suing the NHS, but I felt sorry for them. I hope someday the Government will take it seriously so everybody in the UK could benefit from a real health care system, whatever class, race, age or economic situation they live through.
I personally love the NHS but it is under staffed and underpaid. They draft a lot of foreign nurses in from places like Spain and the Phillippeanes because we do not have enough nurses in the U.K.
GP surgeries in my opinion are not open long enough hours for patients to try and get to them and they also have appointment waiting lists as long as a month into the future as well as only being available Monday to Friday.
Despite these GP surgeries being over subscribed and causing issues that lead patients to attend the ER for non emergency issues we also have a free helpline for people to call if they cannot get to see the GP but are sensible enough to not crowd the ER. This is called NHS 111 and they will ask you a series of questions about your general health and then some more specialist questions about the problem you are calling about. If it appears that you need to be seen urgently they will arrange for a local on call doctor to call you back and they usually then offer you to come down to the local hospital or specialist emergency clinic that are available on some parts of the country.
There should be no excuse for people wasting the time of the doctors and nurses in the ER when we have had these options put in place for many years now.
Reblogged this on Declaration Of Opinion .
Re: your experience in A&E in London.
TRUMPet. This is not most folks experience of the NHS. Your cousin was given pain relief, triaged and diagnosed within…..what? 15 minutes?
Ahah ahahaha. Hilarious. What “other medical condition” did you tell them a fracture would would have impact on? Just so I can use it in future. Only after sitting in A&E more than 4 hours.
Our NHS is wonderful but cut out the BS when you’re telling your “story” NEVER in the history of the NHS has this happened unless critical incident or someone telling lies.
I used to be a consultant ‘in administrative charge’ of an A&E Dept.
What Dr Jen describes was entirely normal; and what she says did happen in the NHS.
Don’t wear high heels. …… that’s not what the NHS is for
My wife suffers from kidney reflux and on dialysis since October 2016. Soon she will be on home dialysis using the newest technology on dialysis, the NXstage portable hemodialysis dialysis. Next week both of us will go on training for a week on how to use the NXstage portable hemodialysis machine. Hopefully next month my wife will be using the NXstage machine independently at home. Thank you NHS for free healthcare! (btw, NXstage machine is new to the NHS so not all hospitals in the UK are using it at the minute)
Nhs isnt free…have you forgotton we pay this in our national insurance contributions…
I’ve posted before but just wanted to mention what happened today and tell you how it shocked me. The NHS finally gave me Hsrvoni which cured my hep c. Today was my day for a final blood test that will certify me as cured. I have been repeatedly assured I do not hsve cirrhosis. Today a student was sitting in so my results were pulled up to explain stuff to her. In the midst of showing why I was not cirrhotic the hepatology team person suddenly announced I’d been misdiagnosed and that I WAS cirrhotic and must be monitored for evermore!
There was no real explanation, just numbers and so on which a layman like myself cannot understand, and little sympathy for how shocked I was. I’m baffled because the person who did my last ultrasound elastography only months ago said there was no cirrhosis just fibrosis.
I’m extremely worried and disappointed as presumably if the student hadn’t been present my tests wouldn’t have been examined again and I’d have been discharged and none the wiser.
http://www.newstatesman.com/politics/2014/10/hunger-filth-fear-and-death-remembering-life-nhs
UK health care spend per capita is on the low end for western countries, and is less than half of what the US spends.
http://www.pgpf.org/chart-archive/0006_health-care-oecd.
https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita
For me, a large part of the problem has been the enormous increase in the number of managers & administrative personnel, at the expense of front line clinicians, doctors & nursing staff. This is to be expected due to the disastrous PPI adventure under Blair, and the continued outsourcing of NHS functions to for-profit companies under the Tories.
The real funding is 4.5 billion Chris spread over 2016/2017.
No it’s 110 billion a year. The NHS has never had so much money or staff or staff pay. Seriously, I have to believe it would be better run if it was run by McDonald’s. The decision to stop Services is a local one and mostly underpinned by the decisions of local staff. The only thing I do have an issue with the government on is devolved trusts, clearly you get no economies of scale – the most basic silly example of NHS waste is the local branding, as I put it, I don’t pay money to Poxy Lawn medical centre, I pay it to the NHS, now run it like a company, that way you wouldn’t waste money on branding for something that clearly doesn’t need branding and stop wasting millions on the design and print of local branding.
The NHS has its good points and its bad points as anyone living in the UK will tell you. One of the biggest problems the NHS has is a lack of funding for people with mental health and crisis care in places like A&E is failing more and more, which often results in people taking their own life because they cannot get the help (despite asking) what they need.
Mental health wards are getting shut because of a lack of funding, Crisis phone lines closing down and the removal of home based support for people with diagnosed mental health conditions.
I’ve had both good experiences and bad. Bad being sent home aged 13 with a broken leg, because there was a lack of swelling after a fall on my way to school there was no need for an x-ray, despite the fact I couldn’t put weight on it. 4 days later and having hardly moved off the sofa I was taken back to A&E, where an x-ray was performed and I was told I had broken my Tibia, and a plaster cast was put on.
Good experiences, I’ve seen my mum who died from renal failure be treated with respect and dignity in hospital, especially A&E, but I also watched her die in pain because of staff shortages after 4 months on a renal ward when she developed the rare complication calciphylaxis.
I’ve personally been so desperate for mental health support I have opted to go private to The Priory, because the NHS has let me down again and again.
If you can try and watch the London Ambulance Service documentary which started last week, it can be found on BBC iPlayer, it will give you an insight into how pushed our NHS is.
And this is down to DELIBERATE lack of funding on behalf of Jeremy Hunt, Health Minister and the Conservative government backing it. They and opposition MP’s have interest in American pharmaceutical co. An arm of Pfizer just got fined £84,000 for grossly overcharging the NHS for epilepsy tablets by 2006% yes 2006% !! thats how lucrative the americans see us! !
I waited years for hep c treatment (thankfully now had it and cured) because rationed due to big pharma charging £858 per pill for Harvoni, and it required 56 pills to cure me.Nearly £900 a day for two months. Obscene. I know development costs a lot but that is an unjustified gouge.
Jeremy Hunt was the author of a book, published about 10 years ago in which he advocated privatisation of the NHS. No surprise as to what he and the government are now doing—cuts to a level that make things unsustainable, then bingo! the case for privatisation is made.
And it wasn’t 2006%, it was 2600%.
Can you please explain why 110 billion pounds is underfunding ? I think waste is the issue and that is driven by poor management and that is at a local level.
You fix waste by cutting waste. if you try to fix it by cutting funding you almost always cut meat rather than fat.
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What has this to do with Dr Jen’s experience of our NHS?
It’s SPAM, so just ignore.
I live in the USA and I’m a Britt let’s compare eggs with eggs here … NHS is free healthcare for all USA health care is for those with insurance or money
– how I long for the NHS it is so simple and if I want speed I use my UK medical care
In the USA insurance / cost of medication – form after form after form -and drugs for everything ( I’m not even sure I need)! private healthcare in the UK is fantastic as was that in Singapore
Care wise has been pretty equal
Agreed and, even with insurance, you sometimes have to make medical decisions based purely on finances. Should you get the CAT scan or pay the mortgage? It should be drummed in to the heads of the Brits that a major cause of personal bankruptcy in the US is medical debt.
It is so lovely to hear someone praise our hospital service. Thankyou! We are extremely privileged to have the NHS in this country. It saddens and frightens me with what is happening to it. Without it I dread to think what would have happened with my premature twins. I have experienced first hand a hospital in Mali, West Africa and for all the complaints we may have against the NHS experiencing something like that truly makes you appreciate what we have. Unfortunately our NHS is under threat and this is seen throughout the country with cuts everywhere including my local hospital the Horton General where they wish to downsize the maternity unit to a midwife led only, with no consultants or theatre staff, and thus also losing the scubu dept. There are contingency plans for other cuts to the other acute services in a town who’s population is growing vastly. If by any means people could help support us and raise awareness of this it would be greatly appreciated. http://www.keepthehortongeneral.org (please delete if not allowed).It makes me very frightened for the future that we may have a private healthcare system such as the US. Hearing stories such as that of the lady who couldn’t afford the $100 makes me very upset. I too would gladly give it to her. Once again thankyou for writing such a fantastic positive article on our NHS.
I’m based in Blackheath, SE London and have joined the SAVE OUR HORTON F/B page. Also I tried to donate to your Crowdfunding page but was unable to do so. I am such a passionate supporter of the NHS. Jeremy Hunt and his team (some of who have an ‘interest’ in private health care) are having secret meetings re our NHS. Did you happen see a TV crew discover a secret meeting with US Health Insurance providers and Health companies. They were royally disrupted and looked rather sheepish as they left the building… Its disgusting what our government is doing by stealth.
In psychology its called the ‘drip drip’ method as used in advertising.
If you can, watch on You Tube Michael Moore’s ‘SICKO’ about European Healthcare, you will be amazed what other countries offer although I would draw the line at having my washing done as in France!!
Good Luck with your campaign.
My NHS story is a short one. I was an American with permanent residency (with husband, a UK citizen) in England from 1974 to 1989). We, of course, used the NHS for many minor and one major incident – with positive outcomes. We did pay for “pop-up” insurance which, when wanting to see a consultant (specialist) and felt the need to “jump the queue”, knowing that while inequitable, the NHS depends on this to lighten the load of resources.
In 2015 after becoming non-resident for the past 25 years, we were visiting the UK when I got an injured foot (lots of walking with grandchildren!) and our son took me to his local hospital in Kent (County). Directed to the non-urgent department, I stepped up to the desk and said I’d been living overseas for the past 25 years. No problem,said the cheerful clerk. Just give me your name and birthday. A moment later she said had found me in the system.
I got the appropriate treatment a few minutes later and went on my way.
Now I ask you, American Taxpayer, why can’t the US come up with a system for healthcare that the United Kingdom has had since 1948? Yes, 1948.
That’s Heartwarming.
I’d swap tomorrow. Pay for what I get or pay for someone else and I don’t treated or get value for money. Only a blind, drunk, unemployed, destitute, crack addict would think the NHS is a good alternative to any other healthcare.
Oh, Chris, do you really want that?
Our medical insurance costs well over $ 20,000.00 per year. If I see my GP, that’s $ 25.00, a specialist is $ 50.00. This does not cover everything that they may want to do. So, if you see an orthopedist, the charge covers the consultation & some X-Rays, but an injection would be an additional bill.
I also am responsible for the first $ 4,000.00 in medical expenses before the health insurance begins to pay towards the care.
A simple appendectomy, with no complications & a 2 day hospital stay in my state averages between $ 38,000 & 45,000. It is always a joy to get any form of hospital treatment, as you get a bill from everyone; the admitting doctor, the surgeon, the anesthetist, the hospital for room & board & any medical supplies. Adding to this joyous experience is that insurers have a list of doctors & facilities that you are allowed to use. If you use the wrong one, the insurer doesn’t have to pay. When you are in a hospital, you can’t always choose who provides services, so there are many times that patients had thought that all the cost would be picked up by insurance, but discover that the anesthetist or other practitioner wasn’t on the list, and has sent an enormous bill.
We are lucky, as we get our insurance through our employer, who pays part of the insurance premium. If I had to buy my own coverage it would be much more expensive.
I don’t deny that the NHS has waiting lists, but top up insurance to get bumped to the front of the queue is not particularly expensive. This is because the NHS covers any emergency treatment.
I’d go back to the NHS in a heartbeat; it’s just such a shame that it is being systematically starved of funds.
Chris: why don’t you move to Somalia then, or somewhere similar with a nonexistent welfare state? See how you get on, we won’t miss you.
I’m probably a bit late reading this. I’m a retired public health doctor in the UK, just for background. What you say is all true. Another side of the US / UK health care equation comes up in the movies. There are a load of US movies where the plot simply could not work in the UK, because they hinge on the unafordability of US health care. As Good As It Gets, the Jack Nicholsen film is a good example, there are two people who’se life is turned upside down by the costs of health care.
Maybe you’d already spotted that, but if not you might find a use for it some day.
The classic meme on that is if ‘Breaking bad’ had been set in the UK. https://www.buzzfeed.com/lukelewis/if-breaking-bad-had-been-set-in-the-uk?utm_term=.xvjJ5NDa7#.sw5PkX4vm
May I reply as a Brit who blacked out in the bathroom of a Florida bar and had to experience your ‘paid for’ services in the US?
I had fantastic travel insurance but spent more time with the lovely lady from the ‘getting paid’ department than I did with a nurse or doctor.
The difference in medical care was marginal at best. I waited four hours in Miami’s eye emergency room. The food in Lower Keys medical centre, was inedible. Given this was being charged to an insurance co.pany why wasn’t it outstanding?
As you rightly say, NHS hospitals are rarely refurbished but the quality of the staff is second to none.
I have once had surgery in 24 hours and yesterday had surgery in a matter of hours. I have not had to pay anything beyond my taxes.
The lovely person at my Florida hospital was shocked when I said I had full cover (well $10M). Jx
The NHS is wonderful but it also has it’s down points, there are waiting lists in the UK to see specialists, some 6 months upwards to see the specialist needed, granted we don’t pay for this but waiting times do exist. Some people do take the NHS for granted, I for one are extremely grateful and especially from a financial point of view that we don’t have to pay hundreds and thousands of pounds for out health treatment. That being said there is also the other half, the background of the NHS or behind closed doors that people don’t see…the primary care side, GP, dentists, ophthalmics etc. Dentists and ophthalmics are business’ who provide the services for the NHS and then have to claim the money back from the NHS. In some areas there are people can’t get an appointment with a GP for 3 weeks upwards, if that’s an urgent appointment you have no choice but to go to a&e. Back to the dentists and ophthalmics side of the NHS, the NHS use a third party company who manages and pays the dentists and opticians however due to the amount of job losses since this company took on the contract the businesses such as the opticians are being paid late or aren’t being paid at all as there isn’t enough staff to cope with the work demand in the third party company and many more issues… that is the side of the NHS that isn’t seen and it’s a sure fine way to begin privatising the NHS which will happen sooner rather then later. I would recommend anyone in the UK to get healthcare insurance.
Fully, wholeheartedly agree about people abusing the NHS.
The downside of a free health service is people know it’s there and can be a little reckless about health choices safe in the knowledge they won’t have to pick up the bill.
And yes, a fair number of our hospitals are old, even ancient by American standards, added to and extended over decades and areas repurposed so the hospital ends up with an illogical layout, porters probably walk miles whilst using navigation skills second only to London famous black cab drivers.
That said, I recently had to use the NHS, more so in the last few months than in all my life prior to developing a health issue. Just shy of four months from being taken to a+e, through several appointments, tests, then a little op. I don’t know if four months would be excessive in the states but knowing how stretched the NHS is, I’m not complaining, especially when I know the operation alone would cost me (or my insurance) tens of thousands in America. Cost to me? Not a penny.
Yes, the NHS is overstretched and seriously underfunded, and I’ll even go so far as to say it’s far from perfect, but I wouldn’t want to go without it.
Great article (read it in The Independent). My only struggle was your use of USofA terms and jargon that is different to the UK’s. e.g. exam vs examination, ER (Emergency Room) vs Accident & Emergency Department, co-payments vs (I’ve no idea at all!), user fees vs (again, no idea), charting nurse vs (I think) Chartered Nurse (it’s a qualification, granted under a Charter from the Queen). Otherwise, wonderful.
I love the NHS I just hate our local A&E. I waited 6 hours to be seen after having fallen very heavily on my knee, bruising appeared within minutes and I was sat crying the whole 6 hours even though I was in high painkillers. I also have many ither problems that they were aware of.
