# UK dopers, what's the NHS like? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [October 28, 2005, 5:53am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284 "2005-10-28T05:53:36Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Rico](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rico/32/3582_2.png) [@Rico](https://boards.straightdope.com/u/Rico)\ **Post date:** [October 28, 2005, 12:54pm UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/21 "2005-10-28T12:54:23Z")
\ IMHO is the prescription for this thread, I do believe. Stat. \ ---
**Author:** ![Brynda](https://avatars.discourse-cdn.com/v4/letter/b/e79b87/32.png) [@Brynda](https://boards.straightdope.com/u/Brynda)\ **Post date:** [October 28, 2005, 2:43pm UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/22 "2005-10-28T14:43:44Z")
I had a good experience with the NHS when I got a UTI while visiting in England. I was seen in Casualty (ER in the US) and was given some sample anti-biotics, so I didn’t even have to buy any. The only problem was when she asked me if I had some paracetemol. Parmecium? No, paracetemol. My British husband had to step in and say yes, and explain to me later that paracetmol is our acetaminophen. Neither she or I knew each other’s name for it. I half-expected a bill, but nothing ever came. ---
**Author:** ![betenoir](https://avatars.discourse-cdn.com/v4/letter/b/258eb7/32.png) [@betenoir](https://boards.straightdope.com/u/betenoir)\ **Post date:** [October 28, 2005, 7:19pm UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/23 "2005-10-28T19:19:01Z")
> [@Brynda](#): > > The only problem was when she asked me if I had some paracetemol. Parmecium? No, paracetemol. My British husband had to step in and say yes, and explain to me later that paracetmol is our acetaminophen. Neither she or I knew each other’s name for it. I wondered about this. Is paracetmol in fact acetaminophen by another name? Or something different? Since no one knew what I was talking about when I said acetaminophen I never got a straight answer. Also I thought the British for ER was A&E…which always amused me due to the TV channel… ---
**Author:** ![GorillaMan](https://avatars.discourse-cdn.com/v4/letter/g/50afbb/32.png) [@GorillaMan](https://boards.straightdope.com/u/GorillaMan)\ **Post date:** [October 28, 2005, 7:49pm UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/24 "2005-10-28T19:49:34Z")
They’re just two different generic names: > [@](#): > > The words paracetamol and acetaminophen both come from the chemical names for the compound: N-acetyl-para-aminophenol and para-acetyl-amino-phenol. > **[Paracetamol](https://en.wikipedia.org/wiki/Paracetamol)** > > Paracetamol, also known as acetaminophen\[a\], is a medication used to treat fever and mild to moderate pain. At a standard dose, paracetamol only slightly decreases body temperature; it is inferior to ibuprofen in that respect, and the benefits of its use for fever are unclear. Paracetamol may relieve pain in acute mild migraine but only slightly in episodic tension headache. However, the aspirin/paracetamol/caffeine combination helps with both conditio In the short term, common side effects of... A&E (Accident and Emergency) and Casualty are used pretty much interchangably, although A&E is the preferred official term. ---
**Author:** ![Ximenean](https://avatars.discourse-cdn.com/v4/letter/x/aca169/32.png) [@Ximenean](https://boards.straightdope.com/u/Ximenean)\ **Post date:** [October 28, 2005, 10:22pm UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/25 "2005-10-28T22:22:41Z")
The NHS is Britain’s political sacred cow. No party could propose abolishing or greatly reducing the scope of the NHS and have a hope of being elected. Even tinkering with it is politically risky. The British are brought up to revere the NHS, and do not tolerate heretics who suggest that it might perhaps be better to arrange health insurance like we do other insurance. Private healthcare is available, but there are many people here who somehow believe that it is wrong to use or dispense private health care. ---
**Author:** ![GorillaMan](https://avatars.discourse-cdn.com/v4/letter/g/50afbb/32.png) [@GorillaMan](https://boards.straightdope.com/u/GorillaMan)\ **Post date:** [October 28, 2005, 10:32pm UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/26 "2005-10-28T22:32:08Z")
> [@](#): > > The British are brought up to revere the NHS, and do not tolerate heretics who suggest that it might perhaps be better to arrange health insurance like we do other insurance. Trying to avoid your baiting, I’d say that the British tend to be brought up with a certain level of socialist leaning, into which the concept of universal healthcare fits comfortably. If an insurance-based system could guarantee universal cover, it wouldn’t necessarily be shunned. If you can create such a system, you’re the next billionaire 😉 ---
**Author:** ![GorillaMan](https://avatars.discourse-cdn.com/v4/letter/g/50afbb/32.png) [@GorillaMan](https://boards.straightdope.com/u/GorillaMan)\ **Post date:** [October 28, 2005, 10:35pm UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/27 "2005-10-28T22:35:52Z")
Oh, and another point about the ‘sacred cow’ status…don’t overlook the fact that over 2% of the population is employed by the NHS (which I guess is perhaps something like 4% of the working population?). It’s integral to many many peoples’ lives as a career as well as a health service. ---
