# 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:** 9
**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 14, 2018, 12:29pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/162 "2018-02-14T12:29:32Z")
> [@Gyrate](#): > > Trying to include “infinity” in determining averages plays havoc with one’s calculator. > > But it remains true that lines will be shorter if vast numbers of people are unable to join them. Indeed; but in this case, “infinity” hardly applies, though I grant, it must be a matter of equivalent uncertainty as to whether those people have a condition they die with, or one they die of, depending on their chances of obtaining a diagnosis in the first place. ---
**Author:** ![thecontantorbiter](https://avatars.discourse-cdn.com/v4/letter/t/9d8465/32.png) [@thecontantorbiter](https://boards.straightdope.com/u/thecontantorbiter)\ **Post date:** [February 14, 2018, 1:08pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/163 "2018-02-14T13:08:24Z")
In response to PatrickLondon’s post on controlled drugs - I think accessing certain controlled drugs through legal prescription, particularly things like codeine, zopiclone, and lorazepam is fairly easy. Problematically easy - despite NICE/WHO guidelines. Certainly this is the case in the UK. I’d imagine it’s true in many other countries, including the US. We (UK) are being privatised anyway. There’s on-going turf wars, an example would be consultants poaching NHS patients for treatment in privately run centres (see Circle Healthcare). Or privately run centres might be run with an NHS contract, using NHS paperwork. The lines are very blurry, so it’s hard for the average patient to be entirely sure whose providing their care. It’s not even easy for the average NHS employee to fathom what’s going on - this is especially true when patients under their care transfer from private to NHS. Generally the queues are shorter when you go private, but the services are not always linked up, meaning there’s greater potential for communication issues going on in the background. I would argue that it’s good that UK patients have greater choice over how they access their care, but encouraging patient choice in this way is more about creating competition between providers than allowing patients greater control over how they are treated. Similarly, the lines are shorter in the US, but the charges seem obscure, and non-covered service adjustments are shrouded in esoteric coding that can be mismatched, miss-bundled, up-coded, or even duplicated. So time saved in the queues can be made up deciphering and negotiating unclear medical bills. Medical bills that the vast majority of patients don’t question and/or don’t understand. ---
**Author:** ![Northern\_Piper](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/northern_piper/32/5304_2.png) [@Northern\_Piper](https://boards.straightdope.com/u/Northern_Piper)\ **Post date:** [February 14, 2018, 1:37pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/164 "2018-02-14T13:37:37Z")
As others have commented, the lines may be shorter in the US if you don’t count people who can’t get health care because they don’t have insurance. How do you factor “infinity” into an average wait time? Because of that significant difference, it’s not appropriate to compare the wait times. They are not covering the same populations. ---
**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 14, 2018, 1:52pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/165 "2018-02-14T13:52:12Z")
> [@Magiver](#): > > I can’t imagine a system where 18 weeks for **non-urgent** consultant-led treatments is the benchmark for failure. (Bolding mine.) If you need to be seen sooner than 18 weeks, you will be seen sooner. If your case is not urgent then you may - I repeat may - be asked to wait. Here’s a clue: the operative (ahem) phrase is **non-urgent**. ---
**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 14, 2018, 2:21pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/166 "2018-02-14T14:21:04Z")
FWIW the median wait time overall has varied around 6-7 weeks. Those who are in greatest pain/distress/impaired quality of life get treated sooner, those who “need it done sometime” but can manage meanwhile wait longer. It all depends on the circumstances of each individual. ---
**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 14, 2018, 3:23pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/167 "2018-02-14T15:23:24Z")
> [@Magiver](#): > > There’s a reason for that. We have a demographic subset that has a statistical propensity of killing themselves at a much higher rate than other groups. In a population of 320 million, how many suicides would you need to appreciably reduce average lifespan? And to reduce it by 3 years? **Magiver,** in post # 86, post # 105 and post # 120 you’ve repeatedly asserted that the US has health care for the poor. Yet my impression from reading boards like this one is that poor people in the US have severe issues with affording healthcare. I also posted a cite showing that tens of thousands of people die due to lack of healthcare. This is certainly very far away How do you feel the US healthcare for the poor stacks up to the NHS? In coverage, results, public health etc? ---
