4 ms·

This is why I disagree with the idea that we should keep increasing funding to the NHS. The argument always seems to come to a false dichotomy of "either this o

by dwedge 7mo ago

This is why I disagree with the idea that we should keep increasing funding to the NHS. The argument always seems to come to a false dichotomy of "either this or the American system" as though other systems don't exist, and as though the NHS isn't top heavy with bureaucrats and questionable contracts

mgaunard 7mo ago
The truth is that the NHS is very bad not due to funding, but for structural reasons. The fact I can't even see a GP I'm not registered with (not even an option to pay extra) is ridiculous. You have absolutely no control over your health at all. With private, you get exactly what you want, whenever you want it.
- shigawire 7mo ago
  With private, you get exactly what you want, whenever you want it... If you can afford it.
  - stvltvs 7mo ago
    Pending availability of specialists, willingness to travel, etc.
    - tracker1 7mo ago
      If you're in a major metro area it's generally not too bad.
  - dwedge 7mo ago
    Compared to the system of no access
    - IAmBroom 7mo ago
      Same system, for the not-wealthy.
- iamtheworstdev 7mo ago
  * if available in your area or within your means of travel, which may include flying to another state
- IneffablePigeon 7mo ago
  You can absolutely see a GP you’re not registered with if you are travelling and need to. I have done it multiple times. I have been offered it same or next day after calling 111.
- array_key_first 7mo ago
  > With private, you get exactly what you want, whenever you want it. In the US this isn't how it works. You can't see whoever you want unless you have a really, really good plan. Otherwise, you need referrals. And lots of specialists won't see you without a referral anyway. And, the wait is often on the order of months. I know that's something people complain about in the UK but I assure you, it happens that way in the US too even though we're paying 10x as much. I know private in the UK is quite good. What you need to understand is that the only reason it's any good at all is because of the NHS. It has to remain competitive. If you go full private, then it very quickly decays.
  - reillyse 7mo ago
    In the US if I want to see my primary care doctor I need to wait 2 months for the appointment. I pay $500 per month for the privilege (and a $50 copay) So I’m paying $1000 in the time period where I’m getting no service.
    - zdragnar 7mo ago
      Where in the US are you? I was able to book a visit with my primary the very next day less than a month ago.
      - tracker1 7mo ago
        That was my thinking... even for specialists, I can generally get into a new one within a few weeks. My SO is on state Medicaid (cancer) and does experience the kinds of waits mentioned above... so I guess it does follow similarly for government/state backed healthcare, where I'm mostly out of pocket. But even when I had relatively typical coverage, I didn't have issues getting into a doctor more often than not. I think getting my sleep study was the longest wait I had for anything, they were months backed up with appointments... but my kidney and retina specialists were somewhat easy to get started with.
      - array_key_first 7mo ago
        Not the person you replied to but I'm in North Texas and I just recently had to reschedule my physical. And yup, the next appointment is 2 months out. I also had cancer in the past and you might think that that would mean I get faster appointments. I do not. And I have a very, very, very good PPO plan.
- jaccola 7mo ago
  If only there were some system where the incentives could freely flow through and permeate every level of the sector. Where those organisations that provide sub-standard care die and those that excel receive outsized funding...
  - thunderfork 7mo ago
