Hi all, I would love to understand how the NHS works. In the States we have, at least momentarily, the ACA (affordable care act). Not everyone however, has access to it, depending on where they live.
It seems to me that all of on this site have rather serious health issues and the levels of care seem to have such variance.
I'm coming from the perspective that being as healthy and productive as any of us is capable of being, whatever limitations we may face, should be a given. And, that means health care for all.
In the states, that often elicits cries of, that's socialized medicine. When asked to define that however, ...
So I, for one, should like to hear from any of you - how it works. That is, how do you make appointments; how easily are specialists seen; how diagnostic tests are scheduled; what follow up care occurs, etc.
Thanks
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TomTitTot
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I have been under NHS since I was born. I am 66. Had heart surgery as a baby. Developed curvature of spine as I grew, and again major surgery at 10 yrs old. Because of curve my lung function is now very poor. I also have a very leaky heart valve and awaiting a new valve and an arrhythmia. I am looked after for all this by the best heart lung hospital in uk. I have paid taxes and national insurance. So treatment is not free but free at point of use. I personally cannot fault NHS. Does this help your understanding. I acknowledge there can be delays, but would rather have our system than US system. Seems our govt wants to privatise but there is huge resistance about this
Hi TomTitTot, the NHS is truly amazing and caring but suffers from good management, lack of funds and staff shortages. This varies to some degree depending on where you live.
The GP is the first port of call and he determines if you need tests or to be referred on to a specialist. Many referrals take a long time to come through.
Pete and I have no complaints about our National Health Service and have lots to be thankful for. Xxxxx
Thank you, how are crisis handled? If you have an emergency what happens? I probably sound a bit of an idiot, I have no complaints to make about your system it's just so different from my own.
Crisis are handled as well as they can be but it can mean very ill people left on trolleys in corridors. Sometimes flu epidemics can put a huge strain on our health system.
We can call 111 for out of hours advice or 999 in an emergency. Many turn up at A&E if they can’t get an appointment with their GP.
You’re not an idiot as your system is very different. I have a friend in Illinois and she tells me about her insurances and costs but anything she needs doing gets done much quicker. Xxxx
The NHS was set up for every British national so no one would suffer or die due to lack of money. Therefore there is a lot to be gained from socialised medicine and I can't understand why the USA hates the idea of this so much.
The principle was from each according to their means to each according to their needs.
It is funded by workers as a form of tax - National Insurance Tax and pays in full for GP visits and hospital treatment and stays. Eye care and dentists used to be included but gradually over the years this was discontinued. You can still get discounted NHS dentists but you have to pay a lot of the cost unless you are on certain benefits where it's free. x
Thank you. I too fail to understand the great fear in this country about providing medical care to all. I think it might have to do with our supposed, rugged individualism...
I have heard right wing Americans say no to it because 'All the foreigners especially Mexicans will be using it too'. Meanwhile people not only die there but suffer as they can't afford their oxygen or meds. Ridiculous. x
It's a strange attitude to have, isn't it? Because certainly those who are sickest without care pose risks to everyone, and then of course, illness doesn't give a damn about nationality, religion, age or race.
Hi Tom, I think the problem with the US having an NHS style system is that you do not have a Socialist governmental system. Both of your electoral party's are Conservative. One more so than the other. Our Labour party bought in the NHS in 1948. The brainchild of the Wonderful, Anuerin Bevin.