My 80 year old mother sat for 13 hours with a suspected DVT!! Was not offered food or drink, the machine didn’t work in a&e reception, and was finally seen at 1am yes 1 am after waiting for 13 hours 12 of them alone as she didn’t tell us she was there, trying to be independent!!
It’s days like this that the system makes you rant and rave and swear. Not at the staff isn’t their fault but the hospital not spending enough on staff.
As an American living in Northern Ireland for 11 years, I have not found the NHS to be efficient in any way. A&E wait times are uncivilised. I’ve had two visits to A&E before being diagnosed with gallstones. In severe pain and throwing up, I waited 5 and 7 hours to see a Dr. Then, 4 weeks wait for an ultrasound to confirm the gallstones. I’m now on a waiting list for gallbladder removal surgery…the wait? 12-18 months. I’ve lost 25 pounds and I’m skin and bones due to fear of eating anything that might cause another attack. The NHS is not working for me. The surgeon who discussed my scan results, in an NHS hospital, told me the wait to remove my gallbladder would be 12-18 months and actually said he could do the surgery in two weeks for £4600 if I went to a private clinic he worked in.
You seem to be really unlucky, mine was dealt with in a week. I would fire off a missive to your local health authorities. Might not work but its worth a try.
Since the 1990’s the 4 countries of the U.K. Have developed in a more semi-independant way and the Healthcare is one of the major areas of difference.
England made much more effort in driving long waits out of the system,
Maximum 4 hour wait to admission or discharge in A&E. 95% target
Maximum 18 week wait for non-emergency surgery
Maximum 2 week wait for diagnostics for possible cancer diagnosis
After the extra investment 2000-2010 these targets were all being met in England every month, with less money since then they are being missed consistently, but not by much e.g. 90-92% of patients being seen in 4 hours.
Scotland, Wales and NI prioritised things differently, England kept co-pay for prescription charges and eye tests, the other 3 abolished them, Northern Ireland has more integration between Health and social care than the other 3 countries.
The truth no one wants to hear. The facts are that the NHS is terribly inefficient and it is the staff who are behind it. Refusing to modernise and refusing to support the population over their salaries. be sure though, the government are not trying to close the NHS, most of us
Wish they would. Or at least give the working man of the the U.K. The option to opt out and take our 4K a year elsewhere.
Oh, Chris, take your 4k elsewhere? Our family insurance in the US comes from my wife’s employer. Last year their share of the medical insurance bill for our family was $ 17,700. In addition to that, my wife also pays $ 400 per month. For that we have insurance that we can’t afford to use as we have to pay out $ 4,000 per family member before the insurance pays a penny.
You say that the NHS workers don’t care as they choose their salaries over the patients. Compared to countries that have exclusively private medical systems, NHS salaries are ridiculously low.
Have you considered buying private top-up insurance? It is not expensive in the UK, as any catastrophic or emergency treatment is covered under the NHS.
Thanks for that David. I suggest Chris watch Michael’s Moore’s ‘SICKO’ on YouTube. Its shocking.
“watch Michael’s Moore’s ‘SICKO’ on YouTube. Its shocking”
… just as it was intended. But appreciate the honesty in not calling the work a “documentary”.
Sicko? A propaganda piece with little regard for the truth. Think Cubans can get to those clinics he was showing?
BULLSHIT. The English take home a mere fraction of what they earn to pay for this.
TROLL alert!
You can’t say troll alert whenever someone writes something you don’t like or in this case gives a view of the NHS you don’t like. I’d actually say you are more of a troll as you continually try to discredit people who say it as they see it (and probably have a more balanced view than yourself).
Bullshit yourself. Up to about $100,000 there’s no significant difference. In US states with a high income tax rate like New York an American can actually pay higher taxes than a Brit.
I’m from Newcastle and work near Seattle as a private practice PT . My Dad has Stage IV prostate cancer and his care has been jaw droppingly amazing. I always tell my British friends and rellies how lucky they are not to be in our system.
I would suggest your limited experience with the NHS may not make you an expert. I lived in the UK for years and was repeatedly appalled at the flaws in their health care system, which is far from free when you consider the tremendous tax burden applied to residents of all socioeconomic classes to fund it. Also, I have never experienced emergency care in the US the way it is characterized in this post. My children have had extensive emergency care and never have we been asked for a co-pay or preauthorization at the point of service.
I guess in the USA it varies from hospital to hospital. I was on vacation in LA many years ago and had to be rushed to ER by a friend. I was charged for everything: exam by a doctor (pay); injection of needed meds (pay); writing prescription (pay); the meds themselves (pay) ; pharmacy fee for dispensing (pay). I left with my wallet empty. The NHS doesn’t do that to USA visitors to A&E. There are failings in all healthcare systems but I don’t think ours are due to the fact that it’s free at point of use. Of course we pay in tax, but most people use the system. Better off folk can go private if they wish. I don’t see the system as some kind of creeping communism as some in America do.
PS: at one point it was thought on my USA visit that I’d have to be kept in hospital overnight. My buddy had to ring a very wealthy guy we both did work for and get him to agree to pay my potential bill before they’d consider it.
Amanda, The tax burden is by no means ‘tremendous’. The part of my tax contribution that goes to the NHS is much, much smaller than the private insurance premiums paid by every (insured) American I know. My parents (now dead) and siblings live in the USA. 25 years ago I watched my semi-conscious mother denied entry into a hospital because she was in no condition to tell them who she was insured with and I, visiting from the UK, had no idea. Had my sister not come dashing across the parking lot with her papers I guess they would have let her stop breathing. I relive that episode all the time. Also,, when my dual national daughter was living and working in the USA for 9 months she fell ill with a kidney infection. She was not registered with a doctor as she was travelling around and would have had to cough up over $2000 on the spot for emergency room care, which she did not have. If my sister had not found a small charity that treated her on the basis of a day of her paltry pay, I do not know what would have happened.
I grew up in the USA, but have lived in the UK for 43 years. At least here you do not have to panic when you fall ill unexpectedly, as I did a couple of weeks ago (detached retina). I just went and got treated.
It is outrageous, I pay 4K, it’s an awful service with rude arrogant staff.
The tax burden is far from “tremendous”. It is tiny in comparison to what US premiums for poor-quality healthcare insurance are, unless you’re in a top tax bracket – and in that case, your income does need to be redistributed.
My daughter just finished her undergraduate course in the UK. For three years she received excellent healthcare through the NHS–as an American student on a visa. i am grateful for the care she was provided there. Even though we have an excellent insurance plan in the US (we are fortunate), the system is much more complicated here–and expensive. No system is perfect, but the NHS is doggone good.
Wow! Again!
My problem with the NHS is that I put a lot of hard work into keeping healthy, and yet when I need to see a doctor I am at the back of the queue because “i’m not dying”. I understand a huge amount of NHS funds go on (a) Fixing lots of age-related issues due to our increasing aging population and (b) Fixing problems with smoking, obesity, general bad diet, lack of exercise…
Last year I had stomach pain that wouldnt go away and it took nearly a YEAR to see a specialist (My appointment got repeatedly cancelled and that was only after an ultrasound, CT scan and gastroscopy (each with several months wait between). During this year I had to stop playing sport because it was too painful, and I lost sleep due to pain, I was on pain medication.. my work performance also suffered. I am otherwise perfectly healthy. It was a pretty bad year because the NHS failed to help me. Yes – I wasn’t dying, it wasn’t cancer, but seeing a specialist fixed the issue within weeks. It feels a bit unfair that I put in the effort and am at the back of the queue.
Which is exactly the problem with systems like the NHS. The emergency stuff normally is done well. The urgent stuff tends to be done well once it has been determined to be urgent. The routine stuff is done well. Anything that doesn’t fall into those categories, however, gets whatever’s left and it’s never enough.
Thank you for the endorsement of our wonderful NHS, the legacy of a leftist, post WW2 government.
Unfortunately, now that our government is more right wing and of the ‘ I’m alright Jack’ mentality they obviously have plans to privatise it by Stealth.
This will obviously result in a more Americanized culture which will take our country back to the dark ages.
As before there is a reassuring story that the NHS helped someone successfully and I’m very pleased to hear that. Amongst the debate and rhetoric it is really only that those who need good care, receive good care, that matters. That Dr Jen and Family once again received effective and prompt NHS care is indeed something the UK is proud of and we’re proudest when it works well and delivers the best, appropriate care.
Last time around I think I offered a recount of my wife’s experience as a Brit (albeit with travel insurance so we were ‘insured’) on vacation and most definitely requiring the ER whilst in the US. She’s a senior nurse with lots of experience and quite frankly she was blown away (positively) by the quality of care. She has discussed many times, since, with other Brit healthcare professionals who have vacationed in America and had need of healthcare whilst ‘over there’, and they all report similar or if not better standards of treatment than when compared with the NHS.
So the debate is really, if the anecdotes are of value, about the difference between a socialist system (NHS, paid for by taxation) or a private, capitalist system (paid for directly, via insurance or otherwise). And here some clarity is needed if a comparison is to be made. We Brits do pay a lot of tax. I’d warrant more than Americans if we were to compare like for like, job for job. (Without just directly comparing income filtered through the fluctuating exchange rate). I don’t know if the insurance premiums on top make such like for likes more equal. Sorry, I’m ignorant of how it works in the US, in detail. It sounds shocking that many can’t afford the excess payment even with insurance. It sound shocking when the NHS can’t afford the best or most appropriate treatment and the patient over here suffers too. Both systems are flawed since you can’t always afford the best care when spare cash is limited
We know that Capitalist systems can be cruel. It favours the haves over the have nots, and as such, when compassion intervened and created Socialism – such that the haves contribute to help the have nots – a nicer world was created, by intention if not necessarily reality. I’d say that, in my opinion, it does seem immoral to put capital profit (at a significant level anyway) above people’s health or life. Let’s close that door in agreement. The US system would be fairer if its insurance system and healthcare providers were at least non-profits, perhaps.
The ‘problem’ however, is that a state-funded healthcare system needs profit in order to thrive. Businesses (and individuals) pay tax on profit, or when value is added (in effect, a form of profit again). When not enough profit is made, not enough tax is generated and systems like the NHS struggle to deliver a service with relatively less resources as its relative income becomes less. People are paid decent salaries to make decisions about where that limited pot of money should be spent and where healthcare is concerned there will never be enough in all of the right places. Often decision-makers are pushed into making less than ideal decisions, cost usually governs and someone (or more) inevitably suffers as a result.
My point is really that the priorities and conclusions each side of the pond are probably different. If we’re considering healthcare for the most needy, then the NHS is a winner. If we’re talking about quality of equipment and pharma then the US may fare better, if one can pay. When my wife returned from ER in the US we were given a prescription with a list of drugs to assist her recovery. I have to add that their purchase, at direct cost at that time was comparable to the standard equivalent NHS prescription charges we’d have comparably paid over here. These were branded drugs not generics. I won’t labour the point, but they’re not necessarily like for like, pharmacologically speaking. I like and am grateful for the NHS and yes, I understand that its Nurses do often take on more responsibility than their comparable opposites in the US. Yes, this is often a good thing, but it was motivated by saving money (Nurses generally, but not always, paid less than a Doc). But ultimately both systems require money. It is a misconception that the NHS is ‘free’. It struggles right now and many are falling through its net and suffering here too.
Social systems done well require profit just as any other system does to make it work. How much profit and where it is dividended and distributed is a fair point, perhaps beyond this blog, but please be aware that, at its core, I don’t think it is Socialism good, Capitalism bad, or vice versa, necessarily. Good healthcare costs money, period. The debate comes down to who should pay, how much and whether it’s fair that I pay for your treatment or if I can’t afford to pay for my own is it right that others should contribute to mine. It’s collectivism versus individualism. Sort of. They’re different and both have merits. It’s about balance. But without good business sense in other sectors and in healthcare there’s neither. And that’s a factor which also should be discussed.
Really great insights between your experience of the NHS and American hospital copayments, Dr Gunter. Thanks for writing about this
The NHS is hugely overstretched and chronically underfunded (thanks to the bloody Tories). At such a time personal responsibility should be paramount. Just because she wanted to wear 5″ heels she needed an expensive trip to A&E, removing vital funds for patients genuinely ill.
Come on!!
True, the NHS is being run down by the Tories as a prelude to privatisation.
However, a patient’s lifestyle is not a reason to give or refuse treatment. So she wanted to wear heels? So what?
In the past, us doctors have been very good at moralising; it’s high time we moved on.
110 billion pounds isn’t underfunding and 1.5
Million staff isn’t under resourced. Chronically mismanaged with too many staff taking their cut and holding the NHS to ransom would be a better description.
Stupid, Chris, really stupid.
If the UK were spending the same GDP fraction on health as the US, with a UK workforce of around 30 million you’d expect around 4 million healthcare staff. Even with the smaller fraction that the UK does spend on the NHS, you’d expect around 2.5 to 3 million UK healthcare workforce total.
My mother in law went in to A&E and they were so concerned with her symptoms they kept her in overnight and ordered a high contrast MRI for the next day. Brain tumor diagnosed and removed by 11 hour surgery within a month at kings college London. 3 months later and she is completely recovered and dancing around the room. The care we received was absolutely top notch and they certainly saved her life (They gave her ~2 months until she would have been paralysed from the neck down). From the day of getting the MRI results to the outstanding treatment and aftercare I won’t hear a bad word said about the NHS. Sure stuff can go wrong in any organisation especially one as big as the NHS but lets face it, the people that work in it and the institution itself are both utterly wonderful.
you are lucky. My mother was misdiagnosed by the NHS 6 times and is now dead. Worst still I was verbally abused when I challenged the lack of treatment. It’s a poor service, she’d have been better off going to the vets.
The only problem with the NHS is the government, its trying to tn NHS in the san thing as US.
If you get a chance then try and arrange to go out as an observer with the local ambulance service and you will then see problems – a nursing home putting in an emergency (999) call for an ambulance to a “sick person” with the call graded to a “Red 2” which is serious – on arrival patient is sitting in room eating breakfast and we have to wait before removing her
Or the calls to 20yr olds with “chest pains” which triggers a R1 response when the pain is only there when they cough and the diagnosis ends up as a minor chest infection which should really be dealt with by their GP
In April of this year I went to my GP with with stomach pains, weight loss and other symptoms. I had blood taken and was called back the next day to say my results were unusual and the doctor would like me to have an ultrasound scan. I had that scan within a week, it was inconclusive so I was booked for a pet scan the following week. Ten days later I saw a haematology doctor who, after looking at my scan pictures immediately booked for a biopsy and I was admitted into hospital that day. I had a large tumour in my abdomen extending into my chest. I was in hospital for twelve days while various forms of cancer were ruled out. Some of the tests can take time to culture cells etc. Four weeks after being my pet scan I was diagnosed with gastrointestinal stromal tumour and immediately prescribed Glivec, which I have been taking since. The tumour started shrinking almost straight away and two weeks after starting treatment I was able to return to work. I see my oncology specialist every four weeks and have recently had a CT scan to see how my tumour is shrinking, but to me Glivec is a wonder drug and has given me my life back.
I did some internet research into Glivec and understand it costs the NHS around £21,000 per year for my medication, but in the US can cost up-to $92,000 for the same drug!
Apparently the NHS get a huge discount because they buy in bulk.
It seems to me in the US, people’s health is put after profit, and lots of money is being made from sick people. In my view people of the UK have a lot to be thankful for, and people who complain about the NHS haven’t really had to use it for something life threatening or serious. Yes there are mistakes made sometimes, and that will happen with 60 million potential patients. But when you need it the NHS is there. No questions about whether you can afford it or even deserve it.
Many countries could learn a lot, but where would all the profit go!