**Author:** ![Ximenean](https://avatars.discourse-cdn.com/v4/letter/x/aca169/32.png) [@Ximenean](https://boards.straightdope.com/u/Ximenean)\ **Post date:** [October 28, 2005, 10:53pm UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/28 "2005-10-28T22:53:54Z")
> [@GorillaMan](#): > > I’d say that the British tend to be brought up with a certain level of socialist leaning… > > …over 2% of the population is employed by the NHS (which I guess is perhaps something like 4% of the working population?). It’s integral to many many peoples’ lives as a career Bloody hell, I hid paydirt there, didn’t I? ---
**Author:** ![Ximenean](https://avatars.discourse-cdn.com/v4/letter/x/aca169/32.png) [@Ximenean](https://boards.straightdope.com/u/Ximenean)\ **Post date:** [October 28, 2005, 10:55pm UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/29 "2005-10-28T22:55:58Z")
Hit. HIT! ---
**Author:** ![Frank](https://avatars.discourse-cdn.com/v4/letter/f/3d9bf3/32.png) [@Frank](https://boards.straightdope.com/u/Frank)\ **Post date:** [October 29, 2005, 12:35am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/30 "2005-10-29T00:35:10Z")
> [@Usram](#): > > Bloody hell, I hid paydirt there, didn’t I? **Usram** , this reaction is inappropriate for this forum, or any forum here except the Pit. Please restrain yourself to responding to the post. There is a word for people who post merely to get a rise out of other posters. I would hope that you would not like that word to be attached to your name. ---
**Author:** ![Arwin](https://avatars.discourse-cdn.com/v4/letter/a/51bf81/32.png) [@Arwin](https://boards.straightdope.com/u/Arwin)\ **Post date:** [October 29, 2005, 12:48am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/31 "2005-10-29T00:48:30Z")
> [@GorillaMan](#): > > Oh, and another point about the ‘sacred cow’ status…don’t overlook the fact that over 2% of the population is employed by the NHS (which I guess is perhaps something like 4% of the working population?). It’s integral to many many peoples’ lives as a career as well as a health service. The number of people not insured in the U.S. also helps make the NHS look rather good, I’d say. ---
**Author:** ![Arwin](https://avatars.discourse-cdn.com/v4/letter/a/51bf81/32.png) [@Arwin](https://boards.straightdope.com/u/Arwin)\ **Post date:** [October 29, 2005, 12:49am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/32 "2005-10-29T00:49:33Z")
> [@GorillaMan](#): > > If you can create such a system, you’re the next billionaire 😉 Too late, we already got one of those. ---
**Author:** ![GorillaMan](https://avatars.discourse-cdn.com/v4/letter/g/50afbb/32.png) [@GorillaMan](https://boards.straightdope.com/u/GorillaMan)\ **Post date:** [October 29, 2005, 12:51am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/33 "2005-10-29T00:51:44Z")
**This Year’s Model** - I’m not sure what part of **Usram** ’s posts your objecting to, but I don’t see them as anything more than healthy opinions. (For now 😉 ) Mind you, I’m not sure what was actually meant by “hit paydirt” ---
**Author:** ![Frank](https://avatars.discourse-cdn.com/v4/letter/f/3d9bf3/32.png) [@Frank](https://boards.straightdope.com/u/Frank)\ **Post date:** [October 29, 2005, 12:57am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/34 "2005-10-29T00:57:46Z")
> [@GorillaMan](#): > > **This Year’s Model** - I’m not sure what part of **Usram** ’s posts your objecting to, but I don’t see them as anything more than healthy opinions. (For now 😉 ) > > Mind you, I’m not sure what was actually meant by “hit paydirt” He seemed just a bit too pleased with himself at your aside about baiting, especially when followed by the post after the one I quoted. Just trying to nip it in the bud, so that we don’t go further than “for now”. ---
**Author:** ![Arwin](https://avatars.discourse-cdn.com/v4/letter/a/51bf81/32.png) [@Arwin](https://boards.straightdope.com/u/Arwin)\ **Post date:** [October 29, 2005, 1:24am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/35 "2005-10-29T01:24:46Z")
Here’s a bit from a speech in 2004 about the system that becomes effective 1 january 2006: > [@](#): > > I shall mention some important features of the general insurance provision: > > 1. The package or coverage > The fundamental principle in determining the scope and the quality of the package that the general insurance provision covers is essential health care. This means that first and foremost the insurance covers the care that is currently insured in the second compartment. In the future the general insurance provision might be extended to include some care from the first compartment. (Example: the short psychiatric treatments). > > 2. The insured > Every Dutch citizen has to insure himself by the compulsory general insurance provision. This means that nobody can withdraw from health care insurance. This is an important condition for the embedding of risk solidarity. Every citizen can choose between different health care insurers to insure himself for the general insurance provision package. No longer is there a difference between people insured by sicknessfunds and people insured by private insurers. Solidarity is guaranteed by partly income dependent premiums and by the same coverage for everybody. The