# UK 'dopers...tell me your thoughts about the NHS **URL:** \ **Category:** Great Debates\ **Created:** [February 5, 2018, 8:53pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260 "2018-02-05T20:53:16Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Gary\_Kumquat](https://avatars.discourse-cdn.com/v4/letter/g/4491bb/32.png) [@Gary\_Kumquat](https://boards.straightdope.com/u/Gary_Kumquat)\ **Post date:** [February 8, 2018, 7:18am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/41 "2018-02-08T07:18:47Z")
> [@Magiver](#): > > People living on the streets get “free” government care. You can decide if that’s a higher standard. Yes, it is. Or are you really of the opinion that a person’s value is determined solely by their wealth? ---
**Author:** ![Mangetout](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mangetout/32/19_2.png) [@Mangetout](https://boards.straightdope.com/u/Mangetout)\ **Post date:** [February 8, 2018, 8:16am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/42 "2018-02-08T08:16:05Z")
> [@Gary\_Kumquat](#): > > To answer the OP, I am very happy with the NHS, and indeed feel indebted to the service for the cover and respite it has provided my family, from cradle to grave. I believe that there is scope for improvement, as you would expect with any massively complex undertaking. I also believe it has been underfunded by the conservatives for the last 8 years, and that this cut in funding is the primary cause of the issues we’re currently complaining about in the UK. This has been pretty much my experience with the NHS - I have had better and more consistently competent service from the NHS than from any other organisation I can think of. Of course nothing is perfect - we live in the real world. ---
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [February 8, 2018, 8:38am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/43 "2018-02-08T08:38:11Z")
And of course the key word immediately above is ‘service’. Like policing, fire, schools - healthcare is quite literally a service, as in serving, the general public. ---
**Author:** ![SanVito](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/sanvito/32/2805_2.png) [@SanVito](https://boards.straightdope.com/u/SanVito)\ **Post date:** [February 8, 2018, 8:48am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/44 "2018-02-08T08:48:50Z")
> [@Magiver](#): > > My heart condition was caught during a routine exam for something else. It was the result of an office visit on-demand. There was no waiting period for any of it. There was no NEED for triage. Hey Magiver, if you’d bothered to read the rest of the thread instead of pulling out your soap box, you would have seen that I too have a routine exam at my poor old NHS doctor’s surgery (this Saturday, 10am, very convenient)(BTW that costs me not a penny out of pocket). It was offered by the doctor, who called me at work this week unprompted, just part of the service. I’ll let you know if I need urgent surgery (that costs me not a penny out of pocket) on the back of it. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 8, 2018, 9:03am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/45 "2018-02-08T09:03:18Z")
> [@Magiver](#): > > I just grabbed some waiting statistics [from the NHS site](https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2017-18/#Nov17). It was from the same time I had surgery 2 years in a row. The average wait was 7.4 weeks for Cardiothoracic Surgery. That’s the wait once surgery is recommended. My experience was a little different. Time to see my family doctor, 1 day. time to see the Cardiologist (that I chose), within that week. Both appointments at my choosing, not theirs. From there I spent a couple of weeks going through a variety of tests starting with an EKG, a TEE, an MRI, a CT scan, and some kind of heart catheter test. Those were to both confirm the heart condition and verify related systems related to the heart. Once those were complete I chose my Heart Surgeon based on the Cardiologist’s recommendations. That surgery was within a week. It was the only appointment chosen by the doctor. I don’t see the relevance of your anecdote. Someone with private health insurance in the UK would get exactly that same service. What point do you think you are making? If you are determined to go against the OP and make those US-UK comparisons then the honest thing to do would be to compare the experience, service and costs of an uninsured USA citizen versus that of an equivalent person in the UK. ---