Beautiful fairy tale. I had the same problem with my ankle. Wait 5 hours in A&E and left without any help….
This is a good story. Sadly there are very many stories of poor care being given also where patient health is not foremost ….. the NHS needs much more investment to make it the system it deserves to be, but where will that money be found….
Thank you for the lovely comments I am a vascular theatre nurse and love my job and the NHS and hear day by day people saying bad things about nurses and the NHS it’s very inspiring to hear some one praise is and say thank you. Your kind words are very inspiring and make us in the NHS proud of the work we do. I thank you for this .
Kind regards SN Gayton
I went to England to visit my daughter and have always been an advocate for a single payer system in the US. I got very sick and was taken to a London hospital. The care I received in the ER was excellent and I was sent to a ward of about 8 people which was a nightmare. I literally provided my own care, including getting up, going out to the nurses station to tell them I thought I was supposed to be hooked up to oxygen . Oops, they had forgotten. I was caughing and my nose running. I had to wait for nearly an hour for them to find a box of tissues. At one point I went to the desk to ask for directions to the bathroom and the person I asked said “that isn’t my job” when it was right behind me and all she had to do was point. I could go on with several more nightmarish stories. I would have left but they kept saying I had a potential “life threatening” problem ( they thought I might have a blood clot) and needed a scan. I waited all day and finally went to the desk to ask when the scan was scheduled. Finally they wheeled me to the lab and when I asked the tech if they had been busy, he responded that there had been very little traffic that day. But…. I had a “life threatening condition”! After the scan, a doctor came and told me I had an infection and gave me anti-biotics. I very pointedly said I was flying to Venice the next day … Was that a problem. I was told it was not a problem. So the next day I flew and by the time I got there I was sicker than I had been and spent my time in Venice in bed. When we returned to London, mail from the hospital was waiting for me . It listed Pneumonia as the diagnosis. PNEUMONIA! I should never have been advised I could fly! So, how do I feel about the NHS and the possibility of a similar system in the US.? I will give you one guess.
Bad experiences happen in all medical systems – I doubt whether it’s tax financed or via insurance has anything to do with it. My late buddy, a famous record producer in USA with good insurance was in hospital with cancer and told me staff vanished at night and he had to get water for other patients. This stuff happens here too, so I doubt it has anything to do with how the system is financed.
I have to recommend the NHS 111 service. I used this recently and after a short discussion, including the person I was talking to, obviously a nurse, speaking with me on hold to a doctor while I waited, I was recommended to go to the local A&E department who sorted me out in a matter of hours. They were surprised I had never used the hospital before despite living in the area 28 years!
I sympathise with the view that too many people turn up at A&E without needing to, but when I tried to book a follow up appointment with my own GP as recommeded by the hospital I was told it was a 6 (six) week wait for an appointment with my own doctor or just over 2 weeks with another in the practice. This is why people go to A&E who shouldn’t.
Nothing but praise for my experience with the NHS front line staff. All wonderful.
My son recently injured his ankle – just a minor sprain – but after a week it had not healed. Got a same-day appointment at the doctor who referred him for an xray; xray also booked for later the same day at the local hospital and all sorted before 6pm and all for free – something I am still getting used to having grown up in Australia…
The NHS is amazing and needs to be supported.
Sadly but you have only seen NHS as a user not employee in particular physicians. There is increasing abuse of serviceand staff all the time. NHS may care care for the patients but not staff. I am sorry but Small co paymentis a must in healthcare to cut down service abuse
You are joking aren’t you. I have never seen an organisation which protects its staff like the NHS, they basically have a zero tolerance policy on complaints, zero tolerance policy on being unhappy with the service and what you call abuse is caused by staff refusing to take responsibility for the service they get. You will find contrary to opinions on most forums (which have numerous NHS staff on them), there are a ton of people genuine unhappy and at their wits end with the NHS. If the NHS protected its patients like its staff then we would truly have a good health service. They don’t and it’s not
I am have excellent service by the NHS for the last 17 years. The doctors, surgeons, nurses are my superheroes. I am still alive due to their dedication and care
Lovely post, it’s great to hear when things work out.
However, “To the British government, stop trying to mess it up”, this would mean that the British people would have to stop voting for governments whose goal it is to sell it off.
As a person living with several chronic health conditions and disabilities and as a person who works within an NHS hospital in the north of England, this is heartening to hear.
Thank you for writing this. The majority of hospital staff, certainly where i work, do take great pride in trying to provide the best care possible for patients.
Reblogged this on danonwheels and commented:
An American Doctor’s view of the NHS…
I was well into the second season of Doc Martin before I realized what I was NOT seeing that would be common in U.S. medical dramas–discussions about how the patient couldn’t afford suggested treatment or an ambulance ride to the hospital. That takes up so much time and energy and sometimes causes heartache as care is avoided for far too long because of high co-pays. It was startling to realize that if the doctor said you needed a treatment, you simply got the treatment–no matter how modest your income. Medical costs never destroyed lives or inheritances. Refreshing! I’m sorry we don’t yet have single-payer medical care here. Insurance companies continue their price-gouging and employers have total control over which plans to offer, if any.
Sadly, while agreeing with most of your post, it’s untrue that medical costs in the UK never destroy inheritances. My dad had dementia last eight years of his life in Scotland, and though because he’d been a WW2 volunteer for merchant marine convoys he qualified for a charity home superior to the usual bog standard, it still cost him several hundred pounds a week. His house was sold and his bank account stripped. They stopped when he had £23.000 left as I believe that’s the rule. A chunk of that went for funeral and other costs so the inheritance my mom wanted to leave me, including a house, ended up being £18,000. In order to have a decent retirement I had to sell my apartment and move into sharing rented accommodation with a friend.
Has anyone heard of Mid-Staffordshire scandal? In which only recently poor care caused hundreds of extra deaths per year at just one hospital.
I am glad you received good care in an NHS A and E unlike my daughter last week with a brain trauma injury sat in a waiting room on a chair for five hours before receiving a CT scan to diagnose the brain bleed that she had. And then put in majors room in a bed that was also housing the departments medical needs equipment etc before moving again to another room housing similar equipment. People in corridors on trolleys, a bed was found after moving again to a ward 16 hours later. A 18 year old girl put in a ward with 90+ ladies. Many of the staff were rude and unkind not caring of the elderly. Not being provided with simple care such as having water to drink. Soiled incontinence pads on the floor underneath where patients sit. I could go on but I’ve got to go back to the hospital to shower my daughter which doesn’t come under nursing care it’s seems. She’s on a different ward now but I’m not impressed with the care and lack of information given to us about her BTI.
I do have to admit. Every time I’ve been to the A&E in the UK (I am originally from Germany) I had to wait at least 5 to 6 hours.
I think you’ve been very lucky the few times you’ve gone.
Still pro NHS though. If a privatisation is needed please follow the German model rather than the US model.
True. You can’t make an appointment at eye hospitals in London and you usually have to wait 2 to 4 hours.
I had my son in the US and my daughter in the UK and the comparison is miles apart. My son cost my mom’s insurance some ridiculous amount. I was required to stay four days in hospital (per day cost for my son and I), pumped up on pain meds that I didn’t ask for so that meant I couldn’t even hold my son, plus additional cost because we filed one wrong document with the insurance company so we had to front up that cost ourselves. I can’t comment as to whether the nurses or maternity doctors provided me with any useful guidance as a first time mum because I was so drugged up. I do remember that they were more concerned about a ‘switched at birth’ scenarios when we were leaving the hospital even though my son and I had a matching ‘security’ name tag on which they put on him the second he came out.
My daughter? Same procedure (C-section), 1 1/2 days hospital stay, I could stand up and walk the next day because they relied on me as to whether I needed pain meds which meant that I could actually take care of my daughter straight away, the maternity nurses helped me with breastfeeding and answered were helpful with any questions I had before I left and a home visit from the midwife a few times the first week to make sure that mum an baby were OK and conduct the necessary newborn tests right there at home (pin prick test, weight check etc). This is all cost me $0.00.
Really? It cost you £0? Were you living and working here? Were you paying NI contributions?
If not, then we (British public) paid for you via our NI contributions.
Sarah, NI contribs are no longer ringfenced for the NHS and State Pension – I’m not sure if they ever were. Both are funded by general taxation: income tax, VAT, company tax, NI …
I had my little boy at an NHS hospital two years ago. I started contractions on and off on the Saturday and he finally arrived by C-Section on the Wednesday.
I’d been into the delivery wing twice in those five days because of the pain I was in and because at one point the contractions just weren’t getting any closer together.
I was seen by a student midwife and a midwife. The student midwife (Carla) was trying to put the trace on my bump to check for my boy’s heart beat but she was struggling to find it. The midwife (Helen) took over and did some extra tests. They got the trace in place then went to get a doctor. At that point I knew something didn’t line up. The midwife at my normal check up earlier in the day had checked to see if he was back to back but had ruled that out. When the doctor came back they did an ultrasound. It turned out that my boy was breech.
After chatting through the choices it was decided between us that C-Section was going to be the better option even with the risks that it carried.
I’m grateful for the NHS because of the level of attention and care I was given.
Rosie the anaesthetist’s assistant was super friendly and kept me calm especially when the anaesthetist was putting the injections in my back to make me go numb. She and Chris (my husband) held my hands and talked to me through it.
The line up of doctors and theatre nurses were all female minus the surgeon who was a guy and even then he literally came in for the bit he was needed, wished my boy a happy birthday and left again. It sounds sort of silly but this somehow made me feel more comfortable.
The NHS has it’s faults I know that. I had a couple of hiccups through my visit but we were taken care of and our midwife team were amazing.
Thank you for your article. Well said. Thank God for the NHS. It is very few places in the world that although there is a waiting time, you can give your name and DOB, get your treatment without paying a penny. We take the NHS for granted. When things are handed to us we thing we have a right even when we haven’t contributed to its existence.
As someone born in another country, well travelled and lived in the UK most of my life I have experienced the ER in the USA three times and I tell you what my travel insurance had to be verified and the agents contacted, card details taken for surcharge before I could be seen. The service in the US was great but money talks.
Don’t moan about the NHS, yes there is always room for improvement but for a FREE service to ALL we must not complain. Love my NHS one of the most courteous and loving service I’ve ever experienced.
It is NOT a free service! We all pay for it via NI contributions!!
Dr Gunter. Stop listening to idiots. We are perfectly happy with NHS. Government gives it lots of money..our money …it could do better..but the improvement has been huge
We do ourselves an injustice every time we say the NHS is the best in the world. It may have been at one stage but no longer. We have rested on our laurels and things have slipped. The author does herself no favours peddling left wing claptrap about the government wanting to destroy the NHS. Nothing could be further from the truth, any government that did that would be committing electoral suicide. The Americans went into Iraq (twice) and Afghanistan and left a bigger mess than there was before they started, it is the American support for rebels in Syria that is prolonging the agony there. I don’t like Assad any more than the next guy but he is the country’s legitimate head – only the Syrian people have a right to say he should be removed. American sabre rattling in Crimea caused the Russians to move in there and now they’re trying to tell the Chinese what to do about the South China Sea dispute. I’m not a fan of Donald Trump but if his rhetoric is to be believed then he’s going to stop America wandering around the world interfering in everybody else’s business.
Actually the NHS was voted number one for the provision of healthcare worldwide in 2015 by a leading Washington think tank
I am utterly disgusted by the NHS and how badly health system works. Me and my family have had so many bad experiences I could write all day about them. However, last week I had exactly the same problem as your cousin: I badly sprained my ankle (even without high heels). On Tuesday afternoon I sprained the ankle while on holiday and my father in law bandaged it. On Wednesday night I took off the bandage to notice massive bruising. On Thursday morning I phoned the GP. I was told they were short on staff and asked if the visit was “aboslutely urgent”. I sort of confirmed, and got an appointment at 2pm. The doctor referred me for X-Rays at the hospital to check if there was any fracture. I was at the hospital by 4, and within maybe a half hour the X-Rays were done. I waited a further 10-15 minutes for the receptionist to verbally tell me the results (there was no fracture). All this has been quick and efficient, although now a further 4 days have passed, I need to go to my GP again to get my full X-Ray report. Furthermore I still might have some ligament damage, I might need some bandage or a splint. Nobody has told me anything, a visit with an orthopedist might have helped but I don’t seem to have such an option…
“To the British Government: stop trying to mess it up.”
“To the American writer: don’t fall into the trap laid by people who claim the government is out to ‘destroy’ the NHS or to privatise it. It’s not true. The government, like all post-war governments, is committed to the provision of a national health service. Sometimes that involves making hard choices, using private as well as public contractors, and so on, but it is not ‘messing it up’.”
If only that were so. If it were, we would wouldn’t have the appalling Jeremy Hunt, who is on record calling the NHS “a 60 year mistake”, in the government at all, much a less as Minister of Health, in charge of the NHS.
Well said. Despite the eye-watering cost charged by big pharma, I did finally get Harvoni treatment for hep c on the NHS and hope to be cured soon. Thank you NHS and Chelsea and Westminster Hospital.
Woohoo! I hope you are better and all clear soon!
Thanks Hannie. I was alarmed in 2009 to find my sudden problems were due to hep c which I probably had for 25 years before symptoms appeared. My consultant advised against interferon as it was “a rough ride” with low cure rates. When better meds arrived I had to wait as costs meant they must ration to the sickest patients which I understand, but they monitored my liver and in the end I got the meds. Whoopee indeed!
So, England has what, 38m people? Their budget is shared with Europe and much of their security is provided for by NATO? They benefited from hundreds of years slavery, imperialism, pillaging of the entire worlds resources and through their egregious interference throughout the world created the conditions for both WWI AND WWII….they tax everything at 17.5% every time it’s sold and tax both sides of the transaction (which makes it really a 34% tax) and they charge insanely high road taxes and even tax your right to watch television on pain of imprisonment for failure to pay. The government gobbles up so much tax money that much of the population is forced to live in tiny homes, use public transportation because they can’t afford cars and spend their lives in garish drudgery and helplessness knowing they will never live any better than their parents….and likely far worse.
But, hey….healthcare is free.
I lived there 3 years. Under NHS my wife nearly lost 2 children due to virtually untrained and/or foreign doctors nearly killing them due to absolutely inane, unsafe practices taken straight out of the 1950s, Orwellian procedural requirements that leave the patient without appeal and filthy hospitals rife with disease and infection. I myself would have been forced to live for a year with a serious hernia due to intolerably incomprehensible wait lists had I not had the financial means to go private and get the same surgery the next day with the same doctor! The NHS literally told me to go home for a year to wait it out!
Anyone who has been there for more than a short vacation knows how difficult it is to accomplish any task once NHS employee union mandated tea time hits…and suddenly all employees literally just leave….regardless of the situation, to go have a cuppa. (What? You’re newborn is bleeding and you cant stop the blood loss? Don’t worry, well be back in 30….minutes.) This happened!
Emergency rooms are filthy, blood spattered, dirty and often under neverending construction. Doctors and medical personnel don’t use sharps precautions or gloves and often go from patient to patient with blood and bodily fluids on their hands and clothes spreading disease. Wait times are ungodly. If you’ve heqrd of Canadian NHC wait times get ready for some truly mind boggling waits as NHS times often extend into years even for brain cancer. Pregnancy wards are shared with large groups of women and there is no privacy unless you pay for a private room. Strangers will wander into the wards gaping at women as they change and women have no redress. If they dont have your birthing room ready, no muss no fuss, you can just have it in the hall or elevator, they dont mind (watch your step). Mental patients are free to disrobe and walk the streets nude in frigid weather (pun intended) as employees charged with caring for those patients get their mandated tea breaks and nevermind the result…(sorry, we lost your mum, dont worry, the police found her on the M1…there were a few inappropriate gender violations but I’m sure she’ll be fine… eventually).