It is a excellent system and I owe to it, both my own life and that of both my Children. Who where born by emergency C'section. Sucessive governments here have cut NHS budgets and a largely elderly population puts a great strain on it. Leaving Nurses and Doctors under strain. They do there best, to though for the most part. Regards 😊✌️🌻
I am so sorry to jump in and disagree here but I feel quite annoyed when it is said the elderly population are by and karge the main cause of the strain on the NHS We older people sit at home for weeks treating ourselves until we get better and inly go to the doctors or especially A& E if we teally need to! The younger generation of all races are in A & E because their child is teething or has a finger cut I am sorry again but blaming the elderly really riles me
As you may realise from my name I too am an older person. Yes, what you say about Teething youngsters etc is true, but many of my neighbours all elderly (we live in bungalows) go the Doc with the slightest sore throat, tummy bug etc. It gives them something to talk to each other about, Sadly. All systems are open to abuse, just the way of things I feel. Personally I have several fairly serious health issues and yet I seldom visit a Doc or go to AnE. Maybe twice a year max. People fear being ill so perhaps the constant GP visitors are deserving of our sympathy. 😊
I totally see your point and like you I am ovr 21 😀 And have several serious conditions and hate going to the doctor I have had cough for 5-6 months and today have finally had telephone consult with doctor most of my friends and family tend to be the same. But like you say suppose the youngsters worry - don't know how we coped - just saying x
I worked for NHS for 40 years and know what a strain it is under now. It is not the ‘fault ‘of the elderly population. But the fact is we have a much larger elderly population than ever before. We are living longer and it’s a given that our health deteriorates with age?
We simply all need to pay more into the NHS for it to survive ?
Agreed! But then that is ALL not just us who have kept it going for the past 70 years. Out NI no longer goes direct to health care now does it? So many people manage too stay under the tax payable amounts the only people paying seem to pensioners. I will now get off my high horse and aplogise once again for highjackng x
Well because most of the people who have the time to keep going to A & E all the time don't work and therefore don't pay tax or into NHS Us as pensioners get state pension and if lucky enough to get private pension continue to pay tax and therefore still pay into NHS However, I really don't want to get into big discussion/argument on the wrongs and rights and wrongs of the oayments into the NHS and and taxes of this country. Hope you stay well xx
I'm stuck in what some in government like to call entitlements. My health forced me to retire at 33 and while I may not pay as much in the system as many do, in the end I shall have paid with my life.
I do receive good medical care for the most part and have a relatively easy access to it, but because of my particular circumstance, I am forced to live below poverty level and that certainly makes other aspects of my life more challenging.
Well you wouldn't have been given just an X-ray here to confirm copd. You would also have been diagnosed by a spirometry test. If your symptoms are consistent with copd then you might not need a CT scan. x
A spirometry diagnosis is based primarily on the FEV1 level. If this is below a certain level then they have copd. If above they haven't but it might still be background. As your lung function can vary naturally by a few points each time you can be borderline and keep slipping in and out of it. A CT scan isn't going to change or affect this.
Over here if the diagnosis isn't consistent with copd ie if you keep getting repeated chest infections for example then you would be sent for a CT scan to confirm or change the diagnosis.
At least in the UK everyone has access to health care which is very different from the USA. I know which I prefer! x
Can I jump in and say that just in joining this site, I find many are diagnosed with COPD. But it really is something of a blanket term and while it may give some patients relief at having a medical term for how they're feeling, for some of us it doesn't go far enough.
I had that label for years but, unless you know for example, that you smoke and thus it might well be emphysema, it might be something else. It might be genetic. It might be idiopathic.
Some of us want more of an answer and some of us less.
Hi I think that as the treatment for emphysema and chronic bronchitis is very much the same especially in the earlier stages it doesn't really matter that much which one you have though I admit I would like to know.
I think it is essential to know in the later stages though. x
Isn't it? Most people have primarily E or CB with a bit of the other. Does this mean those with E progress quicker than those with CB? I assumed the progression rates were very similiar? x
I am lucky as I still have around the mid 70's lung function but I do find the humid weather a big trial and hard to breathe in. Otherwise I can breathe fairly easily which I do appreciate. x
Also I was given a ct scan to confirm diagnosis. In the uk it’s called a postcode lottery. Meaning it depends where you live on how good your care could be.