**Author:** ![Gyrate](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gyrate/32/3588_2.png) [@Gyrate](https://boards.straightdope.com/u/Gyrate)\ **Post date:** [February 8, 2018, 9:28am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/46 "2018-02-08T09:28:42Z")
> [@Novelty\_Bobble](#): > > I don’t see the relevance of your anecdote. Someone with private health insurance in the UK would get exactly that same service. > What point do you think you are making? This is a rather key point. If surgery was needed urgently, you’d get triaged to the front of the line. If you don’t want to wait “the average time” for non-urgent surgery, there is a private healthcare system you can access, and pay for via private health insurance. And because the private system doesn’t have to cover emergency and GP care, it’s a lot cheaper. In fact there’s a good chance that if you add up NI + private insurance premiums + any related private fees, you’d still be paying a lot less for the same care than in the US. ---
**Author:** ![Jake\_Bullet\_Traffic\_Control](https://avatars.discourse-cdn.com/v4/letter/j/3da27b/32.png) [@Jake\_Bullet\_Traffic\_Control](https://boards.straightdope.com/u/Jake_Bullet_Traffic_Control)\ **Post date:** [February 8, 2018, 10:15am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/47 "2018-02-08T10:15:25Z")
The NHS sucks, when examined in isolation. When compared to equivalent systems in certain European countries, it still sucks. When compared to the USA, it’s great _if you’re in the UK_. If you’re a British citizen, you’re likely to have a more communal mindset than the average American. This is a big generalisation, of course, but I believe it’s basically more-or-less true. Americans are, on average, more likely to be individualistic than Brits. Again, #NotAllAmericans and whatever, but _generally speaking_ it’s true. For a Brit, the notion that you can be denied care because you have a pre-existing condition is _horrifying_. Thus, the NHS is set up so that this literally cannot happen. Similarly, for a Brit, the notion that you can be denied care because you don’t have enough money is just flat-out morally repugnant. Of course, there are lots of Americans who feel the same, but there are also lots of Americans who feel that you’re only entitled to the health care you can afford. That is a _distinctly_ minority view in Britain. Therefore, we put up with overcrowded A&E departments (that is ‘Accident and Emergency’, what we call the ER), massive waiting lists, and the fact that, for a lot of people, getting a doctor’s appointment is like getting an audience with the Pope, because the alternative - the _American_ alternative - is just too awful to contemplate. I have been fucked over repeatedly by the NHS. However, I _did_ get treated. It took _years_ longer for me to get the treatment I needed than it may have taken in America. But in America, I may not have gotten the treatment I needed at all. Thus, the NHS wins. An American with decent private health insurance might look at our enormous waiting lists and think he’s got the better deal, but that’s because he’s using a different moral calculus than the average Brit. His moral calculus allows for selective provision of treatment, while the average Brit’s simply doesn’t. ---
**Author:** ![Jake\_Bullet\_Traffic\_Control](https://avatars.discourse-cdn.com/v4/letter/j/3da27b/32.png) [@Jake\_Bullet\_Traffic\_Control](https://boards.straightdope.com/u/Jake_Bullet_Traffic_Control)\ **Post date:** [February 8, 2018, 10:16am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/48 "2018-02-08T10:16:36Z")
P.S. - Trump, as always, can fuck right off. We don’t need lectures on our health care system from someone who could afford to build his own hospital every time he got sick. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [February 8, 2018, 10:28am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/49 "2018-02-08T10:28:09Z")
I remember my partner who is from the UK was dissatisfied with her doctor. So she changed doctors and surgeries. I remember that because the original doctor later lost his licence. Its such an everyday thing, I am surprised at the non-UK people who seem to think the ability to pick your own doctor is something extraordinary. > [@Magiver](#): > > how much is your life worth? Wait, don’t answer that, just wait. For about 44 000 Americans each year, [more than they have](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2775760/). ---
**Author:** ![bob\_2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bob_2/32/3341_2.png) [@bob\_2](https://boards.straightdope.com/u/bob_2)\ **Post date:** [February 8, 2018, 11:48am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/50 "2018-02-08T11:48:14Z")
I have just been to collect my wife’s monthly prescription. She had nine separate prescriptions which would have cost £86 (£8.60 per item & £17.20 per pair of elastic hosiery), but she has an annual Prescription prepayment certificate which costs £104. This is all she pays. The pharmacy was not busy and I asked for a ball-park figure of how much the retail cost would be. The estimate was somewhere North of £500. To my surprise, the socks alone cost just under £50. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [February 8, 2018, 12:01pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/51 "2018-02-08T12:01:21Z")