Oh, and their doctors are sk well trained that they only have to go to school for five years….that’s undergraduate included…(though standards may vary as many get their degrees in former colonies such as Pakistan, India, Indonesia…but I’m sure the standards are the same….dont be racist!)
But since I went there…let’s march onward. If you are not white, English and a member of the upper crust then you don’t get the same treatment. Ask any Pakistani, Indian or North African about thier experiences…anyone of color is treated as subhuman. As a Mexican my wife has darker skin than many Africans. Because of this she was often confused as being Pakistani and as a direct result was spoken to and treated often as a dog by pugnacious, ill-mannered, racist staff to the point that she was often told to go back to Pakistan if she didn’t like it how they treated her or our children. If she spoke up they would send security to try to humiliate her into silence.
Oh, and with cameras in every hall and corner you can feel safe and secure as strange men view you from central security offices downtown…dont worry, they would never record your most intimate, vulnerable moments and put them online…it would violate their standards and practices and may result in a warning (oh, and it has been so effective at halting terror attacks…or rather, ensuring you get ticketed for parking violations.) Everyone knows you need extra video cameras inside hospitals to ensure you cue appropriately and don’t complain about mistreatment.
Last not least, don’t forget about doctor death who killed hundreds of his patients without the NHS ever having caught on despite the literally hundreds of complaints against him, or that nurse who killed off the elderly for decades…or any of the other numerous murderers practicing their trade of death within the NHS over the decades….the NHS caught them…..eventually (or was that the Royal Police?).
3 years under the NHS and every day I thanked God and my embassy that I had the option to go private once I could show that NHS practices did not conform to military standards of care (which everyone knows are quite low). Of course I had to go through the NHS circus each time we needed care but in ALL cases we ended up going private care to get our healthcare because at NO TIME did the NHS ever offer better care or support. Oddoy enough, private care was with the very same doctors but when they are paid more than just 10lb Stirling per month per client suddenly their behavior (and the wait time) improves.
Oh, and before I forget, even Mexican National healthcare has higher standards and practices then the British NHS and most Mexicans will agree that American healthcare is way better. I can say this because I lived there too and so has my wife who was raised there and is of Mexican origin. She hates British NHS. Their system is well and truly broken and does NOT provide a high standard of care. Instead, it minimalizes human beings down to mere numbers and costs and ensures that those who exceed the maximum allowable treatment cost…die.
Don’t believe the hype.
Nor should people believe the diatribes.
Uneducated bollocks.
Yes, USA healthcare is better…for those who can afford to pay! Of course some of the issues you list are true. I recently had to go private for something as I moved a couple miles and my new area refused treatment I’d had for years from my old GP. But it’s mostly due to the governmental gradual privatisation, closing A&Es, too many overpaid managers, but I find it hard to square my experience of our NHS with the notion that it’s a racist organisation who treats those of colour badly – you only have to walk into any hospital to see patients and staff of every race and colour. At the same time you criticise employment of staff from other countries, hinting their qualifications might not be up to standard – pot, kettle, black, possibly? In case you’re unaware, doctors and nurses cannot just come to the UK and work without undergoing rigorous checks. I had a broken finger missed by a nurse, but she was clearly black British born and bred not a newbie so any person can make mistakes. Yes, I agree the NHS has problems, but I can’t help feeling your post reeks of a superiorattitude that quite possibly would put the backs of staff you encounter well and truly up. I have a buddy in LA who is quite successful yet pays hundreds of $ monthly on health insurance yet always pays a fee to see his GP. Trust me, he’s not happy.
I haven’t lived in the US but I lived in Australia for many years and their healthcare, which is a mix of the US and UK systems is massively superior. They have the safety net of an nhs style system, but it’s fully integrated with the private system. So if you choose to go private the nhs equivalent pays the cost that would have been incurred had to you gone nhs to your private doc, you just top it up. What this means is that many more people can afford private care, so the nhs works better too because less people use it.
Also, once you earn above a certain income you are forced to pay for private healthcare, or you pay more tax. It works. There is also (above a certain income threshold) a small fee to visit a gp, although there are fee free gp’s around if you can’t or won’t pay.
Privatisation isn’t always bad- there are blood test centres and x ray centres on every high st in Oz, run by private companies. There is competition between them, so you have a choice to go to the best one. Also, you don’t pay, the govt pays the fee to them directly. So there’s no need to go to hospital for x rays, if your gp wants one you literally walk down the road, walk in, wait 5 mins, and walk back up to the gp. It’s all so much easier.
One of the major problems with the nhs is that docs have no fear of being personally sued. So you get stupid situations like gp receptionists asking what’s wrong and deciding whether you get to see a doctor. My doc in oz wouldn’t believe me that that happens in the UK, because the receptionist isn’t medically trained, but it does, all the time. So then whether you get an appt often boils down to how pushy you are, and how much you exaggerate they symptoms. The old lady with a kidney infection who rings up and complains her back hurts doesn’t get a look in.
The UK has a population of 60 million, not 38 million. It’s hard to believe you actually lived here for 3 years without realising that.
Factual check:
1. UK Population is 64.1m, not 38m.
2. 17.5 x 2 = 35, not 34.
3. VAT rate is 20%, not 17.5%.
4. VAT is not charged at both ends, it is deductible, so the amount payable depends on mark up, but is usually 2-3%.
5. Road Tax rates are based on car emissions so are often not “insanely high”. My new Audi A4 costs £30 a year in road tax.
6. Car ownership rates are comparable to other European countries and only just below rates in Canada. Last survey showed 520 cars owned in the UK per 1000 people, refuting your claim that “most” people can’t afford a car.
7. Around 2% of UK GDP is spent on the military – in line with most other NATO countries showing that the UK contributes to this organisation rather than your assertion that we just take.
8. UK budget is not “shared” with Europe – especially regarding healthcare spending. There is no EU wide taxation rate.
9. Rate of Hospital Acquired Infections (HAI) is higher in the USA than the UK (6.4% vs 10%).
10. Waiting times for cancer patients are not “years” – 94% of suspected cancer cases are diagnosed within 2 weeks and 98% of diagnosed cases start treatment within 4 weeks.
There are others, but I think I’ll leave it there.
Americans love to try be the best at everything, don’t they? I hate that.
I’d be interested to know WHEN he lived here. You give an accurate picture of 2015, he sounds like he is talking about the worst of the 1970’s.
errr … are you sure it was this country you were in? personally anytime myself or my family and friends have had cause to use the NHS the service has been timely, caring and in nice clean facilities with stringent safety procedures. Yes the NHS has problems but in my experience and the experience of the majority of my family and friends what your listing is not among them. Frankly I love my nhs free and the point of service medical care and it’s comforting to know its there if I ever need it even if I am unemployed, homeless or working. Just sayin.
This is hiliarious.
The population of England is 53 million, and the whole of the UK 63 million. You make a schoolboy error in your first sentence and then go downhill from there.
The Nhs is great. I was treated by the same hospital in Sunderland for over 11years for severe glue ear. And thanks to their care I did not lose my hearing which was the alternative. Their orthodontic dept sorted out my overbite with the minimum of fuss. Both problems are things my parents would never have been able to afford to be treated otherwise. We must fight for our nhs.
To me I’m not quite happy with the NHS.
The health practitioners are most of the time not competent, just as examples,every time they have to check in their books and even though they give wrong medications,last time the nurse didn’t even know how to write gelatine on her laptop to check!!! Something online.
The appointments are too far.
Very often they treat you like if you’re asking for charity if you ask the GP for a refferal letter despite the fact that both me and my husband are tax payers.
I twisted my ankle last year and unfortunately my friend had a brokend ankle at the same time.We called the ambulance and we’ve been waiting for it about 2 hours until a friend of her drived us to the A&E and I can promise you,it didn’t take neither 10 nor 15 minutes but about 2 hours at least.
Most of the people I know are complaining from HIS,I wonder how can someone be so happy with it.
They check in books because medication is changing all of the time, and differs from individual to individual. Would you rather they guessed just to look good?!
Perspective is how someone can be so happy with it. Emergency care here in the USA is expensive, and there’s usually a long wait. 2 hours would be short for some ERs.
Think about how bad ours must be if we won’t shut up about how awesome yours is, flaws and all. I know people who have died because they didn’t have the money to see a doctor.
I don’t think the NHS is perfect. But I think it’s better. I think that shooting for perfection is hurting us. We say, “Oh, it’s not perfect, so why bother doing it?” Then we do nothing and nothing gets better. People aren’t willing to try something to improve our system. The ACA was a good idea, but it was hamstrung by a Congress who want it to fail, so that they don’t have to fix our broken system. Now they can say, “Well we tried, and it failed.” Then go back to letting people die for want of a routine well check.
‘the nurse didnt even know how to write gelatine’ this may shock you, but it’s the 21st century, and people with spelling difficulties, language disabilities and dyslexia are allowed to be a part of society. i can only type properly because of spell check, and even then it’s difficult.
they have to check their books because that is protocol. they literally have to do that. it’s a basic rule of patient care.
I’m sorry that you feel the NHS has let you down. A twisted ankle is not really a fantastic reason to ring an ambulance or attend an emergency department, though, so this isn’t really the best example of poor care. As your post indicates that you had access to a friend with a car, perhaps that would have been a better place to start? Ambulances are for medical emergencies. I imagine that the reason it didn’t turn up promptly is because it was diverted to a severe asthma attack, a road traffic accident, a cardiac arrest, or something else life-threatening. The same with taking 2 hours to be seen in the ED. (I recently waited 1.5 hours for an ambulance after suffering from a head injury with temporary loss of consciousness–I was told to ring an ambulance by 111. They rang me regularly while I was waiting to check that my condition wasn’t getting worse, and I believe they were diverted to an emergency, hence the delay).
Also, we double-check medications etc in formularies prior to administering them in case of prescription error, interactions with other medications, or other contraindications to administration. These vary from patient to patient and it would be impossible for anyone to learn every interaction/side-effect/dose per kg for every medication. I’m glad you’ve seen such good practice so often. It would be terrible to be on the receiving end of a drug error just because a nurse was embarrassed to check a dose.
Having read back what I’ve written, I have assumed that you knew from the off that your ankle was twisted rather than broken. Your post does suggest that, but of course if you thought it was broken an ED or walk-in centre would be appropriate. Perhaps not quite life-threatening enough for an immediate ambulance, though!
Great post and probably one of the few people on here who has told the truth.
Had a similar experience with my son when visiting family. The cost didn’t even come up to the deductible.
Found this after a friend posted a link on Facebook. I think you’ve misunderstood something. You say non-emergency care isn’t the best use of the ER. It’s not the ER here. It’s A&E: accident and emergency. It’s fine to go to A&E with an injury that needs an x-ray, though personally I live near a hospital with a minor injuries clinic and would go there instead.
You mention people who turn up for things that aren’t urgent and how a user fee would fix that. That is just not how we roll here.
Actually, if you read the piece again, the author was advocating NOT going with any user fee because they really don’t work in the US. She had been asked, by people at A&E because she was an American and a doctor, if, as has been suggested, such fees might work.
And her cousin was taken to the injuries clinic.
In USA ER is A&E, just different language. People go to ER in just the same way as we go to A&E but with more paperwork, and a bill at the end. Waiting rooms more or less the same mix of different degrees of ill & injured and people UK or USA need to learn what options there are for seeking medical help. GPs too need same sort of tirage/option menu for people because they are being stretched by trivialities that, because there are fewer doctors now, are an underuse of their skills.
You are their perfect patient because you would head to the right place and you are lucky it is an option you have nearby.
Dr Gerber actually advocates NOT instigating a user fee because it doesn’t work effectively in US, at all. It has been seriously suggested, by Hunt circles in government if I remember, that a fee be charged and that is why the author was asked about it when she talked to people as she & her cousin went through the process. While I sincerely hope we don’t change our roll, the NHS is under the worse threat it has ever faced partly because people are even talking about fees at all.
Apologies, can’t find edit. Dr Gunter. Sorry.
Couldn’t she have gone to A&E or a Walk-in centre, she would’ve been seen without making an appointment then
Your lucky you didn’t go to North Middlesex Hospital. If your cousin went there, she would have definitely went home in a coffin.
Patients are very lucky, if they get seen within 12 hours, and when they are seen, the service is worse than a third world country hospital.
It’s a challenging environment to work in. Frequently >900 patients/ day through the door, and higher acuity patients than any other hospital I’ve worked. Agree it is not perfect, but unfortunately what happens there happens everywhere – just not plastered over the media.
I believe it will improve, the measures are being put in place.
The staff there really are some of the best, they are just overstretched and burnt out.
Also, nobody ever died of a sprained ankle, so I doubt her sister would have died.
If you honestly think that serice there is worse than in a third world country, then you’ve obviously never been a patient in a government hospital of a third world country like the Philippines.
Couldn’t agree more … We have this amazing healthcare don’t abuse it .. Take care of it and and all its brilliant staff as they do you !
Dear Jen,
I’ve just read this and your previous piece having been reblogged. I’m delighted your experiences of the NHS were positive, as are most of mine and most people’s in the UK . I was reminded of a number of things. About four years ago at a conference in the US I went for dinner with a number of people and an American started to relate a story about visiting London and his young daughter suffering a head injury on a barge stop at Camden locks on a Saturday evening. Those of us from this side of the pond were waiting for a horror story and getting our excuses ready. In fact we heard a tale of efficiency, speed and good care and allowed the mum to stay in the children’s unit over night. Like you he wondered about payment, checking his credit card limits etc. When he was told there was no charge he was staggered.
The negative propaganda about the NHS often trotted out in the US and parts of Europe is simply untrue in my experience.
Yes the system is under pressure in the south East because of population growth and other factors but in general it works pretty well.
A point not often made is the economic benefits to the country, reducing people’s fears about provision, helping employment mobility and reducing the cost of employment. Most people in the US would be better off with an NHS.
And before anyone asks I am not in healthcare
Bart
Why wasn’t the American family charged? The NHS isn’t supposed to be free for US citizens? I don’t mean to be rude- I was just under the impression that people outside the EU had to pay to use our health system, is that not the case?
afaik, they do pay, but the fee is very small, especially in comparison to american costs. im happy to be corrected, but that’s my understanding of the current protocol. i also think emergency medical care — say, if you were hit by a car — is either free or heavily subsidised
NHS emergency care for non-UK residents is free and always has been. Treatment for a pre-existing condition will be charged if there is not reciprocal agreement with the patient’s home country, but it will invariably be far cheaper than in the latter. NHS prices are significantly lower than those charged for the same procedures in the US.
NHS EMERGENCY treatment is free to all. In this case, funding streams are hotel taxes, air passenger charges, VAT on restaurant meals, etc. That’s true whether the provider is a hospital A&E, ambulance or GP.
Non-emergency treatment for non-EEA or Swiss residents is charged, since 2015, with a 50% markup.
My understanding is that emergency care is free to everyone, and follow-up care is free at the point of use with a claim to your insurance company or a bill to you later on. Unlike the US system where you’ll be asked for a ‘copayment’ (upfront fee) as soon as you arrive in A&E (before they take any details or begin the examination), which seems to be at least $100, just to ensure they’ve got something out of you in case your insurance won’t cover the treatment.
What you fail to realise is that we don’t dislike our NHS but we are frustrated with how it used to be compared to how it now. Fewer hospitals, fewer doctors and nurses, fewer open A&E departments, increased waiting times. But it’s not just that, it’s the fact that almost half of new NHS contracts have been given to private health companies. Many politicians have stakes in said private health care companies. How can we trust that the NHS isn’t going to end up completely privatised in 20 years time when we already know that most politicians lie and some of them have shares in said private healthcare companies? Virgin already has its claws in the NHS and millions of patient medical records were given to Google for their Deep Mind project.