    Unfortunately, a system with these qualities doesn't exist in practice. You just end up with the same too-big-to-fail macro organization minimizing their point-of-care labor spend and maximizing their management spend either way.
- harvey9 7mo ago
  You can call any GP surgery to get emergency treatment for up to 14 days if you're not registered with a GP surgery or are away from home. https://www.nhs.uk/nhs-services/gps/gp-appointments-and-bookings/ https://www.nhs.uk/nhs-services/gps/gp-appointments-and-book...
  - mgaunard 7mo ago
    While away from home, my son (5 yo) cut his finger and was in need of disinfectant and a bandage (steri strips). Pharmacy was useless, no medical skills or knowledge of their own products. Asked me to figure out myself what I needed and put it on my son myself. Local GP surgery sent us away: no registration, no visit. Me saying this was an emergency just made them suggest A&E. A&E is where we ended up, and while that definitely works, going to the emergency services of a large hospital for every little thing is not only a waste of my time but also of resources. It seems however to be the NHS way: whenever the littlest of troubles arise, just go to the hospital, or even call an ambulance.
    - 0xffff2 7mo ago
      Sorry for being too American to understand, but why would you need to talk to any medical professional to put a bandaid on your kid? Is this about NHS being paying for the bandaid? About medical expertise to apply a bandaid?
      - mgaunard 7mo ago
        Not all disinfectants are child safe, and the wound was serious enough to require steri-strips (an alternative to sutures) -- it was not a matter of a bandaid.
        harvey9 7mo ago
        You would have been best served by a Minor Injury Unit but not every town has one, so A&e is not excessive. The great majority of people going there do not need the full capabilities of it (resuscitation etc).
- te_chris 7mo ago
  So naive. Private only works this way in Britain because it doesn’t have to be responsible for anything. It’s a luxury good and works accordingly. We have insurance, it’s amazing! But it’s fake. If you want to know how a whole system of this would work, look at the US
kypro 7mo ago
As someone who largely worked at startups and smaller companies before joining the NHS it genuinely confused me how no one would ever say no to anything when I first started working there. The projects I worked on were genuinely absurd... My team alone spent millions on things that literally wouldn't have made any difference to the quality of healthcare in the UK. Apparently we were given a budget and we had to find a way to spend it otherwise it would be cut. At any normal company we should have all immediately have been made redundant.
0xy 7mo ago
The rate of increase of healthcare funding for the UK is 2,000% higher than France's rate of healthcare funding increases from between 2010 and 2019, according to World Bank data. The UK healthcare system is uniquely incompetent, administratively bloated and drives very suboptimal value for money. UK citizens appear to be in a collective delusion about the NHS that allows them to continue ineptly bumbling through mediocrity while perpetually fleecing more tax money to line the pockets of administrators. Meanwhile actual frontline workers in the NHS are completely ripped off in salary. Nurses get paid peanuts, while even neurosurgeons earn less than 1/6th of their American counterparts. To plug the gap by skilled healthcare workers bailing over these horrific conditions, the UK has been importing people to fill these gaps, often with severely lower competence (usually because of completely faked qualifications or outright fraud [1]). [1] https://www.hrmagazine.co.uk/content/news/hundreds-of-nhs-nurses-suspected-of-faking-qualifications https://www.hrmagazine.co.uk/content/news/hundreds-of-nhs-nu...
- deleted 7mo ago
  [deleted]
- stuaxo 7mo ago
  The rate of increase is an interesting one to choose, what about some absolute numbers ?

