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So what to do with the NHS?

Discussion in 'Personal' started by dumpty, Nov 23, 2019.

  1. lanokia

    lanokia Star commenter

    Who do you imagine is doing the consuming?

    3 billion extra people in my lifetime all wanting a higher standard of living. Population is the root of the problem. That is the only long term solution.

    Anyone saying otherwise needs to join the other climate deniers... off you go...
  2. florian gassmann

    florian gassmann Star commenter

    Indeed so: it is a mix of private and public services and was named by the World Health Organisation as the best performing health service in the world for availability of services and organisation of healthcare providers.
  3. moscowbore

    moscowbore Star commenter

    I agree that extra money is not the answer. All the extra money in the world is pointless if it gets spent on IT projects that never get delivered and they cannot recruit medical staff.

    The bullying culture is so ingrained in some places, a root and branch clearout is required.
    The job of a GP is so unattractive they cannot recruit. Start from the point of addressing the problems pointed out by doctors. Do not try to continue with the existing system. Doomed to expensive failure.

    How about having NHS dentists? Sort out the issues which have made NHS dentists rarer than rainbow coloured unicorns.

    Also, make membership of council run gyms and pools free. People will exercise more and be less of a burden on the NHS.

    It is not rocket science.
  4. lunarita

    lunarita Senior commenter

    Sounds awfully like socialism though
  5. schoolsout4summer

    schoolsout4summer Star commenter

    I like the sensible Conservative agenda of slowly starving the NHS into extinction and encouraging/forcing everyone to purchase their own health insurance, just like the USA.
    Imagine the money that could be made.
    No pay, no healthcare - simples.
    monicabilongame and Burndenpark like this.
  6. border_walker

    border_walker Lead commenter

    But is it sensible? if the issue is genetic then the issue will pass to their offspring creating greater expense going forward.
    Kandahar likes this.
  7. Kandahar

    Kandahar Star commenter

    IVF (like cosmetic procedures) is not what the NHS was intended for...and repairing botched private cosmetic surgery is not cheap.
  8. fraisier

    fraisier Senior commenter

    It used to be the best or one of the best but not any longer, this title of "Best health service in the world" was bestowed nearly 20 ago years ago and the overall situation has changed in France in the meantime, things have become more complex, high levels of investments in the health system have not been maintained etc. From the weekly L'Express:

    « La France, meilleur système de santé au monde » ! Ah ça, on en a parlé, de cette fameuse première place décernée par l’OMS (Organisation mondiale de la santé). Et que je le proclame, et que je me rengorge, et que je donne des leçons à la terre entière (« je », c’est l’État français). Oui mais voilà. C’était il y a presque vingt ans, plus précisément en l’an 2000. Aujourd’hui, « je » déchante…

    Car depuis lors, la France n’a cessé de baisser dans les classements mondiaux : 8ème ; 10ème, 15ème selon les organismes et les critères retenus.

    It is still on the whole a good system (generally ranked in the top 10 in the world) but it hasn't kept up its level of quality and provisions since the 2000s. Many of my French relatives currently work, or used to work, for the French health system in various capacity and they've witnessed first hand the deterioration over the years, it could be described as "creaking" or having reached "critical point" in some areas (health areas or geographical areas). It's all relative but still, it's not as good as it was.

    eg too many people use the "Urgences" (A&E) as a fall-back option (social services and the like are struggling), putting pressure onto a struggling health system, particularly the state hospitals, which deal with about 85% of A&E patients (the so-called "clinics" - private hospitals but patients are reimbursed - are widely used but aren't as well-equipped as state hospital for many of them, they're usually much smaller health units that state-run hospitals),
    In 2016, 21 million people used A&E in France, that's double the 1996 figure (Le nombre de passages aux urgences a doublé en vingt ans [...] près de 21 millions de passages ont été recensés en 2016 dans les 719 structures publiques ou privées d'urgence). The population has grown in that period and but that's not the problem, the crux of the problem is that the successive gvt haven't invested enough in health infrastructure, many small minor injuries units have gone for a Burton, although they are slowly coming back (they're now usually known as "Maisons de santé", they deal with minor health problems). This recent Le Monde article details the many reasons of this huge increase ("Pourquoi le nombre de patients aux urgences augmente d’année en année. Les passages aux urgences ont presque doublé depuis 1996. Un phénomène aux explications multiples, dû notamment à un changement de mentalité des patients)

    eg 100 000 hospital beds have been scrapped in the last 20 yrs (100 000 lits ont été supprimés en 20 ans) there are still nearly 400,000 beds in the 3036 French hospitals & clinics, vs 240K in the UK, for the same population (Les 3 036 hôpitaux et cliniques disposaient très exactement de 395 693 lits d’hospitalisation complète) so, like my dad and my younger sister recently, you are more likely to have your own room than not but it's not as good as 10 or 20 yrs ago.