**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 14, 2018, 3:28pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/168 "2018-02-14T15:28:35Z")
> [@Quartz](#): > > (Bolding mine.) > > If you need to be seen sooner than 18 weeks, you will be seen sooner. If your case is not urgent then you may - I repeat may - be asked to wait. Here’s a clue: the operative (ahem) phrase is **non-urgent**. And as repeatedly pointed out, for those whose attitude is “screw medical necessity; I’ve got money and I want my non-urgent procedure **now** ”, there’s the private healthcare system. It’s not a perfect system and it suffers from the political whims of the people in power with regard to NHS funding, but on the whole it works pretty well. ---
**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 14, 2018, 5:12pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/169 "2018-02-14T17:12:13Z")
> [@Northern\_Piper](#): > > As others have commented, the lines may be shorter in the US if you don’t count people who can’t get health care because they don’t have insurance. How do you factor “infinity” into an average wait time? > > Because of that significant difference, it’s not appropriate to compare the wait times. They are not covering the same populations. NHS waiting times would disappear with 2-3% of GDP injected for a period, never mind the double GDP cost of the US system/s. ---
**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 14, 2018, 7:28pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/170 "2018-02-14T19:28:19Z")
As indeed waiting lists did substantially disappear when the Blair government pushed expenditure up to around the EU average, in GDP terms. ---
**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 14, 2018, 9:02pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/171 "2018-02-14T21:02:59Z")
> [@Magiver](#): > > There’s a reason for that. We have a demographic subset that has a statistical propensity of killing themselves at a much higher rate than other groups. My, that is an interesting claim. Could you please elaborate on what demographic subset you reckon are killing themselves so quickly that they have managed to distort the statistics to this extent? ---
**Author:** ![k9bfriender](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/k9bfriender/32/3283_2.png) [@k9bfriender](https://boards.straightdope.com/u/k9bfriender)\ **Post date:** [February 14, 2018, 9:29pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/172 "2018-02-14T21:29:42Z")
> [@Magiver](#): > > There’s a reason for that. We have a demographic subset that has a statistical propensity of killing themselves at a much higher rate than other groups. And how many of those are because they went bankrupt from medical bills? ---
**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 14, 2018, 10:19pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/173 "2018-02-14T22:19:17Z")
> [@Magiver](#): > > Yes, we spend more per person in the US. And the lines are shorter. > > I said it once already. If the private insurance cuts through the delays the DHS is known for then you have the best of both worlds. If it doesn’t then you’re stuck with the delays. The average cost of UK health insurance is $1905 per annum, with an average total excess (you’d call it a total deductible) of $140\*. The cost of state healthcare per person in the UK is $2922 per annum\*\* In short, a person in the UK can have both forms of cover and thus no waiting lines however urgent their issue actually is for $4967 per annum, 61% of the average cost of healthcare in the US. Of course, the fact that only 11% of people in the UK choose to have private health insurance\*\*\* suggests that most people do not view the longer waiting times justify this relatively modest extra cost. Now I’m guessing you were being facetious when you suggested that this is “the best of both worlds”, and I agree with you. It is not the best of both worlds. It is clearly far better than your scenario (I get the same levels of access as you do for 60% of the cost, but at the same time people less fortunate than I also get excellent healthcare) but it is not even close to a best case scenario. That would be when everyone gets faster access to healthcare, which as noted by others could still be achieved for far less than the US systems costs. That is why people have stressed there remains room for improvement. Can you please outline just why you think the US system, at a cost increase of between 234% to 39%, delivering a life expectancy of nearly 3 years less, is a better model? \*[Are you looking for insurance guides? | ManyPets](https://boughtbymany.com/news/article/private-health-insurance-cost-uk/) \*\*[How much have I cost the NHS? | NHS | The Guardian](https://www.theguardian.com/society/ng-interactive/2016/feb/08/how-much-have-i-cost-the-nhs) \*\*\* [Private health insurance sales surge amid NHS crisis | Insurance industry | The Guardian](https://www.theguardian.com/business/2017/jan/16/private-medical-insurance-sales-surge-health-nhs) ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [February 15, 2018, 1:53pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/174 "2018-02-15T13:53:19Z")
I lived in the UK for one year almost two decades ago, and I was very impressed with the NHS. The simplicity of the system - as in, not even having to think about in-network, our-of-network, differing copays, co-insurances, deductibles, etc - totally blew my mind. But I have a few questions: 1. Over the last two decades or so, what’s your opinion of the state of the NHS overall? Getting better, getting worse, about the same? 2. What one aspect of the system would you improve? 3. And to **Magiver** ’s points, how many of you are posting about your positive experiences with the NHS while having had a leg needlessly amputated, are currently scheduled to start chemotherapy in 2023, are now dead, or have other serious and avoidable medical problems, any of which are partially or wholly attributed due to excessive average wait times? Surely most of you are covering something up. ---