by dwedge 7mo ago

mgaunard 7mo ago

The truth is that the NHS is very bad not due to funding, but for structural reasons. The fact I can't even see a GP I'm not registered with (not even an option to pay extra) is ridiculous. You have absolutely no control over your health at all. With private, you get exactly what you want, whenever you want it.

shigawire 7mo ago
With private, you get exactly what you want, whenever you want it... If you can afford it.
- stvltvs 7mo ago
  Pending availability of specialists, willingness to travel, etc.
  - tracker1 7mo ago
    If you're in a major metro area it's generally not too bad.
- dwedge 7mo ago
  Compared to the system of no access
  - IAmBroom 7mo ago
    Same system, for the not-wealthy.
iamtheworstdev 7mo ago
* if available in your area or within your means of travel, which may include flying to another state
IneffablePigeon 7mo ago
You can absolutely see a GP you’re not registered with if you are travelling and need to. I have done it multiple times. I have been offered it same or next day after calling 111.
array_key_first 7mo ago
> With private, you get exactly what you want, whenever you want it. In the US this isn't how it works. You can't see whoever you want unless you have a really, really good plan. Otherwise, you need referrals. And lots of specialists won't see you without a referral anyway. And, the wait is often on the order of months. I know that's something people complain about in the UK but I assure you, it happens that way in the US too even though we're paying 10x as much. I know private in the UK is quite good. What you need to understand is that the only reason it's any good at all is because of the NHS. It has to remain competitive. If you go full private, then it very quickly decays.
- reillyse 7mo ago
  In the US if I want to see my primary care doctor I need to wait 2 months for the appointment. I pay $500 per month for the privilege (and a $50 copay) So I’m paying $1000 in the time period where I’m getting no service.
  - zdragnar 7mo ago
    Where in the US are you? I was able to book a visit with my primary the very next day less than a month ago.
    - tracker1 7mo ago
      That was my thinking... even for specialists, I can generally get into a new one within a few weeks. My SO is on state Medicaid (cancer) and does experience the kinds of waits mentioned above... so I guess it does follow similarly for government/state backed healthcare, where I'm mostly out of pocket. But even when I had relatively typical coverage, I didn't have issues getting into a doctor more often than not. I think getting my sleep study was the longest wait I had for anything, they were months backed up with appointments... but my kidney and retina specialists were somewhat easy to get started with.
    - array_key_first 7mo ago
      Not the person you replied to but I'm in North Texas and I just recently had to reschedule my physical. And yup, the next appointment is 2 months out. I also had cancer in the past and you might think that that would mean I get faster appointments. I do not. And I have a very, very, very good PPO plan.
jaccola 7mo ago
If only there were some system where the incentives could freely flow through and permeate every level of the sector. Where those organisations that provide sub-standard care die and those that excel receive outsized funding...
- thunderfork 7mo ago
  Unfortunately, a system with these qualities doesn't exist in practice. You just end up with the same too-big-to-fail macro organization minimizing their point-of-care labor spend and maximizing their management spend either way.
harvey9 7mo ago
You can call any GP surgery to get emergency treatment for up to 14 days if you're not registered with a GP surgery or are away from home. https://www.nhs.uk/nhs-services/gps/gp-appointments-and-bookings/ https://www.nhs.uk/nhs-services/gps/gp-appointments-and-book...
- mgaunard 7mo ago
  While away from home, my son (5 yo) cut his finger and was in need of disinfectant and a bandage (steri strips). Pharmacy was useless, no medical skills or knowledge of their own products. Asked me to figure out myself what I needed and put it on my son myself. Local GP surgery sent us away: no registration, no visit. Me saying this was an emergency just made them suggest A&E. A&E is where we ended up, and while that definitely works, going to the emergency services of a large hospital for every little thing is not only a waste of my time but also of resources. It seems however to be the NHS way: whenever the littlest of troubles arise, just go to the hospital, or even call an ambulance.
  - 0xffff2 7mo ago
    Sorry for being too American to understand, but why would you need to talk to any medical professional to put a bandaid on your kid? Is this about NHS being paying for the bandaid? About medical expertise to apply a bandaid?
    - mgaunard 7mo ago
      Not all disinfectants are child safe, and the wound was serious enough to require steri-strips (an alternative to sutures) -- it was not a matter of a bandaid.
      - harvey9 7mo ago
        You would have been best served by a Minor Injury Unit but not every town has one, so A&e is not excessive. The great majority of people going there do not need the full capabilities of it (resuscitation etc).
te_chris 7mo ago
So naive. Private only works this way in Britain because it doesn’t have to be responsible for anything. It’s a luxury good and works accordingly. We have insurance, it’s amazing! But it’s fake. If you want to know how a whole system of this would work, look at the US

kypro 7mo ago

As someone who largely worked at startups and smaller companies before joining the NHS it genuinely confused me how no one would ever say no to anything when I first started working there. The projects I worked on were genuinely absurd... My team alone spent millions on things that literally wouldn't have made any difference to the quality of healthcare in the UK. Apparently we were given a budget and we had to find a way to spend it otherwise it would be cut. At any normal company we should have all immediately have been made redundant.

0xy 7mo ago

The rate of increase of healthcare funding for the UK is 2,000% higher than France's rate of healthcare funding increases from between 2010 and 2019, according to World Bank data. The UK healthcare system is uniquely incompetent, administratively bloated and drives very suboptimal value for money. UK citizens appear to be in a collective delusion about the NHS that allows them to continue ineptly bumbling through mediocrity while perpetually fleecing more tax money to line the pockets of administrators. Meanwhile actual frontline workers in the NHS are completely ripped off in salary. Nurses get paid peanuts, while even neurosurgeons earn less than 1/6th of their American counterparts. To plug the gap by skilled healthcare workers bailing over these horrific conditions, the UK has been importing people to fill these gaps, often with severely lower competence (usually because of completely faked qualifications or outright fraud [1]). [1] https://www.hrmagazine.co.uk/content/news/hundreds-of-nhs-nurses-suspected-of-faking-qualifications https://www.hrmagazine.co.uk/content/news/hundreds-of-nhs-nu...

deleted 7mo ago
[deleted]
stuaxo 7mo ago
The rate of increase is an interesting one to choose, what about some absolute numbers ?