In my opinion It would have more to offer patients if it spent less on middle management and more on Drs and Nurses. Theoretically, it works well and has, on the whole, devoted, professionals giving free care. However, it is over burdened which means something has had to give. All too often we hear that life saving drugs have been withdrawn because of cost, and there are fewer beds available for patients for the same reason. I don't think I don't think I am alone in saying I would be happy to pay more tax for the NHS, but not if it is going to pay inflated wages and pensions benefits to incompetent management
My thoughts entirely. I certainly have no complaints about the N.H.S. in general but I think it needs a really good shake-up. Just throwing money at an unaccountable behemoth like the N.H.S. is not the way to go about it, I think, but I am vehemently opposed to privatization for lots of reasons. How can it be morally right to make vast amounts of profit out of people's suffering ? The Americans have been fed horror stories about 'socialised health care' and now somehow conflate it with 'socialist' and this then leads them to believe that a system like the rest of the developed world's healthcare will somehow lead to the start of communism in the States. These people opposed to our kind of systems still drive on roads and bridges, educate their children in state schools, etc and no mention is ever made of 'socialism'. There really is no valid argument against it. Redsox states that the U.S. is too big and too populous for it but this is a patently wrong assertion because the system would be run by the individual states and not the federal government. The federal government would then be able to use its massive purchasing power to negotiate prices for buying meds and equipment. This will obviously never happen as long as Big Pharma and lobbyists rule the roost. Nothing will change as long as these vast sums of money are being made. Just my thoughts, well, some of them. Take care.
normal radiological x rays and spirometry can confirm lung disease and a ct scan is not necessary so within the Nhs you would have been diagnosed with a non specific lung disease advised to quit smoking and to live a healthy lifestyle and referred to a repiratory consultant. my lung disease was picked up by x ray 15 yrs ago in England and under the Nhs,subsequent Ct scans have confirmed Emphysema and it's severity.
it would only be non specific until you saw your consultant,so your Nhs consultant would investigate further and probably with the aid of CT scans give a definitive diagnosis and treatment plan,in essence we receive much the same treatment as your insurance based system.
I am old enough to have been alive before the NHS was formed in 1948, and like every other healthcare system it has its faults. When it began everything was free, but as always it was abused by some people, so charges were brought in for prescriptions, dentistry and eyecare. Research was encouraged in the previously private or charity hospitals and healthcare improved in leaps and bounds. In 1961 I was diagnosed with congenital heart disease and had major pioneering surgery which saved my life. I can remember my father saying “thank God for the NHS, I couldn’t have afforded this”. The NHS, paid for by everyone’s taxes and National Insurance, literally saved my life, and allowed me the care to have my two sons, and has kept me going for nearly 60 years which I wouldn’t have had without it. True, we often wait for appointments with medical professionals, and sometimes there are arguments about new drugs, but the hospital emergency service, though sometimes very crowded and slow, usually sees the sickest patients first. There are scandals here, but I have also seen them reported from the USA. I belong to an American blog as well, and two things strike me most, one being the incredible and admirable self reliance which Americans have, but the other is people who are seriously ill worrying about the cost of copayment, the arguments with some insurance companies, the complications of Medicare and Medicaid. Also not everyone gets seen any more quickly than here. From what I have read or experienced the doctors on both sides of the pond are generally very good, the treatments are much the same, but with many of the major and expensive tests here being ordered by the hospital specialist rather than a primary care practitioner. On the whole I am in favour of socialist medicine because everyone gets equal treatment regardless of who they are, and I do not understand how a country as rich as the USA can allow 40million people to be unable to have care because they are uninsured. You do not have to allow foreigners to have healthcare free under a socialised system, although the U.K. has not always been sensible about it!
By the way I have just read on the American blog of someone waiting for two months for Ofev for IPF because their pulmonologist and insurance company can’t get their act together
I sometimes have to wait for a routine appointment, but I can get pretty rapid emergency care. It does vary so much doesn't it?
In your earlier response you spoke of those who take advantage of the system and I think that's true everywhere. Myself, I've often thought that more triage assessment could alleviate a lot of that.
I lived in USA for 70 years before coming to England with my British husband. I can call my GP for a same day appointment. I have regular check ups with my rhuematologist and my pulmonary specialists. I have medicines I need each month without a worry of cost and locating the cheapest place for some of my most expensive meds. My blocked artrures in both legs were diagnosed in UK and corrected. Never even discussed in USA. For several years I have spent time back in USA and have total health care coverage due to very good insurance. I continue to pay for US insurance in that I may return home. However, I love NHS. I do not have to discuss cost of meds with GP now, just receive the best available. I do not have to wait several weeks to see a GP. If ill, call an ambulance...999. So much better than living in rural Texas where we have to drive 10 miles to Emergency Room in the middle of the night because I can not breath. I do not have to spend much of my time hunting for medications that are afforable in that my mail prescription company available through my insurance has such a high co-pay. So yes, NHS is very good. In Liverpool I have found it great for one with my health problems. Nurses and doctors care about me and my condition.