If you lived in this country and stopped comparing it to other healthcare systems, you too would be immensely angry with the way the NHS is heading.
Tons of A&E (ER) departments have been closed, as the cost of people’s lives. Women have given birth outside of A&E departments because they were not allowed in. Maternity units have been closed.
NHS managerial staff (which is said to have been in overabundance for years and a huge waste of money) being fired get paid ludicrous paypackets (sometimes in the millions) only to be hired again later with outlandish salaries.
Many high tier staff in the NHS get luxury accommodation, dining and travel expenses, all paid for by the tax payer. This has been uncovered before but has anything been done about it? No.
GP surgeries have not grown with the population and the changes required by the people. To get an appointment at my local doctor surgery, I have to walk there and wait outside for it to open at 8am to ask on the day for appointment. You can ring at 8am, but the chances of getting through while everyone else is calling is very, very slim. What do older people do? Walk long distances to get an appointment that could be set 5 hours later? What about in Winter? Not only this but in both GP surgeries and hospitals, temporary staff is running rampant. Foreign loocums with poor English paid outlandish daily rates because the Government doesn’t want to hire English staff in permanent placements.
The NHS is going to hell and as Type 1 Diabetic which had naively been generalised along with Type 2 Diabetics, I’ve seen my healthcare be limited because overweight people have drastically increased the strain and financial burden on the NHS. My Diabetes is autoimmune, not insulin resistance (which is so common mostly due to obesity). I am aware Type 2 Diabetes can exist without being overweight, as genetic precursors can do almost anything, but overweight people have spiralled Type 2 Diabetic number because fat acts as a hormone which reduces the effectiveness of insulin. Type 1 is very different. Why must I be limited because a bunch of fatties ruined it for others?
It’s easy for someone to have a few good encounters with the NHS to sing praises about it and to tell people to stop complaining, but you don’t have the right. You haven’t seen how things have changed. You havent seen the plethora of closures and cost cutting. The shortages of nursing staff. The foreign replacements, (some of which are ridiculously rude and careless).
You can praise what you want but you can’t tell what to do when you know almost nothing about what goes on in the background.
Greed is why the NHS is dying and because many big businesses in the UK pay zero tax (of which would easily cover the annual NHS costs) the NHS is in huge debt and is no where near as advanced as it could be. Greed is why many people die. Greed is why US hospitals suck. Greed is why families fall on hard financial times. It cost money to walk into the ER in the US.
Your country is a joke as is ours and is greed is the root of all its problems. As an overpaid gynecologist you probably understand nothing about what I’ve written above.
As the the mother of a daughter with Type II diabetes, I am beyond disgusted by your ignorant comment “Why must I be limited because a bunch of fatties ruined it for others?” My daughter has suffered physically and emotionally from this disease for approx 15 yrs. You’re no martyr just because you have Type I diabetes. No one in their right mind would choose to have Type II diabetes. I’m glad that the medical profession doesn’t share your attitude. Here in Canada she is getting excellent care at no additional charge. I say “additional” because I have been paying taxes for exactly this type of universal health care for more than 40 years.
I didn’t say ALL Type 2 Diabetics were fat.
I have sympathy towards those who have a genetic tendency towards type 2 Diabetes, but obesity has drastically increased the number of Type 2 Diabetics on the face of this earth, by a massive number – there is simply no denying that. It has been proven that excessive weight reduces insulin sensitivity and can trigger Type 2 Diabetes. So before crying victim and defending your daughter, realise that what I’m trying to say is that many cases of Type 2 diabetes wouldn’t exist if people looked after their health and weight better and therefore such cuts to certain equipment may never have happened (or Diabetes health care may be better in general). Read things properly before you moan at people you dumb Canadian.
I have an autoimmune disease. Also, I’m in the UK and I am talking about the NHS, not Canadian healthcare systems.
Again, read first before you comment.
I have removed the insults from your reply. That’s not acceptable.
Please don’t do that again or I will spam your comments and they won’t show up again.
It is possible to disagree and also be civil
Excuse the typos. Was typing on a smartphone.
You have some interesting comments there, just a couple I wanted to reply to:
Closing A and E departments, this is something people care very much about, but as and senior clinician who has been both an A+E charge nurse, patient safety lead and risk manager I can tell you that the reason we have less ( but larger A+Es) and smaller A+Es got closed or merged was for very good evidenced based safety reasons. The simple truth is that as we have improved our ability to treat patients with more complex treatments we need to ensure our care settings
1) Getting the patient throughput to be safe, a small A+E seeing only around 20-30k patients per year could not sustain the skill sets in its clinical staff to be fully safe, this is very true with paeds and rarer problems, if you only see one septic child a year your just not going to be as quick of the mark or as practiced as staff in larger centres who may see 1 a month or more. That’s why we shut small departments all the evidence said it was harming people.
2) The new gold standards of treatment need massive 24hour infrastructure and incredible levels of specialist expertise avaliable 24/7, that the small acutes hospitals and A+Es just can not provide. When I started in A+E if you had a stroke there was little we could do, now we can treat you with clot busting drugs, but to do it you need 24hour instant access to CT and the consultant to initiate the treatment, that can only be provided in a larger unit. Small units just can’t sustain the 24 hour immediate access to senior clinical staff. Another example is how we treat heart attacks, 10 years ago we gave you a clot busting drug that could be delivered in any A+E, now standard treatment is immediate primary angioplasty (major surgery on the blood vessels supplying the heart muscles) but for that you need 24 hour access to a consultant level vascular surgeon who specialises in heart surgery and a whole angio suite on call and ready to go immediately.
As for a the lack of professional staff, this is very much about the demand of a modern health system for more and more qualified staff. Entry to nursing is now degree level, most specialist nurses or practioners will have a post grad qualification or masters), consultants are now so specialised that you may only have a few hundred in the country focused on a particular speciality. The more advanced and better we get the more demand we have for higher and higher qualified staff. Just think we need around half a million qualified nurses to run the NHS, each takes 3-4 years and a degree to qualify at the most basic level, every one of them need to have further educated constanty through their working lives just to stay current at a basic level. But we need significant numbers to go on and do masters etc….. Every one of them will also need to accept that they will work in a profession that pays only an average wage and can break you physically and emotionally. We need nurses from across the world because we just can’t work out how to pursued the number of bright people we need (to keep the half a million workforce) that going to uni and training for three years to qualify, then spending your work life doing shifts, see people suffer, getting PTSD from the images in stuck in your head, having pain from a damaged neck and maybe just maybe being human, making a mistake, killing someone and living with it forever, is all worth 22-28k a year……it is worth it all, but it’s very much a damed hard to sell to a clever talented 18 year old. So please bless the staff who come to work for our NHS, they could go to the states and earn 2-4 times what we pay them.
The truth is our county could afford to pay more into the NHS, but we the tax payers make the choice to vote for politicians who keep the funding of the NHS lower than all comparable healthcare systems. The NHS manages because of the dedication of the clinical and support staff and the skill and knowledge of those senior managers you seem to dislike ( my CEO is responsible for a budget of around a billions pounds and the healthcare of almost a million people, he earns less that 150k a year and will be dismissed if he fails to achieve all his quality and financial benchmarks) . We do make the NHS work with the money we have by keeping staff pay as low as we can and being as focused as we can on up stream healthcare (primary and community), which is the most efficient way of supporting good health.
I agree with what you’re saying and I understand, but closures could have and should have been avoided because demand needs to coincide with demand from a growing population. More money could have been put in, but wasn’t.
Hospitals and GP surgeries are, as you already know, overflowing. The money is there, yet it’s not being put in the right places. Yes you’re right, the people are to blame. I was furious when the Tories got voted in a second time. Those savers and penny pinchers voted them in for their own selfish reasons. However now, there is a campaign to remove Jeremy Corbyn, which I honestly think (once you see past all of the propaganda online and in the news) that he is the last hope for everyone in this country – treating everyone as one. Of course, if you treat everyone the same, many heartless, selfish, poisonous people will see that it doesn’t align with their agenda and will chose someone else. People are people. They are no different from anyone else. There is no person above or below another. It’s this kind of primitive thinking which plagues the civilised world.
I dislike managerial staff because it’s been said repeatedly that there is an overabundance of them and they cost a huge amount of money. I couldn’t care less if he earns less than 150K. Is this a sob story? That’s a ludicrous sum of money for someone handling the books, whereas Nurses, as you’ve already pointed out earn a paltry sum. This is part of the problem in this world, stature/position defines the money earned, not the effort or skill that is required in a job.
“Keeping staff pay as low as we can”. Wrong. You lower the pay of all the important workers, while keeping grossly inflated salaries for those at the top. Just like a business or a bank. It is not the most efficient way of supporting good health. If they lowered everyones salary by a smaller amount across the NHS, it would be far less damaging to workers and the NHS as a whole. Of course some variation to that would be needed, as a blanket approach wouldn’t be a great idea, but you see where I’m going with this. It has to be fair for all, not just a select bunch. I don’t care if Mr. Less-Than-150K isn’t getting his fill, but that is a disgusting sum of money to earn on an annual basis, when so many people across this country, both in and outside of the NHS, do far more difficult tasks.
You almost sound as if you’re defending the crown against peasantry. But hold on a moment? You’re from overseas. You type as if you work within the NHS, in which case this page is self-serving. Do you live in the UK or in the US? What’s the deal? Perhaps I missed something?
Well argued and said UK/FX
Greed yes, but it’s the greed of the staff and their refusal to modernise. In short they are killing their own sacred cow. Outsourcing is the only way to circumnavigate the militant and disruptive staff. I’m all for it.
Do you work for “sir” Richard Branson, Chris? Or for the Koch Bros? Everything you write sounds as if you’re a paid propagandist (shill) for profiteers and exploiters.
Modernising to fit predatory, exploitative capitalism is a waste of time. What’s neede is to wreck and scrap it, replacing it by socialism.
@gegenbeispiel
“as if you’re a paid propagandist (shill) for profiteers and exploiters”
Stop making me love profiteers and exploiters.
Frank: judging by your comments here, you’re definitely in bed with profiteers and exploiters already. Whether it’s a loveless or loving relationship is a matter of complete indifference to me.
Dear Ms. Gunter,
Glad you appreciate the UK’s NHS, which is a marvel to behold, and is indeed replicated in quite a few nations, among them Hong Kong, who’s own Health Sevice is very much like that it the UK, as is the obvious want of repair/updating of many premises.
Having had the benefit once of health care insurance, I used it a few times, but eventually worked out that public provision hospitals were superior to pay hospitals, that is the service itself was/is superior and at a far lower cost burden than anything the private sector can offer.
Hence, it was with sadness that Bernie Sanders was denied running for the US Presidency, for its likely, had he won, you chaps too State-side would finally moved to a comprehensive and free at the point of service health care system.
Again, many thanks for highlighting that the UK, despite serious cash shortfalls, has a great health service, one that cares about the patient and not their wallet, which I, and many millions are hugely proud of and will defend to our last breath as they say.
The only education provided to our young people about driving in the UK is at most one session where the police come and speak to yr 11 pupils about not texting/not drinking. There is no driver ed provided in school; all driving lessons (and tests) are paid privately by the young person, or probably their parents.
Also whereas the NHS may work quickly in an emergency, or for a life threatening situation,you wait many weeks for routine appointments
Bob go and stick your head up your ass if you want to talk like that I’ll give it you back also I was writing this on iPad if you to you , writes what it wants I did try to edit it but it wouldn’t let me so now piss off arsshole l worked with 22 SAS and the 101st Us airborne and the 6 th Gurkha Rifles and even when crush Malaya was on the Indo Chinese never tried to talk down to us
Your writings are evidence against the effectiveness of the NHS’ ability to properly care for the mentally infirm.
Get off the internet and onto your meds.
>”l worked with 22 SAS and the 101st Us airborne and the 6 th Gurkha Rifles”
That’s no credit to your writing or thinking ability.
Correct, the emergency care is second to none BUT routine appointments you wait anything from a couple of weeks to several months and it is in this instance that the NHS falls extremely short of the mark. What I find disgusting is that I was born in England BUT because I married someone with a vaguely sounding foreign surname, reception staff in particular regard you as immigrants in the UK for the health care. I now carry my birth certificate, and passport with me just to prove a point and always make a point of noting the duty manager’s name and contact number should I need it because this lessons in manners and not to jump the gun still have to be hammered home quite frequently!!!
Don’t worry, it’s just as crap if you have a British sounding surname.
Your passport and birth cert. don’t matter, the criterion for NHS non-emergency coverage is legal permanent residence in the EU/EEA , not UK citizenship. The best document to carry is an EHIC card , https://www.gov.uk/european-health-insurance-card , even within the UK. A UK driver licence older than 6 months will do, too.
All NHS England hospitals (except A&Es) are now supposed to ask you about NHS eligibility, regardless of your appearance or surname. But I’ve never been asked for documents.
I’ve waited weeks for routine specialist/GP appointments here in the States. What’s your point?
I had Blue Sheild PPO coverage (the best you can get from Blue Shied) in the Silicon Valley of California a few years ago. This area is hardly an unpopulated or under-serviced area for medicine. Their doctor directory for a GP was 10 pages of names, the first 6 pages of names/addresses were not accepting any new patients. The next 4 pages had no GP with less than an 8 week wait to see a new patient (for any reason). Then even that doc had a 2 hour backlog of patients, (meaning you got there for your appointment and waited 2 hours), and then were seen for 15 minutes before being told that is all the time they have. Complete garbage, and it costs a pretty penny to get even that much.
HMO’s like Kaiser are better at this sort of thing and dealing with your coverage (because they don’t work their GPs like rented mules and every department is interconnected). But unless you live in a metropolitan area, even this can go badly.
We pay 5x the international developed world price for this care and it still sucks.
Reblogged this on Welcome to Katkimjac's Space and commented:
NHS rise again, and to the British government stop trying to mess it up!
Really interesting, sounds like you’ve had great experiences with the NHS.
Those wheelchairs are all over the UK and a pest!
I’ve got friends in America who say they oppose free health care there because they refuse to pay for those who suffer from addictions or the unemployed. Which makes no sense to me. We do pay for the NHS via our tax, as it should be.
Also inyerstingly all medical care is free in Scotland, which is a different NHS to England. Prescriptions and dental check ups etc.
There is a big difference between the NHS in England to here (Scotland), I have Avascular Necrosis in way to many joints – I waited 3 weeks from when I told my surgeon at 26 I wanted a hip replacement to getting it – people in England walk about with a collapsed femoral head for 2 years plus.
A friend in Chicago bought glucose testing strips here for £18 (she would have gotten them free if she was Scottish), costs her over $200 at home. Which is insane. I hope one day America figures out a better way – because as your story suggests with the copays there must be people dying.
Also – worth pointing out that a lot of people visit the ED out of normal GP working hours. And I’ve had xray’s booked over the phone – this may just be Scotland though.
2 years ago, here in the US, I was diagnosed with MS. After having a severe allergic reaction to the first medication, that required hospitalization for anaphylaxis shock, my doctor prescribed a different infusion medication. My insurance company (an accountant or clerk probably), refused to cover the treatment. Without insurance, this would cost me $5,200, every other week. After 4 months of plodding through the absolute hell that is dealing with insurance companies here… Appeals, denials, paperwork, 2nd & 3rd opinions, etc… I was lucky enough to be approved by the pharmaceutical company to get the medication I needed at no cost. I still had to pay for the day long process of the infusion which was almost $800, every other week, for months. I received NO treatment for those months and my MS got dramatically worse. Over the course of 18 months of treatments, no treatments, hospitalizations, PT, OT, and in home visits for steroid infusions, I spent every penny of my savings & retirement savings and racked up insurmountable debt. Those 18 months cost me almost $80,000.