> [@Magiver](#): > > I wouldn’t have survived the average waiting times of the NHS. You wouldn’t have had to wait. They would have operated ASAP putting you into an immediate slot that was kept open for emergencies or delayed the operation of someone whose need wasn’t urgent. I know I’m repeating what others have said, but Americans seem to be blind to this. ---
**Author:** ![PatrickLondon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/patricklondon/32/4422_2.png) [@PatrickLondon](https://boards.straightdope.com/u/PatrickLondon)\ **Post date:** [February 8, 2018, 1:08pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/52 "2018-02-08T13:08:10Z")
> [@Quartz](#): > > You wouldn’t have had to wait. They would have operated ASAP putting you into an immediate slot that was kept open for emergencies or delayed the operation of someone whose need wasn’t urgent. > > I know I’m repeating what others have said, but Americans seem to be blind to this. I have no basis on which to comment on your final observation above, but it is indeed not just a matter of “take a number and wait your turn”, or at least, not exclusively. It’s about doctors deciding _clinical_ priorities in the light of medical need and patients’ personal circumstances. That must happen in any system in emergency rooms, or indeed where large numbers of people want to go to the “top” hospital, which has to decide who to take as a patient and when. I do discern a difference of view about the function of government involvement in this. To us the NHS is not “the government” - it’s the doctors and nurses at your GP practice, or that you may come into contact with at hospital or other community health services. Quite apart from the fact that government in the US seems to involve itself in the system through a dizzyingly complicated set of legislation and a tendency to micro-manage clinical practice by legislation to a degree that we don’t - I for one just don’t see this as “the government taking your money and allocating your healthcare”. For one thing, if you want to do it yourself in the UK, there’s nothing to stop you; but for another, it’s about all of us deciding collectively (as we have the opportunity to do at every general election, not that anyone seriously proposes doing away with the NHS because they know what ther chances in an election would be) that it makes sense, morally and practically, for all of us to pay in, not so much for what we individually need as to ensure that all of us are covered - for the best that the doctors can do, according to their clinical judgment, with the money they’ve been allocated. The government stumps up the budgets - but the clinicians decide on the care you get. Put it another way, I’d go further and say tax is the membership fee to a civilised society. ---
**Author:** ![thecontantorbiter](https://avatars.discourse-cdn.com/v4/letter/t/9d8465/32.png) [@thecontantorbiter](https://boards.straightdope.com/u/thecontantorbiter)\ **Post date:** [February 8, 2018, 1:27pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/53 "2018-02-08T13:27:56Z")
> [@Novelty\_Bobble](#): > > I severely doubt that is how or why it happened (_if_ it happened) > > The biggest problem is that because it is seen as untouchable it is very hard to introduce any major improvements either in treatment or funding models and there is no doubt that something rather radical will be needed at some point in the near future. …I couldn’t agree more. From my experience, practically all of the funding issues could be solved by introducing improvements - NOT throwing more money at it. The service works, but many jobs are outsourced to expensive and inefficient agencies, CCS is an example of this. Carillion is another. The NHS still uses Oracle whilst simultaneously using open source. Petty debates rages over how to train staff. Meanwhile, there is little insight into how one can most efficiently organise units and wards (statistical research in this is woefully limited), meaning patients are often unnecessarily kept in (for any number of days) due to poor information exchange. I’m not purposefully bashing the NHS. I believe the USA has it own set of problems when it comes to healthcare. It’s just frustrating to see to see this system being managed poorly. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [February 8, 2018, 1:45pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/54 "2018-02-08T13:45:11Z")