Had written a long response to this but had not signed in so lost it all anyway the essence of it was to many people using and not contribution to it and to many people coming in to country to quickly and the infrastructure has not caught up with it. In years gone by population could be calculated in advance and provided for now everything is under pressure school's doctor and dentist newly arrived people have not had time to contribute into system before they use it now if to many people take and not enough pay well I think we all know where that lead to. Now I understand that not everyone will agree with me but in your own home if you have one breadwinner paying for everything a nd there is two people fine but if you take in another few things get tighter and then another turns up it gets tighter still and so on not enough beds have to wait longer to get in to toilet in morning then maybe you can see it a bit better.
NHS is wonderfull always has been since it started my care up till now great can't fault it the problem is it is now grinding to a halt still wonderful but slower with longer waiting for appointments for example at moment I have been waiting g for a biopsy comming up to 3 months now !!!
I absolutely love the Nhs. I was just pottering along minding my own business when I got a call from my doctors saying he thinks I am ordering antibiotics too often, so he made an app for me to see him a couple of days later. I went to see him and he has asked me to do 2 sputum samples, 1 to check the type of bacteria to see if I’m on the right antibiotics and the 2nd to check for tb. He is also sending me for an X Ray and is checking my bloods. And we will take it from there. And that’s all from him getting in touch with me. I would have just carried on as normal otherwise. They also phone when the weather is hot to see how I am coping. He was running 30 mins late for my app and I know we all moan but I think they are all stars.
My elderly father had a stroke last week. Paramedics were there in 30 minutes, straight to hospital and on meds within 4 hours which probably saved his life. The care he is receiving is amazing. The doctor sees him every day, he has a speech physio, a mobility physio and someone checking his cognitive ability. He has been rescanned, the food looks good and when he goes home they will provide aids such as a chair to sit on and wash, walking frame, physics coming to home to continue work. All for free! The NHS is truly amazing and I have never been so thankful x
It is a massive question you have asked TTT, I will try to be brief 😊
The NHS is an health care system that you pay for during your working life called National Health Insurance contributions, which is a percentage of your total wage, each wage earner in the family pays these, but if there is only one earner in the family then, his/her contributions cover the whole family ie: husband, wife and children under 18. This then entitles you to visits to your GP, hospital stays, all tests and treatments, your GP can also refer you to physiotherapists, psychiatrists, therapists in fact any specialist you or your family may need, these services are all free. If you need to visit a dentist or an optician then you have to pay an amount towards the cost unless you are on certain benefits, or you are under 18. You also have to pay for prescriptions, a fixed amount per item regardless of the cost of the medicine you are taking, the pharmacist will usually tell you if you can buy it cheaper for items available for sale over the counter. If you are under 18 and when you reach pension age your prescriptions become free. That is a very basic explanation of the NHS.
The treatment I have received over my long lifetime would have cost many, many thousands of pounds, and while there are many complaints about the NHS, some warranted, some not, it is a system that works well. It suffers from lack of funds, overworked doctors and nurses, and there will always be individual horror stories, which I am sure happen wherever you live and whatever system your country has or how much you have paid for it, but in my opinion it is a system that works well
I can only tell you about my own families involvement with the NHS and so not to bore you from the birth of my grandson who is now 9 years old. He was born 1 month prematurely at 3lb 7oz with serious genetic and an organ defect. He had his first major operation at 4 days old and remained in the special care until he was a month old over the next four years he had a further 6 major operations. He has to have new glasses twice a year and has problems with his hearing which is monitored by a specialist. He will require further operations when he reaches puberty.
My husband became ill last summer and by the time I had dragged him his to see our doctor he immediately contacted the cancer unit, 4 days later we saw a consultant who immediately referred to a major cancer hospital and he had pre-op tests done and was booked in for an emergency op. a further operation was done 2 weeks later help with his washing and dressing was given a home while he was recovering. He had a further operation last week and is now well on the way to recovery.
