[Closed] Hospitals - a rant

Did you notice whether the nurses were fat ?

Am currently in hospital waiting for some stuff for my ears. I have seen two consultants, several nurses and had a number of hearing tests. I may have to have grommets installed in 9 months time.

Stirling service for me; goodness knows what's going to happen once we turn into the US style of healthcare that the government is currently proposing.

I didn't because I wasn't there.

I'll ask...

how is this if he is the duty GP in a hospital

Probably a locum and never been to that hospital before.

Don't get me wrong - I know the service can be amazing (seen it with my mum's recent operation and subsequent care and with my children in special care).

But to have people who simply cannot do their job (and can't even identify whether or not a patient has tonsils) is rantworthy.

I didnt know that you got GPs in a hospital.

Whenever I've needed the nhs for serious, life threatening stuff they have been outstanding.

So, your rant is about a hospital (singular) rather than your general experience of hospitals (plural)?

While slow, I've never had issue with the level of care I've had at a number of hospitals around Edinburgh.

Oh, and maybe you had one of these guys:
http://www.bbc.co.uk/iplayer/episode/b00zh82t/Junior_Doctors_Your_Life_in_Their_Hands_Episode_4/

goodness knows what's going to happen once we turn into the US style of healthcare that the government is currently proposing.

Ummm... It will get better?

And people want to protect the NHS budget so this kind of ineptitude can continue?!

And before I get flamed I'm a big fan of the NHS, just not the levels of waste and non accountability we see across large parts of public service.

And people want to protect the NHS budget so this kind of ineptitude can continue?!

Not sure how you think a change of how the NHS is budgeted will get rid of those that make mistakes.

So, your rant is about a hospital (singular) rather than your general experience of hospitals (plural)?

Well actually it isn't, there was the time before Christmas when one of our daughters had a bacterial infection that developed into pneumonia and spent two nights in hospital but the emergency out-of-hours GP wouldn't prescribe anti-biotics for her twin even though she subsequently displayed identical symptoms. On that occasion we insisted on a second opinion in order to get the anti-biotics and our insistence was applauded by our GP at a subsequent follow-up appointment.

Ummm... It will get better?

Your proof for that being? Certainly not if we turn into a mini US. Rich get all the benefits, the poor get asked for their credit cards or don't get treated. Or don't go to their GPs because it would cost too much.

Sounds like a locum to me. While I think it's a great idea that some A&Es have introduced GPs as gatekeepers so that services don't clog up, there is no point in doing it if they can't diagnose. The arrangements differ from trust to trust though, so as ever it's dangerous to make sweeping generalisations. Unfortunately it is often very difficult to persuade experienced GPs in local practice to cover services like this.

bol - I am entirely sure that is the case and it has left me very angry as my wife could be on the road to recovery yet she has only just got the diagnosis confirmed that she tried to tell the GP about on Saturday.

Part of me wonders whether they have targets for spend on prescriptions too.

And - is there any sense in the suggestion she drinks more fluids to 'dilute' the mucus which may be causing some of the pain?

@adamw

Real competition coupled with complete information leads to better, more efficent, more customer centred services.

If you want 'society' to pay for it, fine, have the government finance insurance coverage.

Prescribing antibiotics is not always the answer. Some doctors do it just because they have patients demanding them and it makes their life easy.

Having said that in your case sounds like the first GP was incompetent no noticing that the tonsils weren't even there.

jonb - I do agree but, given the history of the complaint, we knew anti-biotics got rid of it last time and reasonable assumption would be that they would do so again. On both occasions she left it for a few days (just taking Sudafed and painkillers) in the hope it would get better and on each occasion it didn't work.

I didnt know that you got GPs in a hospital.

Ohh, and the GP on the phone said he'd write a prescription for anti-biotics if my wife was happy for that, but said he was suitable concerned that he felt she should actually go down to the hospital to have it checked out! Then she got that service! Mad.

My GP mentioned my sinusitis, could be down to fungi!

All I could think of for the next week was, Ive got fungus growing in my head!