> [@thecontantorbiter](#): > > The service works, but many jobs are outsourced to expensive and inefficient agencies, CCS is an example of this. Carillion is another. The NHS still uses Oracle whilst simultaneously using open source. Petty debates rages over how to train staff. Meanwhile, there is little insight into how one can most efficiently organise units and wards (statistical research in this is woefully limited), meaning patients are often unnecessarily kept in (for any number of days) due to poor information exchange. Change a few words and I see this kind of thing as a frequent consequence of any kind of “less government!” or “lean management” campaigns. “Let’s subcontract stuff out, that will be more efficient” - except when it’s not. Subcontracting something on short contracts makes sense when it’s infrequent and short-term; it doesn’t make sense when talking about something permanent. At the very least, this kind of situation requires longer contracts with enough overlap and oversight to ensure decent handover between contractors (hey, I’m an optimist by choice). I see companies where the computers were set up by one consulting firm, manuals written by another, and maintenance is now performed by a third one which has no idea where the documentation (if any) is and who’d kiss any user who says “well, when I look at the manual…” “_perks up and tries to avoid sounding too interested_ do you have that as a local copy or do you read it from a remote location?” “uh?” “is this manual something you have printed out, a file in your computer, do you read it from a webpage…? I need to make sure you have the latest version.” “Oh. Oh, I get them from [shared disk].” IT person, switching off his microphone and turning to his coworkers: “_GUYS I FOUND THE MANUALS!!!_” That’s bad when it happens at a company making bricks. It’s double triple quadruple bad when it involves the tax system (hi, current government of Navarre! please stop breaking your own website!), healthcare, or schools. ---
**Author:** ![thecontantorbiter](https://avatars.discourse-cdn.com/v4/letter/t/9d8465/32.png) [@thecontantorbiter](https://boards.straightdope.com/u/thecontantorbiter)\ **Post date:** [February 8, 2018, 2:21pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/55 "2018-02-08T14:21:16Z")
> [@Nava](#): > > (hey, I’m an optimist by choice). …I wish I shared that 🙂 ---
**Author:** ![up\_the\_junction](https://avatars.discourse-cdn.com/v4/letter/u/f1d935/32.png) [@up\_the\_junction](https://boards.straightdope.com/u/up_the_junction)\ **Post date:** [February 9, 2018, 12:19am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/56 "2018-02-09T00:19:35Z")
> [@thecontantorbiter](#): > > From my experience, practically all of the funding issues could be solved by introducing improvements - NOT throwing more money at it. … What is your experience because mine tells me no gov has “thrown money at the NHS” in my lifetime. Indeed, to do so would be irrational. Sounds like a painfully obv straw man. Fwiw, I am relieved as hell the first and most of the second Blair gov invested considerably in modernising infrastructure and shortening waiting lists. Is that “throwing money”? ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [February 9, 2018, 4:18am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/57 "2018-02-09T04:18:21Z")
> [@thecontantorbiter](#): > > …I wish I shared that 🙂 It’s a five-step, one day at a time kind of thing. Step 1: have a lot of relatives who always jump into the worst conclussion they can find. Step 2: realize they’re a bunch of bitter fucks. In fact, there is a direct correlation between amount of negativity and amount of bitterness. Step 3: realize that the happy people you know always give every person and situation a chance or two but not more than two. Step 4: join the second group. Step 5: when you find yourself jumping to negative conclussions, remind yourself that you’re NOT going to be like your Evil Relatives, period. Give whomever just did something completely idiotic a chance; remind yourself that statistically speaking, he’s more likely to be stupid than evil. That doesn’t mean you shouldn’t watch out for further stupidity, only that you shouldn’t let stupidity screw your day. /hijack. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [February 9, 2018, 9:22am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/58 "2018-02-09T09:22:54Z")
> [@up\_the\_junction](#): > > What is your experience because mine tells me no gov has “thrown money at the NHS” in my lifetime. All governments have thrown money at the NHS ab initio. It was how they got buy-in from the GPs in the first place. Spending really took off with the Labour government of 1997. See the first two graphics in [this BBC article](http://www.bbc.co.uk/news/health-38887694). Note that the graph is adjusted for inflation. ---