But I was “lucky!” I had savings and retirement funds. I have a large family that helped me and a group of friends who held fundraisers for me.
I have family in Scotland, have been there many times and seen how the NHS works there. Someone complained about the “supposed” amount of time to wait for procedures… 4 MONTHS with NO treatment at all because of the US system.
No one should have to hold raffles in order to receive needed medical treatment!
I apologize for the lengthy and rambling nature of my comment. Because my MS worsened so much while not being treated, it now affects me cognitively and I don’t communicate as well as I used to.
The NHS is something to be enormously grateful for. The alternative here is a hellish, system that financially ruins those who can pay for it, and kills off those who can’t!
Absolutely, most bankruptcies in the US are related to medical care. I have had expenses that are comparable to an average income. I have only avoided bankruptcy due to saving since my 20s.
This is for Margaret but for some reason it won’t let me reply to her so I’m replying to message above hers:
That “research” that showed that most bankruptcies were related to medical expenses was garbage. What they actually showed is that most bankruptcies involved at least one medical bill. That’s hardly news.
A Google search for “percent of bankruptcies due to medical bills” lists a number of studies. I have read through some of them and don’t find the same “garbage” that you do.
Here’s a recent article from The Wall Street Journal on a study by a researcher at Northeastern University in Boston. http://blogs.wsj.com/bankruptcy/2015/07/01/the-future-of-personal-bankruptcy-in-a-post-obamacare-world/
Here’s a highlight from his research: “Massachusetts residents who file for bankruptcy protection these days have way less medical debt compared to the rest of the country. The typical Massachusetts person or couple who filed in 2013 had $3,041 in medical debt, while people everywhere else had an average of $8,594 in medical debt.
In fact, he found that Massachusetts is the only state where medical debt isn’t the leading cause of personal bankruptcy. (A loss of income is the No. 1 reason, he found.)”
Don’t forget we were paying the Yankee for 50 years they said it was for them helping us in the war ?well the
Germans had a real good time in Us ports sinking your ship they called it the Happy time? Then the Japanese took out most of your ships then and only then did the US decide to come into the war so we had been fighting for years before thatwas helping them realy. The Russians told the US it was the US war as well as Russian. And they paid nothing to you. But our lads were getting killed for nearly two years befor the Us decided to come in then for the firs year while our lads were still being killed fighting Germans , Italians, and and Japanese while the gi was living it up here in England one reason we had no money after the war and on top of that paying money to you for a war that was yours and ours the Yankee did very well out of this war that’s why they have rockets now and also plans and other things for aircraft they stole from Germany any way I hope everything turned out OK for you
Here Here on that! Yes the Germans did not have to pay war reparations after the war…. in fact they had their country rebuilt by other nations. The Brits had to repay – after the war – the cost of the armaments which had been sent by the US while they – the Brits – were the only ones fighting the Germans. I think the cost of the war ….to the Brits …was something like $6,000,000 a day but I may be wrong on that. From an almost 90 year old who lived in the UK during WW2.
Wrong: Germany paid billions! https://en.wikipedia.org/wiki/German_reparations_for_World_War_II
I agree, the Anericans acted selfishly, late and without any concern about their allies. Their claimed development of the Atom bomb was a lie, the concept was put in place at Birmingham University in 1937 and the accelerated development was by German scientists smuggled out of Penemunde and other German sites into the USA.
Britain paid for the “lend – lease” programme for more than 30 years whilst Gremany, under the “Marshall Plan” was rebuilt at no cost, the same in Japan.
Although living in Australia, I grew up in the UK in the 1940 – 1950s where the NHS struggled for funding because of the payments to the USA.
We are now in a position where Americans generally, have little or no knowledge (or care) about the rest of the world with most thinking that they “own” it!
To be honest I also have seen both sides I was taken to one Hospital and no one saw me for two days so I got dressed and started to go home then Doctors sergion and nerses and matrons seem to come out of the wood work to try to get me to stop in. And the next time a few months later I was put in Bolton Royal Hospital within two days they had done tests put a camera into me sent me through two scanners like big washing machines then told me they couldn’t find anything wrong with my heart but they found two small stones in my Pancreas they took them out and the small stones that I saw on the camera pictures turned out to be as big as base balls all this was done in two days of going in? So I have seen the bad and the good.
How is this barely coherent mess relevant to the post? Do you pay any attention to what is appearing in the screen as you type? Over half your comment is a single sentence. If you want people to take you seriously, learn basic concepts such as punctuation and sentence structure.
GOLD!
I think you are on the wrong thread, unless the Russians are going to take over the NHS?
All of which has absolutely nothing to do with how the NHS is funded, nor how fantastic it is! Maybe I’ve missed your point?!
.. add to that millions of slaves who worked for free ..
What’s any of this got to do with a post about how good the NHS is?
What a great post. So nice to hear positive messages about our wonderful NHS. I have had cause to use the NHS on numerous occasions throughout my life (although thankfully rarely In an emergency). Recently I had to rush my elderly father to A&E with chest pains and breathlessness. We were of course seen immediately but what pleased me was the way the receptionist cut through the bureaucracy. Her words to me were, “I need a few details but I’ve got a triage nurse on her way now so don’t worry…” Absolutely fantastic. My father was having an ECG within 5 minutes of walking through the door. He made a full recovery after a few days in hospital by the way.
I get so tired of hearing people complain about the NHS. We all know it’s not perfect but it’s pretty damn good!
Hey, if you want we can do a ouija board and tell my mum that. 6 times we took her to a&e, six times they pushed her back out home. It was only once I got really rude with them that they did what they should have done and made a diagnosis. Bowel cancer, we had been taking her to a&e for 12 months (the 6 times), the NHS admitted if she had been dealt with quicker she’d have survived – if that was a car I’d be wanting the head of the mechanic who screwed up – but in the NHS you don’t even get a sorry. This has nothing to do with underfunding or the government, this was the staff and their lax approach. It isn’t holly city I there, the staff don’t give two figs and if it’s near to home time you have no chance of getting anyone to step up. This isn’t isolated, the problem is that the naysayers are discredited on sites like this by the army of NHS and socialist supporters who see the idea of the NHS and the gravy that comes with it as more important than any patient. I’ve never met anyone who has had a good experience with the NHS, yet I come on here and various people describe a health service I have never seen. As a general rule it takes 3 weeks to see a gp, 3 months to get a referral and if you get an appointment lasting more than 5 minutes it’s a miracle. A&E is a place where you can wait 5 hours despite there being no activity what so ever. Staff hanging around, talking and laughing. Getting anyone at the NHS to take any responsibility is impossible and the devolved trusts make that harder too, the governors of hospitals are out of touch and when I tried to engage unobtainable. In short they aren’t interested in the patient, we exist so they can pay themselves on the back. I pay 4K a year for this. It’s not worth 4 pounds.
How many years wait is there for a CT scan in the UK for a post-diagnosis cancer patient with a spot on her lung? And you say a US $100 co-payment is cruel? Rubbish.
There is a maximum wt of 4-6 weeks ! Usually is within 2 weeks ! So the notion that there is years of wait in uk is rubbish!
A friend of mine is still waiting for a consultation with oncologist 8 weeks after being told there is cancer ‘somewhere’. So it’s a lottery nhs
The major issue with the NHS is with lack of joined up thinking and underinvestment. I needed 3 different scans (ultrasound/MRI/CT I think) to try to get to grips with some pain I was getting in my stomach and other symptoms. 6 week wait for the first, a week to look at the scans, another 6 week wait for the second, 2 weeks to look at that, another 6 weeks for the third. 5 months later I get the all clear, had I had cancer, the wait might have killed me or at least meant I lost the benefit of catching it early. I’m sure the French would have done all 3 scans on the same day within 2 weeks.
Also their IT systems are terribly inefficient. I’ve just missed an appointment with a specialist nurse because a letter went missing in the post. I asked the nurse who requested the appointment 3 days before whether there was anything on her system about it as I should have had notification, and despite the fact that the appointment was at my home surgery and they were notified a week before, it wasn’t on their system, apparently they only add it afterwards so when I looked online I couldn’t see it and neither could she. Get into the 20th or 21st century, book appointments by phone or email, and send email reminders if the patient consents.
I’m very glad to have the NHS, but it’s not perfect. It frustrates me that it could be better.
agreed….. I have a letter here dated 19th August, advising me of my CT scan booking on Sunday 4th September 7.40am
Steve dannell, I work in the NHS and have been getting some information to help my brother in Law who sounds like he is being investigated for similar symptoms, the ultrasound, CT and MRI are looking for different things, and differential diagnosis both in US and UK will be look for the most likely cause, and rule it out then work down list of possible other causes. So do ultrasound first makes sense as if it had found what they had suspected you would not have need the others.
I still think 3 x 6 weeks waits is too long, my BiL had something closer to 2 weeks, 1 week, 2 week, but what both of you have faced poor response in explaining what is happening and why.
IT I agree with you, we wasted a fortune trying to end up with a single super system for all of England and should have just got on with putting in improved IT locally.
First, read carefully, the patient was not post diagnosis cancer but awaiting new diagnosis as a previous cancer patient HUGE difference.
Secondly, What on earth led you to believe that CT scans for something as almighty serious as cancer check would take a month let alone years through the NHS? No one I know of who has had experience of cancer has ever had to wait long and most definitely NOT even close to A year let alone years.
And no cancer patient in this country has to be concerned about having to pay for any of their diagnosis or treatment at all, let alone beforehand. How would you feel having to cough up cash you don’t have while you cough up what might be your life? It is cruelty and people HAVE DIED for it!!!
Your exaggeration makes me shudder because it is that kind of blithe disregard of context and perspective that sets the NHS in jeopardy from those who would prey on the sick to make profit.
THANK YOU for correcting the bad information that “Noval” wants to peddle. That’s part of the con game run on the American people for decades. Those who fight tooth and nail against a rational system of health care for the U.S. lie with impunity, and too often their lies are taken up as gospel.
It’s a two week wait maximum on the nhs for cancer diagnosis and treatments to start.
I’ve recently been through it myself.
Do tell, how many? 🙄
My mum waited 12 months for a cancer diagnosis for bowel cancer. She was losing weight and couldn’t keep good down. They said she wasn’t looking after herself and asked us not to bring her back. That’s the NHS I know. When I complained I was told “this sounds like we need to get our solicitors involved”. All I wanted was answers.
My husband when getting a check up for a constant cough and suspected lung cancer was sent for a CT scan almost immediately I suggest you get your facts right before such inane comments. ANY money when you have none IS cruel. Not everyone is well off and remember that America does not have unemployment and disabled benefits. Its a supposedly civilised country with very uncivilised practises. Just be bloody grateful for NHS.
The United States absolutely does have unemployment benefits as well as disabled benefits.
YESSSS!
2 weeks or less. There is a target that is religiously stuck to
2 weeks or less, once your doctor decides the chance of it being cancer is above a certain level and agrees to order the scan. Sadly, it can take months of repeat GP visits to convince the gp to do that, as my family sadly found out. I don’t blame the GP, as he told me afterwards he has a small budget and has to prioritise, but in another country like Australia, where money isn’t the same issue, the scan that showed the cancer would have been ordered months earlier.
What a load of old cobblers, there is NEVER years of waiting for a CT scan in the UK. I’ve had 2, neither for suspected cancer and the longest I waited was 4 weeks for one and only 2 for the other. As another poster commented a scan is usually performed within 2 weeks if cancer is suspected. My youngest son had suspected bowel cancer and received an appointment within 3 days to see the consultant and 1 week for his scan and colonoscopy. My ex husbands 3rd wife has recently died from cancer in the US, actually she killed herself because she was terminal and they couldn’t afford any more treatment. Their insurance no longer covered her and they had sold everything including their home to pay for treatment. They even had to buy oxygen, she had lung cancer caused by working as a fire fighter on oil rigs and at home, no compensation was ever forthcoming. So before you slag off our NHS any further, ask yourself this; when have you ever heard of someone blowing their brains out in a motel room because they could no longer afford treatment and they where in agony in the UK.
wife has had a brain tumor, she has a scan once a year, if she is feeling unwell due to the problems it has she contacts her doctor at the neurological center who makes the request, it then takes 10 days or less, we would struggle to find this $100 co payment rubbish that YOURE advocatin, but please carry on, you seem to be doing so well over there…..
Erm… It’s a 2 week wait? National guidelines? Is that ok?
You would likely be seen within two weeks if cancer was suspected. I recently had symptoms that suggested possible cancer and was seen within a week.
1 week wait in my experience. CT scan and biopsy done 7 days after my dad visited the GP. The results were given two days later.
whilst this experience was shared(internet) at the same time there was another younger cousin (not a model) hidden away in a small room in a council house waiting to die from a recently diagnosed aggressivebrain tumour. query family communication/priority ???
When I had suspected cancer I had “two week turn around” written on my notes answers@linkedin.com was guaranteed to get all scans and teats results within two weeks.
People sometimes wait months for non urgent treatment like hip replacements but not for time sensitive stuff.
How about telling us about your sources for such a ridiculous statement? Or could it be the old “socialised medicine” paranoia? As commented, plenty of people cannot afford $100, be glad you can. I lived in the US for a number of years and was horrified to see people not getting treatment as they could not afford it, or benefit concerts for musicians who got cancer, etc. The most ridiculous comment is ever heard out there was, when I mentioned that musicians often had to raise money like this was “they should have considered their career choices”.
I would be surprised taking into account the pre history off the example mentioned if she wouldnt be seen there and then ( as she was already at a hospital) it would be less than a week if not on the day
For a ‘suspect cancer’, any cancer, anywhere, in any age group, the maximum wait allowable by government legislation is 2 weeks. And there is a drive now to make that 2 weeks to treatment so the scan would probably be within a few days. Any fairly of a service to meet this deadline is met with an investigation and financial penalties to the provider. I have never heard of the deadline being missed. And I have worked in the NHS for over a decade. Clearly $100 is nothing to you but it is a lot to many people both here in the UK and in The USA.
Possible cancer imaging is performed under a rapid access 2 week wait pathway. This includes follow up.
I broke my ankle while living in London but on holiday in Ireland. I had x-rays, diagnosis, back plaster cast (couldn’t get a full cast since I had to fly back from Ireland) and doctor note with instructions to get full cast as soon as I returned, given it was partially displaced and the back plaster cast was already on twice as long as it should have been… but when I got back to the UK, I was told I had to go back to A&E, after an hour and a half wait, I was told it would take two weeks before I could get an appointment at a fracture clinic to get a real cast. Fortunately I had private medical so was able to get seen more quickly. I imaging it’s better outside of London, but I for one regret paying National Insurance for unacceptable service when I actually needed it. Give me the US (pre Obamacare because I know things have changed since I have been living in the UK) where I would have been seen immediately and the cost really isn’t that much more when you take into account how much you pay in NI contributions annually!
I have quite a lot of sympathy for US-style individualism but I think it misses two really important points re. health care:
First, healthcare is a public matter. One person’s choices affect other people. Recently there was a severe measles outbreak in Wales where people died, because over the last few years a lot of people had chosen not to have their children vaccinated against measles. It’s in ALL our interests for life-threatening and other illnesses not to be allowed to be widespread.