😯

He did say, if it was fungal, anti-biotics were no good for treating it & warned against the nasial sprays as they could make it worse in the long run too!

Mine cleared up after using the old fashioned bowl of steaming water three times a day for two weeks!

How do you know that it was the ABx that improved her condition? And not the natural course of the disease which resulted in her getting better?

Mastiles - You titled the thread incorrectly its actually Out of hours GP Service. The fact that it is in the hospital is just coincidental.

Does sound like your wife saw a locum, but if your questioning his clinical ability then maybe you should take it up as a complaint, not just a moan on an internet forum?

Also if your wife has a recurring problem, has she spoken to her GP about getting an ENT referral?

No idea whether water makes any difference - I'm a faceless NHS beurocrat, not a clinician. I doubt they've got targets re prescriptions - other than to try and keep as much of a lid on them as possible.

@theyeye: good luck with that. Personally I think it could be a disaster. The easily defined, stand-alone procedures will get cherry-picked and there will be little or no competition for the more complex stuff - just less resource. Even the GPs can see that all they'll end up doing it rationing services. You'll notice that no-one in government refers to postcode lottery any more...

Mastiles - You titled the thread incorrectly its actually Out of hours GP Service. The fact that it is in the hospital is just coincidental.

Does sound like your wife saw a locum, but if your questioning his clinical ability then maybe you should take it up as a complaint, not just a moan on an internet forum?

Also if your wife has a recurring problem, has she spoken to her GP about getting an ENT referral?

2 - I suggested this and she can't face doing it although I feel it is worth telling them about

3 - Her normal GP is nor monitoring it (after she saw him this morning) and recognises it may be part of an ongoing developing problem

How do you know that it was the ABx that improved her condition? And not the natural course of the disease which resulted in her getting better

And she is doing the bowls of steaming water daily too (with Albas Oil).

@adamw
Real competition coupled with complete information leads to better, more efficent, more customer centred services.
If you want 'society' to pay for it, fine, have the government finance insurance coverage.

Utter rubbish. Competition causes the easiest cases to be cherry picked, allowing remaining hard stuff to dropped back into then-underfunded NHS, including where the private gods of medicine screw up. Result: everyone ends up having to take insurance or not get treated. The US is a perfect example of how awful it can be.

Last time I took my wife to hospital was for an appointment at the GP Assessment Unit... arrived, confirmed we were expected (i.e. had an actual appointment)... and finally got home a brief 5 hours later... if that's how long they take when they're expecting you heaven only knows what happens if you pay a surprise visit... saw 3 different nurses/doctors who each asked exactly the same questions & wrote down our exactly-the-same answers each time - what value does that add to anything? - I suppose at least they've got the paperwork in triplicate... maybe in a weird and twisted way I'm supposed to be grateful for being able to use what my tax/NI has been pumped into all these years for 5 whole hours, rather than the meagre 20 minutes it could have taken...

And then it dawned on me.

Problems experienced with the Health 'Service' in the UK make perfect sense once you learn to understand it's not [i]really[/i] a service & patients are just a pain-in-the-butt inconvenience.

Set your expectations low enough & the NHS is just an extenstion of whatever it was that injured you or made you sick in the first place.

she has realised that what she is taking isn't having an effect yet.

Is that the ones she started today?

Problems experienced with the Health 'Service' in the UK make perfect sense once you learn to understand it's not really a service & patients are just a pain-in-the-butt inconvenience

Really? I guess I shouldn't be in the NHS then.

she has realised that what she is taking isn't having an effect yet.
Is that the ones she started today?

Have had similarly ropey service from out-of-hours GP service on a couple of occasions. I suspect their reliance on locum GPs to staff it do have some impact on the quality of service (which is not to say all locum GPs are rubbish).

joao3v16 - that was a rather poor attempt at a troll, right?

Or are you really that much of a tosser?

I think I know Woody.

5 hours, that's good going must be a quiet hospital it was taking a over 40 mins for us to hand over an emergency case on Friday. Partly because of the people wasting hospital's time with things that could have waited or arranged Out of hours visit for. But no they can't wait at home for up to 4 hours for visit but they'll happily sit in a waiting room for 5 hours or more.

