Tuesday, 30 January 2018

The NHS and Hospitals in Our Bit of the World

Someone from across the pond asked me to explain how hospitals etc work in this country.

That's a jolly good question.

I can only answer very simply. SIMPLIFIED OK? and only what I think. I might be writing complete rubbish!

Well for a start we don't pay anything at the point of use for being in an NHS (National Health Service) hospital or seeing a NHS doctor. This is because in theory we've all paid National Insurance Contributions and Taxes through our working life which covers costs. This worked fine when the proportion of elderly people NOT working and not paying NIC was less than the amount of people working and when there were no expensive treatments available to treat things like cancer.
Now it doesn't work so well, there isn't enough money going into the NHS, no political party dare raise NI. Although each government always says that THEY'VE put more money into the NHS than any other previous government of the OTHER party - Funny That.

Prescriptions and medications are also free for over 60's and many other people - cancer patients included. Otherwise people pay a set amount (£8.60 at the mo)for each thing prescribed. Maybe it covers costs - maybe not. It's possible to get 3 or 12 month pre-payment cards which work out lots cheaper.

 People are living longer with more complex health problems and hospitals are always busy. Accident and Emergency departments are often overstretched not helped by it becoming increasingly difficult to see a local doctor at short notice. Also not helped by the amount of people who turn up at A & E with minor rather than life threatening issues.
Another huge problem is "Bed Blocking" this is when someone is well enough to go home but needs a care package put in place for them to be looked after at home by District Nurses, Carers etc. Because of funding cuts it takes longer for Social Services to organise this. Someone we spoke to at Addenbrookes said there are usually 60 - 80 people who could go home each day but have to stay in hospital until things are organised for them.Why funding cuts to Social Services? - which I think are paid for out of a local authority money - because they've been given less? Get less from local taxes? Heavens knows.

There is Private Health Insurance that some people have, so they can go to private hospitals. I have no idea about the Whys and Wherefores or how much specialised treatment people can get privately, so can't comment more. A lot of people think this government would like everyone to pay private insurance and that all NHS services would be phased out. I have no idea, I suppose they are right they might be wrong, who knows.
No doubt comments will say..................

Hospitals are run by Trusts, they have so many government targets to reach that people say that too much time is spent on chasing targets. there are too many 'pen pushers' and not enough people on the wards.  I don't know how hospital Trusts work but someone will say in comments I'm sure. I do know that, as in many other areas, a lot of work is contracted out to private companies not always an improvement but supposedly a cheaper way of doing things. ( It certainly wasn't cheaper or better for the people who do the work in what was  Suffolk County Council Highways Dept. which is the area we do know about)

What I DO know is that our doctors, where we are registered is 4 miles away, it seems to work OK. Haven't used it much in the year we've been here because all Col's care is from hospital and "touch wood" I've been well all year. We can ask for repeat prescriptions online and there has only been a problem once when I've gone a few days later to pick them up. It's the same practice we used when we lived in Mid Suffolk in the 1980's (although the doctors are different obviously!)
If we need referral to hospital for anything our hospital for East and Mid Suffolk is Ipswich and then Addenbrookes when things get even more serious. Ipswich hospital works closely with Colchester hospital mainly because Colchester was classed as a failing hospital a few years ago and the Top Bod of Ipswich is now Top Bod of Colchester too. There was lots of talk about having to centralise some services to Colchester from Ipswich but I don't know if that is/will be happening.

I really don't know if that's the information folk wanted to know but I do know that from our point of view the NHS is wonderful - I have nothing but praise for the nurses and doctors who all work so hard in increasingly difficult circumstances.

I await comments! But won't reply to any!

Back Tomorrow


  1. I have strong and fairly unpolitical views on the way our government is dealing with the NHS which I won't air in here because I'm usually a very peaceful person but I totally agree with you - the doctors, nurses and other staff at our local hospital are absolutely wonderful, work their socks off and cope with increasingly difficult and approaching impossible situation usually with grace, humour and compassion (which is more than can be said for this government). When I had my health scare last year, they were fantastic.
    J x

  2. Our GP surgery, the local small community hospital and large general hospital in Taunton, all of whom we have regular dealings with, are all wonderful. We don't have a problem getting GP appointments and the wait for any referrals for hospital attendances are fairly short. But then we live in a rural, less populated area - up in the Midlands where we lived previously on the edge of a large town and where our family still live, it's a bit different, they have longer waits for everything and frequent cancelled appointments. Can't fault the staff though, they're unfailingly lovely - well, they are here.

