TV Program: Clapped Out: Is the NHS Broken?, Dispatches, Channel 4, UK

"After 18 months of Covid, award-winning journalist Matthew Syed travels the country asking some tough questions about the performance of our much-loved NHS"

https://www.channel4.com/programmes/clapped-out-is-the-nhs-broken-dispatches/on-demand/72600-001

I watched some of this last night and it was quite hard hitting and revealing.
There was one bit with a young person who after being repeatedly fobbed off and told she was a hypochondriac eventually got an MS diagnosis.

Contrary to the constant narrative of underfunding, although relevent, the documentary pointed out flaws in the way the money was being spent and also the culture of protecting the NHS reputation at all costs, often to the detriment of the patient.

They cited the Netherlands model as a more efficient, patient centred system, but the person (not sure if it was a minister) being interviewed said that to implement such changes in the NHS would be very difficult because of the hierarchical nature of the NHS.

(this is from memory and as I said I didn't watch it all)

 

I watched it too. The young girl had seen 3 different GPs, after starting to fall over repeatedly at school, and it was an optician who suspected the diagnosis from her visual problems and his examination, and sent her to A & E whom he contacted directly. I think she said she lost some degree of vision from the delay.

 

I didn't watch the program being discussed. But every time I read about the NHS being described as broken or some other derogatory words being used (often justified, I agree) I start to worry that the response to this will be "Well, if the NHS is broken then let's have a private system."

Any private system - and I know that huge parts of the NHS have already been privatised - has to make a profit, and it inevitably means that profit will be put before patients. All my life I found it (and still find it) hard to get any treatment from the NHS. My limited experiences of private medicine have not been any better than the NHS they have just been more expensive - a LOT more expensive.

 

As far as I am concerned the problem is very simple - underfunding. I don't know why journalists want to go with the alternative waffle they get spoon-fed.

In my experience continental Europe medicine is much more hierarchical than in the UK so I am not sure what that was about.

The big change we need is to abandon the concept of separate primary care and get everything done directly in buildings with proper facilities - usually called hospitals. We used to have that pretty much and we could also do home visits from there. Now we have the worst of all worlds

 

The Dutch model isn't all that. We have much shorter wait lists for a host of treatments, but similarly to the UK we suffer from underfunding and a lot of useful treatments are taken off the table because of a cost/benefit analysis. A lot of Dutch people don't even visit the doctor when sick because of the 300 euro or so "own risk" we have to pay for a lot of treatments before we get coverage from our insurance companies.

There is a lot of red tape that needs to be cut through here as well. Several of my family members work in care jobs and are getting more and more frustrated by the things they can or cannot do. My aunt(now sick with Long Covid) worked in elderly care, to give one of their patients something as simple as paracetamol they'd first have to ring up someone higher in the hierarchy. It's just a shitfest of unnecessary extra actions like that.

Another example is my dad being at the hospital, the clinician there tells him that his GP needs to refer him through for something that he could have quite easily done himself. So the GP's assistant here was a bit flabbergasted at first, but quickly realized it was because referral by a GP means the hospital makes more money out of it for some stupid reason.

There are so many added layers of bureaucracy here it's maddening.

The constant shifts in what trained nurses or carers can or cannot do is driving people out of the profession too. I mean, you think you're getting a good education that allows you to do stuff. You actually get to do said stuff for a couple of months and then your diploma gets downgraded for nonsense reasons beyond anyone's comprehension. So the stuff you were fully allowed and able to do you don't get to do anymore, it now has to be done by someone with a more expensive diploma and a higher degree. I'm talking basic stuff like giving people injections and more like that.

 

I'm afraid this just repeats the lie that it's possible to get ever more efficiency from a low investment system that is facing ever increasing demand. The NHS has been for almost all it's existence the most efficient health system in the world for any comparable country. The US which has the most expensive health care in the world, spending per head 2.5 times that of the UK, it has slightly worse health outcomes than the UK, although these are near equal if the impact of fire arms is removed.

The UK is second lowest spender on health out of the G7, with only Italy spending less per capita. The Netherlands (not in the G7) spends 1.6 times per capita on health care than does the UK. We've had decades (excepting 97 -2010) with politicians pretending that we can have health care on the cheap and that at the same time the system will continue to deliver. So yes it's clapped out, that's what happens when you work something to breaking point, and there's no amount of clever efficiency talk (Syed is a motivation speaker and organisational psychology wonk) will get more out of the system than it can deliver.

 

https://threadreaderapp.com/thread/1451095654995005445.html

Sir Chris Ham

Co-Chair NHS Assembly, Chair Coventry and Warwickshire ICS, NED Royal Free London FT, Emeritus Prof Uni of Birmingham. Health policy and management wonk

 

From the quote in post #8 above...

How do these record numbers of patients get appointments?

 

I haven't watched this, but I've enjoyed Matthew Syed's book and podcasts. He's pretty good at debunking nonsense, for example he did a very good episode on the Stockholm Syndrome, and another on subliminal advertising and subliminal self-help recordings, debunking both of them.

https://www.bbc.co.uk/programmes/m000s2kt/episodes/downloads