Problems experienced with the Health 'Service' in the UK make perfect sense once you learn to understand it's not really a service & patients are just a pain-in-the-butt inconvenience.

Set your expectations low enough & the NHS is just an extenstion of whatever it was that injured you or made you sick in the first place.

OK, I'll bite. I've read some crap on STW over the years, but this is currently winning the "so depressingly ill-informed it hurts award for ignorance". Sure, there may be places where patients aren't given the respect, choice or quality of care that they ought, but I don't think I have met many people in the NHS - even the not particularly effective ones - who aren't motivated by wanting to make people's lives better.

Drac - does your PCT do home visits?

Pfff, 5 hours is nothing. I went into the acute admissions and receiving unit at my local hospital on Monday at 2:30pm, and was finally discharged on Friday at 1:00pm. And they're none-the-wiser as to what's wrong with me.

Drac - does your PCT do home visits?

Well they're supposed to but they usually just ring 999.

Drac - they don't in Harrogate - that is long-since gone unless you have special circumstances such as my mum when she was recovering from her cancer operation when they came out to do some monitoring.

To be honest I didn't think anyone did home visits at all any more and was surprised when my mum told me they had with her.

Not sure how you think a change of how the NHS is budgeted will get rid of those that make mistakes.

We pay for this service so I think we're entitled to expect a good service. The not knowing how to fill a prescription part of the above you can understand if it's a locum, but if a doctor can't even see that your tonsils aren't there what the hell else are they missing?

If you employed somebody that couldn't do the job, what would you do with them?

I know what I did/do and I work in the NHS, so would you like to try again?

if a doctor can't even see that your tonsils aren't there what the hell else are they missing?

Agree but if it's not reported then their employer won't know about it.

Yeah MF it varies area to area not all NHS areas have Out of Hours visits.

but if a doctor can't even see that your tonsils aren't there what the hell else are they missing

He didn't even feel around her sinuses - just took her temperature, listened to her chest and looked in her throat. Which all seemed odd when she was complaining of sinus problems around her eyes.

And still - can anyone shed any light on this 'water will make mucus runny' suggestion by the GP?

And still - can anyone shed any light on this 'water will make mucus runny' suggestion by the GP?

Sounds plausible but not sure how effective it would be, with any infection it's good to drink lots of fluid, that means more than the persons normal intake.

I agree with drinking more fluids in any case but that wouldn't directly make mucus runny would it? It just seemed a bit of an odd one that.

I know what I did/do and I work in the NHS, so would you like to try again?

It's nice that you're supporting a colleague, but do you not think you might get tarred with the same brush? From your defensive position it seems to me that you do. I'm not attacking you, merely questioning the state of the system that allows someone who misses something like this to practice. Maybe it's an easy mistake to make, I'm no doctor.

If Mrs MF presented to you would you notice her tonsils aren't there?

merely questioning the state of the system that allows someone who misses something like this to practice

He might've been fired by now, you don't know.

I agree with drinking more fluids in any case but that wouldn't directly make mucus runny would it?

If dehydrated then the mucus may be thicker but if not I can't really see it getting runnier but I may be wrong.

So what did/do you do? Let it slide or deal with the issue? You may be good at your job, doesn't mean to say everyone in the NHS is (or any organisation).

I dealt with the issues. Well yes but it also doesn't mean everyone is bad, like any organisation there's good and bad. Budgets won't make any difference to that.

It's nice that you're supporting a colleague, but do you not think you might get tarred with the same brush?

I hate being tarred with the same brush which is why I defend those that aren't in the wrong. I'm not defending this guy missing the tonsil being absent.

If Mrs MF presented to you would you notice her tonsils aren't there?

I'd hope so.

I'm not attacking you, merely questioning the state of the system that allows someone who misses something like this to practice.

The system relies on these people being identified, ranting on a forum for example means he goes unidentified. Maybe the guy in question needs some training, some rest time or a good slap.