  3. Thank you for this information Sue as it is something I had often wondered about. Living in the states I am very interested in how medical care is handled in other countries. I do wish we could have some positive changes in health care here but that seems unlikely. A few years ago my husband had some heart problems and since then our medical expenses have been outrageous. The prescriptions are so high that some were simply not affordable and we had to ask our doctor to prescribe replacements. Like you said there are more older people not working and more expensive treatments now and that makes it difficult in all countries I'm sure. The health care system you have does seem to work and reach all people fairly and that is a blessing. I think as long as there are politicians they will argue over these things and how they are handled. I do appreciate you taking the time to write this post.

  4. Nothing but praise here too for the wonderful staff working for the NHS! My husband is terminally ill and I'm caring for him at home. Only last evening I rang the community nurses to say his catheter was blocked.....again. After only 2 hours, at 10 pm, two smiling nurses arrived and did what they needed to do, happily and expertly. We too use Ipswich hospital and although it's always very busy, they somehow manage to squeeze you in if you need help urgently.

  5. Despite the cuts and problems I salute our NHS. It doesn’t matter if you are the richest or poorest person. If you end up in Accident and Emergency you get the same excellent care. The stories of beds queueing up in corridors is sadly true at times. The staff looking after them at this point are still wonderful as they are still providing the best care that they can. As a cancer patient I could not fault my care by a team of dedicated and overworked people. Our small island is a popular place to live and the strain on the NHS is inevitable. We have an ageing population to care for. I don’t know the answers to the problems, but I’m hoping the government can do their best to keep it going. I am grateful I live in the UK.

  6. Your account of the NHS is very good. I was only talking to Weaver via email at the weekend about the marvellous care given by the NHS today, contrary to what the Press would have people believe. In 1969 my father was treated with contempt by the doctors at the N&N when he was admitted with cancer and there was no ward space so his bed was put in what my mother described as a medicine cupboard. He was discharged after one night because they said there was nothing they could do for him. He refused to ever go near the hospital again and died six months later. There were no McMillan nurses or hospices in those days, and cancer was a taboo subject. Thank God those days are gone. After university in the 1970s I joined the NHS Management trainee scheme. I was required to attend the management meetings of the local Hospital Trust. All decisions were political with a capital P and went according to who was in power and who the committee didn't like, the answer to which is obvious and I won't say, and NUPE and COHSE, the two nurses unions representatives blocked any decisions being made as a matter of course including things that I considered good decisions to improve patient care. No wards and equipment would sit unused because the unions blocked them. The local authority closed the convalescent hospitals scattered around the region and bed-blocking began, no half-way houses exist any longer. Common sense was very much in short supply even though everybody locally and the local paper were shouting at the Council that they were making the wrong decision. It fell on deaf ears. I left the NHS before completion of the training because the NHS was not for me. No common sense, nobody with any nous or guts to make sensible decisions. The 1948 model fitted then but it needs to constantly change to fit now.

    1. Sorry that is rather long. It should read "new wards and equipment ...."

  7. Brilliant post. I like you Sue think our NHS is wonderful, Doctors and Nurses have saved our son's life 3 times last year and because his epilepsy has got worse we know we will always be needing their help , we are forever grateful.

  8. Back in 2010 I had an all year problem, with three operations and loads of treatment. Then in 2012 another two operations, the NHS staff were brilliant, the underfunding is putting everyone under strain, but thank goodness we have our NHS.

  9. I have had mixed experience with the NHS, including poor nursing care, and incompetent doctors who had a God complex. My 92 year old MIL has been in hospital 3 times in the last 12 months. Her care too has been mixed. In her case this can mainly be put down to understaffing. Yes, the NHS can be wonderful, but if you are on the receiving end of incompetence or a lack of care, then it can be a nightmare. Along with this comes the long waits to be seen. My hospital opthalmologist referred me to a colleague back in November as I need more specialised care of my corneas. My appointment arrived last week - it is for the end of April, which means that by the time I get to see the corneal specialist, my corneas will not have been checked for over 5 months.
    The NHS is gradually being privatised, usually by stealth. The walk-in centre at my local hospital is run by a private company - fortunately it's not Virgin Healthcare, who have a poor recorDd yet won £1 billion worth of NHS contracts last year, and they don't pay tax in this country. Here's a link to a report about it .... https://www.theguardian.com/society/2017/dec/29/richard-branson-virgin-scoops-1bn-pounds-of-nhs-contracts
    And here's a link to a 2014 report about Tory MPs who have links to private health care companies...
    And of course, there's the fact that the health secretary Jeremy Hunt co-authored a book/ report that called for the NHS to be replaced by private health insurance.
    There may be staff who are wonderful,and who are doing a fantastic job, but they shouldn't have to work in the conditions that they do due to understaffing/ insufficient beds. And it's not just doctors and nurses; it's physios, radiologists, clerical staff,pharmacists, porters, drivers, ambulance staff and cleaners too, some of whom are paid a pittance for the work that they do, because they are at the bottom of the payscale, but who never get a mention in the media.