Myself well I have received medication for hayfever and asthma since I was six at the moment I take a cocktail of 18 different medications, am now on 02 24/7. Have had to go to a&e 5 times in the past for years and have had a couple of stays due to my lungs I have several professionals monitoring me.
All of the work and medication was done totally free, and will continue to do so. I never knock the NHS they have some of the best staff in the world and we should be proud of them.
Fantastic dialogue. I appreciate the question TomTitTot, and all of the responses. As a US citizen I have had somewhat the same question. I tend to be with RedSox on this( even though I'm a Yankees fan!)). No system is perfect, because it involves humans, and the NHS seems to function well -- overall -- but I'm not so sure it would work here. The federal/state interaction RedSox noted is one of several reasons I feel that way.
In the end it comes down to the patient/caregiver relationship. I've gotten better -- due to my frequent interactions -- at managing this. I do respect the British system -- and the insight and empathy shown on this website. All first rate!
If health care was fully implemented as the affordable care act intended instead of state governors being able to opt out depending on their political persuasion, I think that yes, medical care could be (as it should be) available to all.
I do know that no law is perfect, but the ACA is a good start...
Hi and thanks for replying. You are right that I don't have any idea of how things are in the States but I can well imagine. As an outsider I think that the only way things will change, not just in the U.S., will be when countries start practising proper democracy and start to listen to their respective populations and acting on it. This applies to here as well as anywhere else. Corruption in government is now endemic and people just let it happen nowadays because they've all been ground down, are frightened for their jobs that barely put bread on the table and are in a state of despair. I'm glad I'm not long for this life and that my son is grown-up and settled in a good job because I really worry about how things are going. Take care.
Hi Tom, interesting question and interesting answers from both sides of the pond and I'm sure that you now have a broader idea of our NHS.
However, there are some Health Service advantages that are not so apparent and maybe even some posters here are unaware of the help they can get. For instance, I have the help of a Community Matron who is essentially a very well qualified nurse and she also can call upon a team of district nurses. The CM can prescribe medication, organise a fast appointment with one's GP or an immediate home visit from an area doctor, will organise a plan to help one's medical condition and make regular home visits to check things out. For example, mine spotted my quickly developing oedema in the early stages and linked with my Respiratory Nurse Specialist to organise a scan of my heart which revealed advanced heart failure which is now under care of a Cardiologist and may have given me a better couple of years of life. She also referred me to a specialist Physio who visited me at home and organised a number of home aids, extra stairs bannister rail, shower grab rails, a 3 wheel braked walker with a bag for my NHS portable oxygen concentrator and a number of other things. I could have had an electric hospital bed, but preferred to buy myself a multi position rise & recline chair for sleeping etc. My two home oxygen concentrators and my mobile one, are also of course free, courtesy of our NHS, as is my nebuliser. I personally can't speak highly enough of our overworked and underfunded Health Service and would be most willing to pay more into it, my only annoyance is when I have seen the drunks and drug users puking everywhere and abusing the emergency services and staff, annoyed that they put up with it and still try to help them. There are many helpful things covered by our NHS which are unseen and unheard of by the general public.
I wish you and yours well and hope your health stays as good as possible.
John.
PS.. I forgot to say that the part of my electricity bill that covers the running of my Oxygen concentrators is also refunded to me, which is very nice.
Sadly these services are not available in all areas in the country.it is heartning to hear you are being looked after so well.As said in previous posts it does seem to be a postcode lottery.A survey on this site may highlight the the better areas to receive support and care ? Best Wishes xx
I think your system has some really excellent follow up and I think that have someone actually coming into your home is such an important part of having good care.
Hi, I just wanted to input my opinion for what it’s worth. I have COPD for the past 7 years I am 58 now the treatment including medications, oxygen etc is all paid for, so st least I dont have that worry!
I can see my GP the same day, ring my respiratory nurse if I am concerned about anything and have regular checks every 3 months.
On a slightly separate note and not to do with lung conditions..... my daughter is a thrombolysis nurse and on many occasions due to the speed of ambulance personnel, staff in A&E and my daughter thrombolising the patient within the magic 4 hour period have saved many people’s lives, giving them another chance, all I can say is I am beyond proud of her.
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