health care insurer will be obliged to accept everyone who wants to be insured for the essential insurance package, making no distinction according to health risks. We call this the duty of acceptance. > > An essential element of the duty of acceptance is the ban on premium differentiation. This means that every health care insurer must charge all the people he insures the same premium for the same product. This rules out the possibility of risk selection by way of lower premiums for people with a good health outlook and higher premiums for those without. Another way in which health care insurers could select according to health risks is by introducing differentiation in the package of health care entitlements. By ruling that the duty of acceptance applies to everyone on the same package, the government is also blocking off the package differentiation route, thus safeguarding risk solidarity on that package. > > 1. The insurers > The insurers are competing which each other and are risk-bearing. When they organize efficiently the execution of their insurance, they can receive their efficiencyprofit. But they are also risk-bearing when they aren’t able to organize the execution efficiently. There is no longer the difference between sicknessfunds and private health care insurers. All health care insurers will have a private character. We don’t need a risk pooling in the new insurance system. Risk selection is prohibited, therefor a watertight system of risk equalization is necessary. Risk equalization compensates the health care insurers for insuring people with less good health prospects. The equalization system must provide incentives that encourage health care insurers to pursue the effective steering of the provision of health care. To this end it is necessary for the health care insurers to run a risk in their activities. This can be achieved by giving health care insurers a risk compensation in advance. This risk compensation have to be based on objective characteristics of insured people such as age, sex, and incapacity for work. Because this risk compensation is not by definition equal to the actual costs, health care insurers run a certain risk in this respect. Taken from: [http://www.burkestichting.nl/nl/actueel/gezondheidszorg.html](http://www.burkestichting.nl/nl/actueel/gezondheidszorg.html) (towards the end of the page, the part that doesn’t look like gibberish as much as the rest 😉 ) ---
**Author:** ![Arwin](https://avatars.discourse-cdn.com/v4/letter/a/51bf81/32.png) [@Arwin](https://boards.straightdope.com/u/Arwin)\ **Post date:** [October 29, 2005, 1:28am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/36 "2005-10-29T01:28:27Z")
Oh, and here’s a link to an official document I found in English: [http://www.eiz.nl/eiz/docs/pdf/ministryreformofthehealthcare.pdf](http://www.eiz.nl/eiz/docs/pdf/ministryreformofthehealthcare.pdf) ---
**Author:** ![zelie\_zelerton](https://avatars.discourse-cdn.com/v4/letter/z/59ef9b/32.png) [@zelie\_zelerton](https://boards.straightdope.com/u/zelie_zelerton)\ **Post date:** [October 29, 2005, 1:31am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/37 "2005-10-29T01:31:03Z")
Well everyone seems to have about covered descriptions of the NHS - from my experience i’d say it’s a good system. Even at my very poorest it would never have occurred to me NOT to go to a doctor if i needed one and i don’t think that’s the case in all countries. One thing \*\*Mangetout \*\* forgot to mention was that the NHS may also pay for treatment within the EEA countries - so if a British citizen falls ill while on holiday in France, for example, then the cost of treatment is typically reimbursed to the medical care provider by the NHS. It is also the case that if a foreign national falls ill in the UK then they are technically supposed to pay for their care. I think it’s quite rare for this to happen though unless it’s a case which requires lots of treatment (presumably it sometimes costs more to fill out the forms claiming back the money from an overseas health insurance company than would be reimbursed). [linkety link for those interested](http://www.dh.gov.uk/PolicyAndGuidance/International/OverseasVisitors/OverseasVisitorsBrowsableDocument/fs/en?CONTENT_ID=4099060&chk=fmpJFL) ---
**Author:** ![Ximenean](https://avatars.discourse-cdn.com/v4/letter/x/aca169/32.png) [@Ximenean](https://boards.straightdope.com/u/Ximenean)\ **Post date:** [October 29, 2005, 8:14am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/38 "2005-10-29T08:14:33Z")
> [@This Year's Model](#): > > **Usram** , this reaction is inappropriate for this forum, or any forum here except the Pit. Please restrain yourself to responding to the post. There is a word for people who post merely to get a rise out of other posters. I would hope that you would not like that word to be attached to your name. I wasn’t trying to do that-thing-which-we-will-not-name, but nevertheless I apologise for stepping over the line. That was a real post-pub post :o. **GorillaMan** , by “paydirt” I meant that your post seemed to confirm and explain the sacred cow status of the NHS, from the mouth of apparently an ardent supporter, which as you will have guessed I am not. Ardent, that is. ---