Second, none of us (except legit billionaires) can be sure we can cover our own medical expenses. Serious, long-term illnesses can easily cost six, seven, eight figure sums over a life time. Thankfully, most of us will never need that sort of treatment, but we don’t know who will. That’s why we have insurance. In the US that’s private insurance, in the UK it’s national insurance (and, if people choose, private insurance on top of that). The choice is between private, for-profit insurers, or public, not-for-profit insurers. I know which I would rather trust to make decisions in the best interests of my long-term health.
It’s great to see such positive support for the NHS from an American doctor. It is a fabulous system. The dubious presentations at ER are not really anything to do with education though. Of course, there are hypochondriacs and no amount of preaching is going to convince them they don’t need attention. And then there are a lot of genuine people who come up against the frustrations of the NHS. It is very hard to get a timely appointment with a GP. Services are overstretched, triaging over the phone is very officious, the appointment allocation system Kafkaesque. ER – or A&E, as we’d call it in Britain – is a way of circumventing all this. I say this because in defending the great principle of the NHS, it’s important to be honest about its shortcomings.
It is incredible what the staff of the NHS do for us all, despite the attacks on their funding and contracts. Imagine what could be done if the government were not trying desperately to make them fail, so that they have an excuse to privatise!
I’m so glad to live in Scotland, where our NHS has a bit more protection than England’s, and is better funded and better preforming (despite Westminster’s constant attempts to force the situation otherwise).
I honestly can’t imagine living in a country without social healthcare. I find it insane that the USA clings so strongly to their outdated and failed system of health for the wealthy.
For 90k a year as an qualified doctor and 40k for a nurse, plus gold plated pension, never a minute worked that you don’t get paid for, cheap housing, cheap mortgages – bursary grants other students can only dream of, guaranteed pay rises regardless of your performance – and the knowledge that if anyone tries to take any of it away, you can go and strike and socialists will give you unconditional support. We are so lucky to have the staff who work in the NHS, all 1.5 million of them. (Shakes his head)
What cheap housing, cheap mortgages? They don’t exist. Bursaries don’t exist any more either.
It’s actually become worse for many in the US.
The days of a $ 100 deductible for the ER are long gone. My wife works in medical diagnostics, and we get our coverage from her employer. Two years ago, we did have a $ 100 deductible for the ER, we had a $ 29 co-pay for our family physician, & $ 49 for a specialist. Now we have a $ 4000 deductible per person (up to a family maximum of $ 8000) that has to be satisfied before the insurance pays a penny. The last time I went to the doctor I was told that it might be an idea to have some tests done. I told the nurse who was going to schedule the tests that I couldn’t afford to have them done. She told me that the nurses at the practice and the hospital that ran the practice were in the same situation; they had all been moved to high deductible medical plans, and would not be able to afford the out of pocket expense in getting treated at the hospital group they worked for.
Next time come out with me (consultant level nurse practitioner) in my rapid response ambulance and see how we treat at scene- avoiding ED, hospital all together. We admit, prescribe, offer a full range of tests and diagnose. We see life threatening through to end of life. Complete autonomy and very positively received by all.
Jules
“To receive this care all my cousin had to do was provide her name and birthdate.”
In the end, who paid?
“Dear U.K., the NHS is awesome.”
Based on only two anecdotes, that may be reaching.
I paid, as does anyone who pays National Insurance.
A couple of weeks ago I was admitted with breathing difficulties. On that occasion, I relied on other people’s payments.
I am fine with this as a system.
Of course, all beneficiaries of a wealth transfer scheme are usually “fine with this as a system”.
The vast majority of us DO love, appreciate & respect our NHS. Everyone I know who works in the NHS are very passionate & proud of it too. 😊
I can see the family resemblance! I trust your cousin is mending well.
What you describe is what should happen most of the time in the NHS. Alas, politicians have got involved – particularly the Tories – and are intent in wrecking it with their neo-liberal market-driven ideology. But it’s still far better than anything the US has to offer, isn’t it?
Dr Gunter. Thank you. I so hope our government listen to. Sadly they seem to believe the only way to improve our still wonderful NHS is to give some of it’s funds to wealthy health care corporations to distribute to their wealthy shareholders.
“obesity causes 30% of cancers”
Could you provide a source/citation for this?
I see research linking *reduced activity* to health issues, which is different from linking *obesity* to health issues. Also, is that 30% of all *varieties* of cancers, or 30% of all *instances* of cancers?
This statistic seems to be all kinds of problematic.
What I’d like people in the US to understand is at least part of why we have a welfare state, of which the NHS and pensions, disability benefits and help for people out of work are a part.
Between the August of 1940 and May 1941 we endured the Blitz. Just about every city in the UK (save Oxford and Cambridge) was bombed. Coventry was pretty much destroyed. London was hit time and again. Just under 40,000 civilians died. That’s the equivalent of a 9/11 every fortnight for eight months.
That wasn’t the end of the bombing. Even towards the end of the war it became more terrifying in the shape of V1 and V2 rocket attacks. More than 100 rockets fell on the four parishes around where I live in Sussex in the middle of the countryside. Again London in particular suffered. Famously the present Queen’s mother is supposed to have said that the fact that Buckingham Palace was hit allowed her to look the East End in the eye.
And just as the home front was endured together people from all walks of life fought together from Malaya to the North Atlantic, made friends and became comrades.
The NHS and the rest of the welfare state was our way of recognising that we had endured that we had endured that conflict together, rich and poor alike. In 1945 Churchill was unceremoniously turfed out of office in the general election and a Labour government started work on the welfare state, arguably the greatest political achievement of the last century, an extraordinary act in extraordinary times.
I know the United States (apologies for the sweeping generalisation) likes to think of itself as a nation of rugged individualists forged in the revolution and the trek westwards and that has shaped the nation’s character. Well we have achieved our best through working together, not alone. Our struggle to build a better nation was a collective one.
The NHS is our greatest monument to that principle. That’s why we love it. It treats us all the same, rich and poor alike, because no life is worth less than another despite a world apparently determined to act as though it is.
Thank you for appreciating it. It’s there for our friends and guests too.
How strange. Someone seems to have started slicing onions.
TROLL alert !!
“Our struggle to build a better nation was a collective one.”
Thank you so much for this comment. Yep, we Americans are “all about the bootstraps.” Sadly, too many of our citizens can’t afford “boots” much less bootstraps. We’re too busy trying to protect what we have rather than taking a look around us and realizing that we too “could build a better nation” if we would only come together as one.
Here here , my British heart is as proud as yours . We brits do know what we have and most of us respect it greatly. The fact that it does not discriminate rich or poor makes me very very proud of our NHS .
It’s an awful legacy which people pay for with their lives everyday. It’s 1941, it’s 2016 and a socialists ideal shouldn’t be the basis for whether you live or die.
If it’s an awful legacy then why on earth is it consistently found in polls to be the thing of which Brits are most proud? We have great healthcare and we don’t have to worry about whether our insurance will pay out. Moreover it has been maintained by successive governments of both the left and right.
@Jonathan Kent:
“why on earth is it consistently found in polls to be the thing of which Brits are most proud?”
because it’s a major subject of propaganda? because they don’t have much of a choice?
Oh you’d rather live and die by free market capitalist rules, where insurance companies decide on your treatment?
Utter bullshit. What you call “modernise” is really “make compatible with market fundamentalist capitalism”. The latter is responsible for the Greater Depression 2008-forever and is a complete, unrecoverable failure, to be scrapped ASAP (and have its adherents re-educated).
Market fundamentalist capitalism (which often masquerades as “libertarianism” but is strangely reluctant to liberate the capitalist-owned means of production, distribution and exchange) must be trashed, wrecked and replaced by egalitarian socialism.
I’ve just come back from Addenbrooke’s A&E in Cambridge – had really wonderful service there
Thank you for spreading the news about our amazing NahS and the fantastic people who work there. ❤️
Thank you Dr Gunter
I live in the UK and have the greatest respect and gratitude for the NHS. I don’t know how widely known it is that they also have a phone number (I think 111) where anyone can ask for advice, 24/7, for any worries. I’ve used it twice in 8 years and had the most competent, most scrupulously detailed, most time-efficient response. I had an accident 9 years ago and the level of care was outstanding, top specialists brought in for each potential problem, every possible angle covered, excellent after-care advice, excellent care for the ensuing problems, in each department where I needed to go. It’s true that, in 20 years in different parts of UK, some GPs and GP surgeries were less pleasing than others. My current one is stellar. But specialist care is outstanding, and GPs are worked very hard, they try their bests, and some or perhaps most of them manage to remain wonderful. It pains me to see how the system is hassled, because it is wonderful and it should be greatly celebrated and helped.
Reblogged this on Arranging Reality and commented:
The view of an outsider. And not just any outsider, one who knows how other systems work and how crap they are compared to ours.
Strange to think that in the late 30s Hollywood would have as a film idea, a health service where the community put in a few cents a week to support it. It was one of the Dr. Kildare films entitled Dr. Kildare Goes Home (1940) where one of the rich in the community ‘poo-poohed’ the idea from these young doctors until (IIRC) his own son needed urgent medical attention which was offered.
I hope and wish that the delightful government of our strange little group of nations reads your post – and sees what really happens – and maybe, just maybe, realise that the NHS is probably the best thing to have in this country ever. Of course there are problems and issues and things that need sorting – but – without it, lives are lost, people are made bankrupt. Healthcare, free at the point of use, is what no-one ever ever moans about paying taxes for – and long may that continue.
Meanwhile in Birmingham my mum has been waiting for the hospital to remove he thyroid as its crushing her windpipe since October 2015… That’s 10, that’s right TEN whole months… Brilliant… In pain and can barely breath for 10 months…
I’m an American living in the UK (8 years) and I think the NHS is great. I broke my arm quite badly several years ago and had excellent treatment (2 surgeries) and rehab and never paid anything. I can’t imagine how much that would cost in the USA. My sister was over for a visit once and managed to forget her insulin at my house when we were away for a weekend. Got an evening appt to get a script (they did charge but were hugely apologetic) and picked up the insulin the next morning (again paid £7 and got major apologies for having to pay). I’m really quite proud to work in this country and contribute to such a fair and practical system. I really hope the current political climate keeps the NHS working the way it does (or even improves it…!)
Reblogged this on In the Dark and commented:
Remember that story a couple of years ago by an American doctor about her experiences of the NHS? Well, here’s a sequel…
Got to “mess it up” before they sell it to their mates and future employer’s
That is so, so true…. exactly what the Minister for Health, Jeremy Hunt and his cronies are up to. If you are not already, join the group 38Degrees, an organisation which up to par on the NHS. They very recently reported on a ‘secret’ paper concerning the NHS and .Jeremy Hunt.
There was a documentary on TV whereby investigators found out about covert meetings with USA Health Care companies and Insurance providers…. Thankfully they disrupted it royally! ….
If they were to go to the British public and asked could they agree to pay an extra £1 in their taxes or pensioners (like me) a £1 less, they most certainly would. Hell I’d take a £5 less. I am so passionate about the NHS and so is my husband who is on dialysis 3 times a week.
Reblogged this on jeanid123.
I fear you missed the glaring point that is the main problem. Your cousin couldn’t get to see her GP.
I have ended up in A&E because my GP refused to help me and brushed me off, even complaining that when she took my blood pressure she would have to deal with the fact that it was sky high (missing that it was high because of the stress about the problem I had got to her for).
I have what I believe to be a ganglion in my hand and I am constantly tired…. but to get a GP appointment is too much to deal with only to be brushed off with no support.
Our NHS is awesome, once you get into the system, but getting that appointment, past the bulldog receptionist on the end of the phone, is a nightmare. If you work full time and can’t take time out of work to get to an appointment it is nigh-on impossible.
We need more GPs, solve that, and you solve so many other problems.
Yup–this is actually showing the problems with the NHS, rather than showing it works. They went to the A&E because it’s the part of the system that does work. If it’s not an emergency it’s way too slow even on things where that’s totally not acceptable.
Loren Pechtel: Wrong. They would have gone to A&E or Urgent Care anyway from the GP, because GPs don’t have X-ray devices.
Sungirl: I doubt if more GPs would solve the problem. The real solution is to fine or disqualify employers who will not give staff time off to attend GPs/hospitals during the workweek. You MUST be able to take time off work to care for your health, and that time must never be used as a promotion or job security criterion. Any employer who violates that should be forced into bankruptcy.
Reblogged this on Mantonite – A Worksop Liberal and commented:
Before anyone else tells us the NHS is failing or that the don’t already have a 24/7 NHS, read this post from an American doctor, especially the bits about “copayments” and what it means to those who need care ut can’t afford to pay (and those who can afford it so abuse the system).
No, the NHS is not perfect. I work in it so I know there is waste and inefficiency, but before we start tearing it to pieces we need to understand what the alternatives are, if they are any better and, most importantly, are they better value for our taxpayer money.
To judge from this story, we should be very grateful for what we have!
Over the years I have had 8 operations, all provided by the wonderful NHS, and I am so grateful for the care and kindness I have been shown. My mum had terminal bowel cancer, and the care provided by G.P.’s, hospital staff, district nurses etc. was nothing short of incredible. To arrive at a hospital ward with a heavy heart, and seeing a nurse sitting next to mum holding her hand, was so amazing. Mum wanted to die at home, and thanks to the brilliant district nurses and doctors, that wish was granted. I have a fond memory of mum’s G.P. visiting our house, and sitting on our patio, gently explaining to myself and my sisters that they would make sure she had the best care possible. It’s not perfect, there are problems. However, we really are fortunate, and people who abuse the system need to realise that they are wasting money that is needed for those who really need help.
I’m really glad you’ve had another positive experience of the NHS and the hospital.
I’m not sure your cousin has done justice to her GP though. Almost all surgeries have emergency appointments either with the doctor or nurse or at least telephone triage. It seems unfair to say it’s impossible, without even trying. And of course an x-ray wouldn’t be ordered on the phone. X-rays come with radiation risk and should only be ordered if appropriate. The best orthopaedic surgeon wouldn’t be able to make an appropriate assessment on the phone.
Not at 11am in the morning, they don’t. Usually you have to phone on the dot of 8.30am to get an emergency appointment for that day. So if you missed that on Friday, Monday would be your next chance.
This was actually one of he bits I found most interesting about the differences, between the two systems. The U.K. has discouraged GP’s setting up their own mini labs, and radiology units it’s more efficient to have a single unit at the hospital than buy 100 x-Ray machines that are at every GP surgery but are rarely used.
However why not have the ability to bypass AE and go direct to X-Ray based NHS 111 assessment, sometimes it will need medical assessment first but some cases will be straightforward.
Delighted that you had such swift, skilled and friendly care, which is quite typical in the NHS. And you could have speeded it up further by going directly to Urgent Care as your first stop – you’re right about the need for more education on how to use the system most effectively to maximise use of resources. You tend to learn your way around the system as your kids grow up, and a bit of explanation in (high) school would make that easier for everyone.
That varies from place to place. Our Urgent Care Unit in Cambridge only accepts patients via GP or A&E (as in Jen’s cousin’s case) referral.
No mention of the Ottawa rules for suspected ankle fracture, but I very interesting article. Thank you. Iain ,
Reblogged this on The musings of gutless Dick and commented:
Another interesting take on the NHS by an American doctor.
So your friend was part of the issue if you did turn up at an A&E.
A&E depts are for life threatening injuries only, unexplained chest pains, head injuries, excessive loss of blood, ambulance cases, etc.
Your mate should have been taken to a minor injuries unit. They deal with sprains, breaks, fractures, superficial wounds.
You are right though education of the masses is key though it’s somewhat pointless just doing it in school as emergency services on the NHS have changed over the years. From the availability of NHS direct (a helpline you can call to be advised by nurses over the phone) to the instantiation of minor injuries units, it all changes.