  10. Having grown up in the UK and used the NHS as a child and then spending my grown up life in the USA I can say the NHS is great. I pay $750.00 per month for health insurance through my job and in the last few months a fractured ankle and an eye operation, and the bills for out of pocket, or not paid by your insurance are still coming in, probably total of $2,000 and I had nothing major done. It's horrible and I have health ins. But I'm 64 and want to give my job up, but all the Obama Care is being dismantled. So yes give me the NHS any day.

  11. I have nothing but praise for the NHS and my local hospital is wonderful. I do think some people abuse the system however. My son worked in an A and E dept on a military placement and said the way some of the public treat the hospital staff is appalling. Also people turning up at A and E for minor problems that should be treated at home but once they have checked in they have to be seen, therefore the queues get longer and if they are not seen in a certain time the government fines the hospital!

  12. Yes, I'm another one full of praise for the people working in the NHS, but the overall system is failing due to lack of money and resources available. The staff work so hard in ever failing circumstances, as do all the emergency services in our country at the moment. Cuts have a lot to answer for. The voluntary sector is having to pick up an awful lot of the slack.

  13. I share the view that our excellent NHS is a valuable institution staffed by many dedicated people. But if more people took responsibility for their own health by taking exercise, giving up smoking and not running to a GP with every sniffle, the NHS would not be groaning at the seams and those with genuine illness, like Colin, would have a much smoother journey through the system. Sorry don't mean to nag, but so much illness is self inflicted. Would we over indulge so much if we had to pay for operations such as gastric bands from our own pockets?

  14. I worked in the NHS for 30 years. There's too much red tape to enable the medical/surgical side of things to run smoothly and efficiently. I have nothing but praise for the NHS but it's not managed well. There may be managers, etc, and Chief Executives with business acumen but in my opinion the nitty-gritty business of healthcare shouldn't be run like it is at present.

  15. In the USA, where we pay outrageous monthly payments for our healthcare, the services are very similar to yours. We can get an appointment with a general practitioner or nurse practitioner pretty easily, but we may have to wait months for a specialist. Because at age 65 we go on Medicare which pays 80% of hospital and doctor care, we might not be accepted by a doctor because they don’t get reimbursed as well. We also have to buy a supplemental plan (if we can afford it) to pay what Medicare won’t. The price for this plan, depending on your age can be very expensive but it is something you need or all your savings could be spent over one illness. Needless to say, Americans pay a lot of money to be healthy and statistics show that people in countries with socialized medicine fare better.

  16. This is fascinating. Thank you for the post and the robust commenting. I'm across the pond and very much interested in how your health system works. I've wondered about a lot of what is laid out here.

  17. We have something similar in Canada, however we can go to any hospital or doctor in Canada. Harvey and I do have extra health insurance though to help pay for eye care, prescriptions, and dental visits. And in no way does our extra insurance negate our government insurance, or cost even half as much as insurance would in the United States.

    God bless.

  18. Thanks for that great post, Sue.

    We have only ever had wonderful care from the NHS. My mother with cancer an kidney dialysis, my husband with heart attacks and a quad bypass and my son who has severe learning difficulties and epilepsy. Not to also say fab maternity care for myself , daughters and DIL.

    We have never had problems getting GP appointments and all have regular screenings for our various long term health ailments.

    I feel incredibly grateful for the care we receive. I do think the way the general public use A and E is shocking, using it for trivial problems .

    All hail the NHS. I would happily pay more NI to keep it.

    SO glad you feel you are getting good care for Col. Prayers said for you both.


  19. That is such a good post and sums up the NHS very well. It is not as good as it was but better than lots of countries so I am pleased we have it.

  20. Over 10% of the entire NHS Budget goes on legal fees.

  21. Very interesting responses. My experience of late echoes everyone elses. Apart from long waits in A and E, the doctors and nurses were so good and compassionate, and most of all caring that I spent much of my time just saying thank-you. The NHS is a jewel in the crown but it is being eroded not just politically but by the people who use it and those legal fees are a worry'