**Author:** ![Eva\_Luna](https://avatars.discourse-cdn.com/v4/letter/e/e495f1/32.png) [@Eva\_Luna](https://boards.straightdope.com/u/Eva_Luna)\ **Post date:** [October 29, 2005, 8:57am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/39 "2005-10-29T08:57:32Z")
> [@zelie zelerton](#): > > if a foreign national falls ill in the UK then they are technically supposed to pay for their care. I think it’s quite rare for this to happen though unless it’s a case which requires lots of treatment (presumably it sometimes costs more to fill out the forms claiming back the money from an overseas health insurance company than would be reimbursed). That was also my experience with the NHS. I am an American who started having problems with my foot while on vacation at my friend’s house in Kent. It wasn’t horrendously excruciating, but as I have a long history of problems with that leg/foot related to an old injury, I was afraid it could have been a stress fracture or something more serious. My friend called her GP and explained the situation, and they booked me an appointment a couple of hours later. I was told I’d have to pay 20 pounds, as I am of course not an NHS member, which I told them I was perfectly willing to do (this woudn’t have been a whole lot more than my specialist co-pay in the US). Saw doctor, doctor interviews and examines me, diagnoses plantar fascitis, tells me to go buy a 99p tube of OTC analgesic ointment and stay off my feet for a couple of days as much as possible. It was sheer genius and solved the problem entirely, and in the end they didn’t bother charging me, because it was more of a headache to figure out the accounting than it was worth. ---
**Author:** ![casdave](https://avatars.discourse-cdn.com/v4/letter/c/c6cbf5/32.png) [@casdave](https://boards.straightdope.com/u/casdave)\ **Post date:** [October 29, 2005, 9:31am UTC](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284/40 "2005-10-29T09:31:22Z")
I think part of the reason why the UK public attach such importance to the NHS has partly to do with the class system which is not as powerful and pervasive as it once was, but the perceptions remain. Put simply, the great mass of the population look at those who try to tinker with the NHS, and they generally see people of high income, and low paternalistic values, who seem to want to make a large buck by cosying up to certain business interests, or they seee people who would like to pay lower taxes and ignore the needs of the majority. There is a worry that the wealthy would have no problem purchasing healthcare, but would not give a damn about the rest of us, the ones upon whose backs their wealth is created. In others words, potential tinkering with the NHS is regarded as less about the interests of the average UK citizen, and much more about those of the middle and upper classes. This view does get in the way of useful reforms however, I have worked in the NHS and I can see a goodly number of improvements that could be made, but the changes that were implemented by the previous administration were poor, buearacratic and expensive and it has taken nearly a decade to get rid of most of them. This is one reason why UK public are wary of big changes in the NHS, its seens as essential and affects the lives of everyone in the most important way. When the NHS works, it works extremely well, but there are areas in which it does not, mostly on a regional level, partly because the ability of any local NHS department depends upon relatively few individuals, one duffer can make treatment in one discipline rather average, yet one outstanding person can transform it. There needs to be reform in they way in which consultants are appointed, this has been recognised, but these are very powerful people, these are the ones who can make the big differance in treatment and its around these folk that the NHS revolves. The main problem is that there are too few of them, in certain disciplines such as orthopeadic surgery especially, and the selection process to appoint more is not straightforward. The standards of ward care varies form average to excellent, but what has happened is that the most experienced nurses have been given managerial roles that are probably not appropriate to their role and this takes them away from the training and supervision roles they should be undertaking. There are simply not enough nurses, this results in filling gaps with short term shift pattern changes, overwork, not enough time for training and demoralisation, resulting in a constant hemmoerraging of staff. Things are improving, but after 18 years of Conservative misrule over the NHS, it takes a long time to catch up again, longer because things have moved on so much in the time. The Conservatives might have had some good ideas, but their implementaion of them was abysmal, with their in-the-pocket appointees to run large units, despite never having had any experience whatsoever of running organisations of such magnitude or any real knowledge of the industry. I think that way too many people have an interest in the NHS at levels they are not competant to pursue, politicians, local businessmen, and oftentimes the general public all have influence in matters that they don’t really understand. That’s democracy I guess. [Previous page](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284.md?page=1) [Next page](https://boards.straightdope.com/t/uk-dopers-whats-the-nhs-like/328284.md?page=3)