**Author:** ![Novelty\_Bobble](https://avatars.discourse-cdn.com/v4/letter/n/a3d4f5/32.png) [@Novelty\_Bobble](https://boards.straightdope.com/u/Novelty_Bobble)\ **Post date:** [February 9, 2018, 9:39am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/59 "2018-02-09T09:39:05Z")
> [@up\_the\_junction](#): > > What is your experience because mine tells me no gov has “thrown money at the NHS” in my lifetime. Indeed, to do so would be irrational. Sounds like a painfully obv straw man. > > Fwiw, I am relieved as hell the first and most of the second Blair gov invested considerably in modernising infrastructure and shortening waiting lists. Is that “throwing money”? To a great extent…yes, throwing money at it is seen as the ultimate solution to all of the problems and it ends up not actually solving a lot of core inefficiencies. Thing is, NHS funding has increased under every government since inception. No government has cut funding in real terms…ever. So the system gets more and more money and outcomes do improve so the obvious solution continues to be yet more money. It is an easy and lazy political point. There is an ideological barrier on all sides to considering other options. No-one would think that the German, Austrian, Netherlands, French etc. systems are in danger of sliding into USA-style healthcare delivery and yet when even a small move towards those european models is proposed all hell breaks loose. People fixate on things like waiting times in A&E without stopping to consider how such targets end up actually driving problematic behaviours. It is perfectly possible to have long reported A&E waiting times and a great health service and also to have short reported times and a crap service. My professional career has been in healthcare, pharmaceuticals and associated areas and I’ve seen first-hand how the NHS operates and the obscene inefficiencies in it. The staff are great, they work their collective nuts off but in many cases they do it within a process that is badly organised and that soaks up cash that could be properly allocated for more resources where it is needed. As good as the NHS is (and it is!) it is harmful to see it as a fixed system that cannot operate in a fundamentally different way. More money is needed. It is being provided and will continue to be provided but if that is seen as the only possible solution to every problem then nothing will actually get much better. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [February 9, 2018, 10:10am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/60 "2018-02-09T10:10:53Z")
> [@Novelty\_Bobble](#): > > To a great extent…yes, throwing money at it is seen as the ultimate solution to all of the problems and it ends up not actually solving a lot of core inefficiencies. > Thing is, NHS funding has increased under every government since inception. No government has cut funding in real terms…ever. So the system gets more and more money and outcomes do improve so the obvious solution continues to be yet more money. It is an easy and lazy political point. Well, no. I think every healthcare system in every developed nation constantly gets more costly. All populations grow older, and medical innovation keeps coming up with new ideas and devices. The thing is, their costs do not increase at the same rate. The American system was pretty even with the various north-western European ones in 1980. Its just increased faster than the others since then. > [@Novelty\_Bobble](#): > > There is an ideological barrier on all sides to considering other options. No-one would think that the German, Austrian, Netherlands, French etc. systems are in danger of sliding into USA-style healthcare delivery and yet when even a small move towards those european models is proposed all hell breaks loose. I think that is because the model that Germany and the Nederland’s uses is far more expensive than the UKs model. Hybrid systems like France and Austria are also more expensive. (There is also the cautionary tale of the US system looming over any changes in that direction). The UKs model is in fact the cheapest one out there, and gives the best results per pound spent. As a strategy, “Lets move to a more expensive model” lacks appeal. > [@Novelty\_Bobble](#): > > As good as the NHS is (and it is!) it is harmful to see it as a fixed system that cannot operate in a fundamentally different way. More money is needed. It is being provided and will continue to be provided but if that is seen as the only possible solution to every problem then nothing will actually get much better. Like I said earlier, comparing the NHS to properly-funded Beveridge model systems may be helpful. It does appear that lack of funds is actually a major issue with the system. [Previous page](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260.md?page=2) [Next page](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260.md?page=4)