**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 15, 2018, 2:08pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/175 "2018-02-15T14:08:00Z")
> [@Ravenman](#): > > 1. And to **Magiver** ’s points, how many of you are posting about your positive experiences with the NHS while having had a leg needlessly amputated, are currently scheduled to start chemotherapy in 2023, are now dead, or have other serious and avoidable medical problems, any of which are partially or wholly attributed due to excessive average wait times? Surely most of you are covering something up. Well, my grandmother’s dead, so there’s that. Mind you, she would be 129 if she was still going (she died at 94). Anyway, this thread made me realise I hadn’t been to the doctors in ages, so I decided to book a routine appointment - got one tomorrow, 9.20 am. They also have a same day appointment service if you’re desperate. ---
**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 15, 2018, 2:43pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/176 "2018-02-15T14:43:26Z")
> [@Ravenman](#): > > I lived in the UK for one year almost two decades ago, and I was very impressed with the NHS. The simplicity of the system - as in, not even having to think about in-network, out-of-network, differing copays, co-insurances, deductibles, etc - totally blew my mind. But I have a few questions: > > > [@](#): > > > > 1. Over the last two decades or so, what’s your opinion of the state of the NHS overall? Getting better, getting worse, about the same? > > Many things are better; some are worse. We have a brand new hospital with all the latest equipment in Birmingham but another in Worcester which is creaking at the seams. Much depends on what you need and when (better to avoid Friday/Saturday nights in A&E). Demand is growing all the time but supply is simply not keeping up - this mak well be a result of what is percieved as a ‘free’ service. > > > [@](#): > > > > 1. What one aspect of the system would you improve? > > It needs to be more joined up. If my GP thinks I need to see a consultant, they should be able to check online and book me an appointment there and then. > > 1. And to **Magiver** ’s points, how many of you are posting about your positive experiences with the NHS while having had a leg needlessly amputated, are currently scheduled to start chemotherapy in 2023, are now dead, or have other serious and avoidable medical problems, any of which are partially or wholly attributed due to excessive average wait times? Surely most of you are covering something up. No one that I know, although I know several people who suffer from long-term health problem and have made numerous visits to various hospitals. ---
**Author:** ![Red\_Wiggler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/red_wiggler/32/13190_2.png) [@Red\_Wiggler](https://boards.straightdope.com/u/Red_Wiggler)\ **Post date:** [February 15, 2018, 6:32pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/177 "2018-02-15T18:32:51Z")
If it’s not against the rules in this forum to say so, I too would like to read the opinions of previously deceased posters. ---
**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 15, 2018, 11:45pm UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/178 "2018-02-15T23:45:44Z")
> [@Ravenman](#): > > 1. What one aspect of the system would you improve? It’s a good question because I don’t have an answer - at least an answer other than improved funding. Something that is very difficult to communicate is a dynamic that drives the NHS; 1. People who work in the NHS believe in it, sometimes to the point of almost quasi-religiosity 2. Funding for the NHS will always be finite 3. You can always help more people 4. Therefore you must continue to search for methods to improve delivery and outcomes It’s not perfect, but it’s the best of us. ---
**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 16, 2018, 1:43am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/179 "2018-02-16T01:43:36Z")
> [@up\_the\_junction](#): > > It’s not perfect, but it’s the best of us. This pretty much sums it up. People are dismissing the ‘pretty good’ because it’s not perfect. ---
**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 16, 2018, 5:52am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/180 "2018-02-16T05:52:05Z")
No system is perfect, or ever can be. We all have a condition with a 100% mortality rate; medical science does not have a cure for everything, or even understand everything about what keeps us well or makes us ill. All care systems require compromises. ---
**Author:** ![Batano](https://avatars.discourse-cdn.com/v4/letter/b/b487fb/32.png) [@Batano](https://boards.straightdope.com/u/Batano)\ **Post date:** [February 16, 2018, 8:05am UTC](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260/181 "2018-02-16T08:05:39Z")
> [@Red\_Wiggler](#): > > If it’s not against the rules in this forum to say so, I too would like to read the opinions of previously deceased posters. you need to post that to a zombie thread [Previous page](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260.md?page=8) [Next page](https://boards.straightdope.com/t/uk-dopers-tell-me-your-thoughts-about-the-nhs/808260.md?page=10)