Confused about A&E and when to use it? Take a look at this: http://6qg7i41tyj019gihpa2y01a1.wpengine.netdna-cdn.com/wp-content/uploads/AE_Torbay-883×575.jpg
It varies from city to city, because in many major hospitals you will have a minor injuries unit co-located with the AE. There are often Minor Injuries Units as stand alone units in much smaller towns with smaller hospitals.
I remember reading your last column about the NHS. Thanks for this one too. I’m a dual national US & UK. I grew up in the UK and have always lived here. I inherited PKD from my American mother, who came to the UK in 1967 after marrying by British dad. I’ve now had two kidney transplants – the second from my US cousin, whose flights and loss of earnings were paid for by the NHS as it’s cheaper to do that that keep me on dialysis. I don’t believe I could ever live in the US, as it would be impossible to afford the necessary insurance and immunosuppressant drugs as a freelance musician: all treatment is free under the NHS. I often wonder how much happier a place the US would be if it wasn’t full of people doing jobs they hate because it’s the only way to afford health insurance. Is that how it is?
Thanks for writing this.
Thank you for writing about your experience of the NHS emergency system. The NHS is far from perfect but most of our big issues are politically created. I’d personally hate to work in a system where I’d need to consider a patient’s ability to pay before discussing investigations and treatment options with them. If you need a full body CT because of multi-system trauma you’ll get it, usually within 30 minutes of the request.
Keep spreading the love for the NHS!
Dr Pete (Emergency Physician)
Great post. Thank you!
I used to work in an A&E(ER) as a receptionist, in the NHS, and I was struck by the other European Union nationals who came to reception to pay, only have to explain that’s not how we do it here.
When I needed to use the Public Health Service in France, I had to pay for the ambulance, unheard of in the UK, and for each appointment at the hospital afterwards, apart from some of the costs that were covered by my EHIC.
When I went back to Ireland, where I was born, my parents’ GP gave me a “Health Card” prescription, which meant I didn’t have to pay for it, like a pensioner back in Ireland.
The NHS is a treasure the British do not realise that they have.
Hi , we do know what we have , it’s just the government f*****g things up for us . They want to save money on the situation but don’t realise how much it will cost .
They decided to close A&E departments down ( ERs ) and gave the Drs and Nurses their P45 ( leaving cards ) .
The government now only have A&E departments open around Westminster ( House of Commons ) in case an MP gets a cut finger .
( With greatest respect and partially sarcastic ) .
Addendum – partially sarcastic to the government NOT to you . 🙂
They have to close a and e because the staff refuse to modernise their contracts or processes. Stop blaming the government when it is clearly the staff who are the problem.
I blame the government because the poor performance is because they accept it. It’s the expected problem when you have the same guys setting the standards and paying for compliance with those standards–it makes it so easy to turn a blind eye to problems.
I live in London but have lived in the US: I love the NHS and it’s no surprise that there was a homily to it on the 2012 London Olympics opening ceremony.
Actually, it was surprising, given that the UK Secretary of State for health didn’t want the homily and has written a book about privatising the NHS.
She doesnt seem to know that that was Nhs England and that the Westminster English gkvt only regulates health in England. Scotlands Nhs is separate.
Good thing Sunderland is very much in England then…
Luckily we have the 111 system here in the UK so if you’re not sure if you need to see your GP or go to A&E you can call them for advise. They’ll explain if you can look after the condition or injury at home, arrange an ambulance if it’s required and they’ll even phone ahead to let the A&E know you’re coming. So if you’re reading this and you’re from the UK and you ever find yourself not sure what the appropriate action is – call 111. Don’t believe the headlines that it’s a rubbish service – it has helped my family a number of times.
Just like to agree wholeheartedly with this. In Scotland its called NHS24. I have a long term condition and sometimes I’m not sure about going to hospital or not so I phone NHS24. Always get a good service and they’ve phoned ambulances and had doctors waiting for me to arrive. Sometimes they just give advise such as taking pain killers or ice packs or just putting my feet up but it always works. The NHS is our greatest treasure and anyone who thinks we should gp for a private system really needs to read up and think about how it would be if you had a long term condition that insurance couldn’t cover. I’ve also have mental health issues and had great treat!ent. The length ofvtgime I had to spend in hospital would have bevway beyond my mrans if I had to pay. I’ve also been told that when my mental health deteriorates just get to e ward. A bed will be found. Knowing that is a great comfort.
NHS 24 is brilliant. It’s a great way to deal with those marginal calls. I phoned it a few times when my kids were small and a couple of times they were able to tell me that the problem wasn’t severe and saved us a trip to A&E and exposing other kids to whatever virus my kids had. And once they got an ambulance to me in 5 minutes because it was serious and my daughter needed a night in hospital on a drip to recover. From the point of view of a worried parent all those incidents looked exactly the same.
American who moved to the UK a year ago-
Agreed on the 111 service- it has been fantastic. They helped when I thought I was having heart palls again and the GP followed up that week with a phone call to make sure things were still okay.
I’m thinking that gent above makes a lot more money than I do, because taxes and NHS fees are seperate payroll deductions. As an immigrant, I’m in the 12% payroll bracket which is the highest charged for anyone in the UK for NHS. Some folks are on lower ones. It is still less than the 22% of my income I paid the last year I was in the USA to health care for just myself.
My tax bracket is seperate, and since I’m not in the top quarter of earners I’m in the 20% payroll deduction lot (You have to make over £40k to get taxed 40%, and that is more than the average salary of someone who has worked 20 years). My US taxes last year were 25% 😦
So God bless the NHS and the kindly staff they have; they have been nothing but amazing so far.
You do not pay a 12% payroll tax for the NHS. National insurance is not ringfenced at all ie its just general taxation and is to pay for all social security benefits and government pensions as well.
Agree with the 111 number. I had a deep cut on my leg that was not healing. I had some anti-bios from the my local GP, but just 2 days before the follow up appointment I woke up with my leg in pain and sweating. I tried some codine but it just got worse. Called the 111 number and they asked if I could get down to the emergency doctor (it was about 2am now). Jumped in a taxi and went to the emergency doc. They were waiting for me, took one look and got driven round to the A&E who admitted me right away into hospital. Got given morphine for the pain, then sent for x-ray, then admitted to the high dependency ward and later the infectious disease ward. I was told it was a close thing to either loosing my leg or worse involving a 6ft deep hole. A week later I was discharged to a thing called Hospital at Home where for 2 weeks, 7 days a week, twice a day folks came round to give me IV drugs and look after my leg. I had 3 follow up’s , including one where I was given massive box of drugs and dressings to take home. I’m now healed, my leg is coming on fine and I’m back at work. Cannot praise the NHS highly, and of course, all free. Yes, I’ve paid through my taxes, but I doubt 10 years worth at 100% of what I’ve paid would have covered the costs. Yes, the Sussex hospital is a maze where to pass through you go up in a lift, then down further on, and it’s been a building site since I’ve lived here in Brighton (16 years) as it’s been added too, then upgraded, but they fixed me, no problems. Love em!!!
Agreed. They were absolutely brilliant when my father had a non-responsive incident a couple of months ago. They gave very good advice and arranged for him to get an appointment at the Sunday afternoon clinic later that day, just to be sure there was nothing more serious going on.
I’ve had moderate to severe pain in my foot since March, yet because the x-ray showed no breakage (that they saw) I’ve been wait listed for a foot specialist. Three months ago. The pain is not getting better or going away. I agree that the ER should not be used for non-emergency situations, but I can kind of see why people do it. I’d be happy to pay a fee if they could just get me in in a reasonable time frame.
You can pay a fee and see a specialist privately. Has your GP requested a scan?
Hi Pat, no just the x-ray, which was inconclusive. Sounds like I should call my GP back and ask about the fee and scan?
Yes but why should we pay a fee when we pay 40 % tax plus other contributions towards the NHS ? Waiting lists are a major issue in the NHS, which dampens the good quality of specialists and training we have (I know as I worked in the system and the large majority of Drs are great !). Our time is mainly wasted on Saturday nights on drunks and associated activities eg fighting, etc, which are self-inflicted… my suggestion .. first time free .. after that, they pay for visits which are alcohol-related. It needs to be fair to others who genuinely need the system.
Retired: total rubbish. “We” don’t pay anything like 40% tax. Most UK people pay only a marginal rate of 20%, the first GBP10000/year or so are tax-free, you have to get GBP40000 or so to start paying 40% on the income above that.
You must be rich to spout nonsense like your comment. You need to be levelled down, radically so.
I so agree with you about educating people in how to use the NHS/A&E. people need to learn how to treat minor injuries/problems at home, and use the ER for actual emergencies.
We have so much ground to make up in regards to administering healthcare…that being said, our problems are political in nature. The actual care is negotiated from the insurers perspective, which is skewed toward profit not results (Medicare shows you all you need to know). Insurance has no federal regulator, even after the largest provider on earth failed during the credit crisis. Legislatures talk big, until the big money starts threatening to withdraw funding, then they resume being the lying cowards they truly are!
Reply to “retired”…where do you draw the line? Motorbike accidents, heart attacks caused by obesity and poor diet, people falling off horses, twisting their ankles in skyscraper heels – ALL self inflicted. You’re opening up a moral quagmire penalising “drunks”. Alcohol misuse may also be an illness.
Is there any logical reason why we can’t get that in the US? It’s all about money and greed, isn’t it?
Yes.
They prefer to call if “Freedom”.
Not just. It’s also about ideology that dictates that organizing things by putting them into the hands of a state run agency is inherently inefficient, while markets will always deliver. It is about an ideology that judges it more unacceptable that someone might get something they don’t deserve, than that someone might go without something they need.
It’s the moral hazard argument…
And I believe they use a similar false argument about voter fraud.
Thats the nail on the head, right there, I have American friends and I have heard that argument so many times and from the outside looking in, its so selfish.
Spot on re: getting something one doesn’t “deserve”.
I know someone without health insurance at the time who, about six years ago, needed an emergency appendectomy. A middle-class guy. It ended up costing him, out of pocket, around $17K. Yes, he paid, he had the savings. Afterwards I said something like “wow, after that you should be in favor of public universal health care” The response? “No way, I don’t want to pay for any scumbag’s coverage.” Scumbag = poor or otherwise socioeconomically distasteful to him.
It was more desirable to him to forgo coverage completely, even for himself, than to have people he didn’t think deserved health care get it for free. That’s a very common attitude here in the U.S., especially if you start adding race into the mix (see “sociologically distasteful” above).
See: British Rail, et seq.
We don’t have drivers ed in schools in the UK.
We leave school at 16 and you can’t start learning to drive until you’re 17. (In England it’s now compulsory to stay in some kind of education or training until 18, but that’ll be in a sixth form college, further education college, or workplace apprenticeship rather than at school.)
Nitpicking much? Out of everything she said, drivers ed is what you took from it?
Angilinab: What am I supposed to do? Write a line by line breakdown saying “yes, I agree with that. Yes, I agree with that,” up until I got to the point where I noticed something that the American didn’t realise about the British education system?
That seems like a dramatic waste of both my time and the time of anyone reading the comment.
It’s not compulsory to stay in education until the age of 18.
Yes. It is. In England at least, you must stay in some form of education until you are 18. And has been for at least five years. https://www.gov.uk/know-when-you-can-leave-school
In England it is, and has been for years. https://www.gov.uk/know-when-you-can-leave-school
The students that are 18 this year are the first year for whom these guidelines affected. Although it has been the law for years it is only the class of 2016 whom were not allowed to leave education to work until 18. For the class of 2015 it was 17 and for the class of 2014 it was 16. The law is now fully in place which is also why there is an increase in the number of apprenticeships that are available as people now have to stay in some form of education.
Compulsory to do 6th form ?!!?
It is now (see Zoe’s comment just above about the timescales for the introduction of it). In England only. The other home nations you can still leave full time education/training at 16.
The US is the richest country in the world yet the only developed country without universal healthcare. I grew up in Australia, lived in England for many years, and now live in the US. US healthcare is shameful. I am so grateful that my husband was a veteran so I qualify for Tricare and can afford the copays. I had a couple of friends who died because they couldn’t afford to get help, and others who deal with life-threatening conditions and chronic pain themselves because they just can’t afford to go to a doctor or the ER. The Affordable Care Act (“Obamacare”) has helped many, but sadly the for-profit medical insurance industry is still in charge of healthcare in the US. 😦
I cut my hand open on a smashed ceramic at 6.30 am one morning. Solihull Hospital could not have been a friendlier place. The nurse was very open minded and non judgemental about me self-Reiking whilst I was being stitched up!
I lived in London for a while (also in high heels) and had to take a child to the emergency room once – it was very well organised but OH MY – I do agree – that place was a maze and we ended up in an UNMARKED corridor of blank doors – totally lost. Thank fully we had brought snacks and a drink or we could have starved to death in there trying to find our way out. We have a similar set up in New Zealand. I honestly live in fear of having an accident or getting sick here in America.
“I honestly live in fear of having an accident or getting sick here in America.”
A real fear. As a retired emergency nurse my advice is avoid illness as much as you can here in the US.
I’d avoid it in the uk, my uncle went in to an NHS hospital with a chest infection, he died of mrsa. You can’t even complain here because the nurses are reconstituted angels.
Here in Toronto, we have a system of coloured lines on the floor of the hospital hallways, that lead to different departments. Also different wall colour schemes in different departments. Typical staff to patient directions …….Imaging is on the 4 th floor, when you get off the elevator, follow the green line.
I have seen this in a number of hospitals here in the US as well. But, strangely not in all new ones. Hmm.
We have that in English hospitals too (only the weight of traffic usually wipes out sections of the lines over time so I get lost anyway). But I’d rather the hospital prioritise care than paint.
Where is that woman who didn’t have $100 for that test? I’d gladly donate it to her. Heck, if she’s not too far away, I’ll go pick her up!
Hi,
Just a wee point… I’m a Brit who lives & works in the USA. Love your articles.
Hospital ER nurses (in the US) do order & medicate (per policy) for extremity injuries before an md sees them 🙂
Glad to hear! I’ve rarely seen it and then only for Tylenol for fever. I think it’s ER dependent. Wish it was done more!
Not at my hospital. Only PAs & NPs, but we’re behind the curve onpretty much everything else as well.
Your lucky you were not still in the US the come out and ask have you got insurance ? If not have you got enough money? If not the ambulance drives off leaving you in the middle of the road we have a saying if you live in a glass house don’t throw stones ?
Absolutely agree with your comment. These tourists come over to England, have an accident and then automatically assume they are going to be treated for FREE! They should have insurance to cover their treatment, pay up front and then get reimbursed in the states. We could not get free treatment as tourists in the U.S.A.
As you say “people in glass houses etc.” free loaders!!!!
The NHS has been so badly abused, planned trips to the UK for births, surgery, etc then the mental health system clogged up with people wanting letters of support for a bigger council flat or house pretending to have mental health problems when it’s clear, that after a couple of appointments and not being provided with a letter, they discontinue therapy. I work in the NHS and believe me, I am well and truly fed up, I’ve been covering two roles for the past 3 years, then get a part time support admin who promptly takes sick leave and continues to do so every 2 weeks. Those left in the NHS are there for loyalty and patients, but there comes a time when you have to ask yourself, ‘Am I a fool?’ covering someone else’s work, while managers make lame excuses to avoid confronting the malingerers, and let’s face it, the malingerers are better protected legally, than the loyal employees who cover their work and end up with serious stress. One previous admin support, once she received her contract, showed up 3 days in 4 months and knew every trick to take it as far as she could and get paid in excess of 300,00 pounds for doing nothing and of course, annual leave added on to that. Sadly, I will be leaving after 15 years, it’s an open house for scammers and abuses loyal staff.