    One of the main problems affecting France in terms of healthcare provision is its rural character. The majority of GPs and consultants (226,000 of them altogether - 102,000 GPs & hospital doctors, and 124,000 consultants), as well as many nurses (636,000 nurses in France, about 20% of them self-employed) don't want to live "in the sticks" (i.e more than 20 miles away from a sizeable town or a city), so the more rural areas are left behind in terms of health provision. It's known in France as "le désert médical" (poor or relatively poor access to healthcare) and it's reckoned to affect up to 8 million people to varying degrees (carte de France des déserts médicaux).

    I have to say though that the GP system is much better in France I find (if you don't live in one of those "medical deserts" that is). Because GPs are self-employed, they do care more and put in more hours than their UK counterpart. When my dad was ill a few months ago, our family GP used to call my mother and my sister every other day to enquire about him. Most GPs work 50-60 hrs a week too, and see their patient for longer than in the UK. GP visits are free for patients (the €25 fee is reimbursed). Contrast that with the UK when provisions at surgery level has really gone downhill, eg I can't even see my GP when I want now - there's a tough triage system in place - and often I can't choose which GP I can see, most of them seem to work 2 days a week (they maybe part time - can't blame them - or may work for the private sector). Ditto the consultants in France, although waiting times to see one (particularly ophtalmologists) are much longer than they were 20-30 yrs ago, so my relatives tell me anyway.
    Last edited: Nov 24, 2019
  9. ajrowing

    ajrowing Lead commenter

    Should the NHS in your opinion carry out any cosmetic surgery?
  10. florian gassmann

    florian gassmann Star commenter

    Which GPs and/or NHS hospitals have asked to see your private health insurance details before providing service?
  11. needabreak

    needabreak Star commenter

    Clearly some cosmetic procedures are not simply vanity, like say after an accident/trauma, after all weren't these procedures developed for that purpose during the war?
    monicabilongame and Kandahar like this.
  12. Scintillant

    Scintillant Star commenter

    Not even wrong.

    The solution is cutting emissions, and progressing development and education, as the experts recommend.

    "Population" is the knee-jerk response of those who are poorly informed on both population demographics and climate change.

    Poor people in Africa do not emit much

    The poorest 10% of people produce only 0.5% of global carbon.
    The richest 16% produce nearly 40% of emissions.

    A North American produces 17.6 T of CO2 on average per year
    An African produces 1.1 T on average per year

    Besides, as you know, we are wining the battle on population, but it will take some time to have an effect as people live a fairly long time and we can't "remove" them.

  13. dumpty

    dumpty Star commenter

    When I moved to Asia I was contacted by the NHS there for a medical. To my utter amazement it checked for everything from HIV to a heart and brain scan.

    Coming back here yes, was asked to complete a medical as part of registering. Was a weight and height check, blood test took two weeks and was cholesterol only.

    So my question is does the NHS do enough preventive care? I guess in its defence many people would still not turn up for what was in Asia a three hour medical - incredibly with most blood test results done there and then.
  14. Duke of York

    Duke of York Star commenter

    It very much depends on your age. Once you reach certain ages, you statistically become more prone to suffering ailments that can be screened for with a view to early intervention if the screening shows signs it's required.

    Last year I was invited as a matter of course to have a scan to check whether I had an enlarged aorta. I routinely get invited to provide a stool sample to check for signs of bowel cancer. My sweetheart gets routinely invited to have mammograms etc.

    Fortunately, the tests have always been found to be clear of any problems. My GP told me when I needed a minor op, that because I'd reached 60, I became eligble to treatment within two weeks. Well to be more precise, I would be entitlrd to have an appointment with a consultant within two weeks, to assess whether treatment would help my condition.
    Jamvic likes this.
  15. peter12171

    peter12171 Star commenter

    That was one of the big questions when the technique was first developed. Since then thousands of children have been born that haven’t passed on whatever he problem was, for example Polycystic Ovary Syndrome. Most children born through IVF have gone on to have children without recourse to the technique.
  16. Kandahar

    Kandahar Star commenter

    The NHS should be actively discouraging procreation - not assisting it.
    border_walker likes this.
  17. Duke of York

    Duke of York Star commenter

    Who will pay for the NHS in the future if people don't have kids?
    Jamvic likes this.
  18. peter12171

    peter12171 Star commenter

    I can only assume that Kandahar has never had children and has no desire to. Fair enough. But it is a natural urge for the vast majority of people, and the NHS has no right to ‘actively discourage’ it.
    ajrowing likes this.
  19. Skeoch

    Skeoch Star commenter

    There is an interesting issue of political interference. Where small hospitals are closed, the expertise in particular specialties gets concentrated in bigger hospitals and there are better outcomes for patients (recovery time, survival etc.); however hospital and A&E closures are emotive issues and the "Save Our Hospital" campaigns are often very strongly supported in local Press and by politicians despite the evidence in favour of closure. One specific example has been stroke treatment in London.
    Somewhere decision-makers have to find a position which uses evidence but which addresses the emotional side.
  20. Kandahar

    Kandahar Star commenter

    Fewer kids mean fewer patients in the longer term = less funds needed.
    BelleDuJour and border_walker like this.

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