He might've been fired by now, you don't know.

Utter rubbish. Competition causes the easiest cases to be cherry picked, allowing remaining hard stuff to dropped back into then-underfunded NHS, including where the private gods of medicine screw up

Right back at you AdamW -- utter rubbish.
The hard stuff will end up being priced properly. At the right price, the market will be happy to provide the service, and there will be competition to provide it.

The system in the states would work well with just a couple tweaks -- tort reform being the major one.

So, woman has blocked nose and hospital suggests over the counter remedy, woman goes to GP who suggests expensive drugs that she'd had before but clearly didn't work, no wonder the NHS has no money, I can't wait for GPs to be in charge of the budgets

rocketdog - she has more than a blocked nose*. This was recognised by her GP and he has prescribed a course of drugs that worked the last time she had the same condition.

*She is in so much pain she is sometimes almost in tears, just being a passenger in a car is painful, she can't wear her glasses because the pressure on the bridge of her nose is too severe. On Saturday morning she couldn't even move her head from side to side when she first woke up (which was why I insisted she went to the hospital).

Well yes but it also doesn't mean everyone is bad, like any organisation there's good and bad. Budgets won't make any difference to that.

I've always worked in the private sector and one thing I've noticed is that when a company is growing and/or has a huge budget it's easy to throw money at headcount. Because of the speed required quite often not enough diligence is applied to the selection criteria, so you end up with some less than ideal candidates getting jobs. I'm sure the NHS is no different.

I think the 'expensive' drugs did work RD but this is a recurrence of the same problem, which is the point of the OP's post.

Edit: too slow - that's what comes of working at NHS pace 😳

What I am suggesting is that if management were held a little more accountable then they might start to look for better value for the budget they have

I think you seem to have a misconception, management are accountable. If I'd ignored the issues I raised and had been found out chances are I wouldn't be working in the NHS any more and even lost my registration.

"He might've been fired by now, you don't know."

Unfortunately I doubt it. I quite often hear about poor performance in frontline NHS and it appears that very little often happens to get rid of poor performers even when colleagues complete the official incident forms or complain to seniors.

In fact I even know of one senior consultant who has been know to perform babdly for many years, yet no one has ever tried to get rid of him because of his status within the NHS. Colleagues and juniors try and avoid working with him where ever possible as they do not want to be involved in his negligence.

Anyhow.. on the whole frontline NHS staff work very hard and will always try and do 100% for the patient. The majority of the time its the system that goes wrong, not the individuals providing the care.

simple terms, people get ill, this is not the fault of hospitals or their staff, its a human condition. The people that work in hospitals are people, sometimes they make mistakes. Ever cut a gear cable too short or rounded a bolt?

People remember when things go wrong, and assume everything is right all the time. their are a lot of patients who don't have bad experiences, and a lot that do.

The people that work in hospitals are people, sometimes they make mistakes. Ever cut a gear cable too short or rounded a bolt?

Not read all of this but it has a certain familiar ring to it...

Patient attends out of hours at the weekend and is dissatisfied with the outcome. The patient then sees their own GP in normal working hours and is given what they wanted in the first place.

It happens all the time and also happens the other way round.

It's not got much to do with health or medicine or science, it's got a lot to do with people getting what they want/think they need/were given last time this happened.

If you want science:
Most respiratory tract infections are self limiting i.e. they get better no matter what you do. If you get better after taking antibiotics you tend to assume it was the antibiotics that made the difference.

Just looked up the local guidelines:

With sinusitis, about 30-40% are bacterial, and 70% resolve in 10 days.

In a STUDY comparing antibiotics with placebo (and both groups used decongestants and steam) antibiotics showed no benefit over placebo, and caused harm.
So best practice is to consider antibiotics only after 10 days of symptoms.

That is all fair enough but given the GP in OoH didn't know how to write a prescription and didn't spot that she didn't have tonsils didn't fill us with confidence in his abilities nor his diagnosis.

And on top of that he appeared to have chosen not to consider the history and that this is a recurrence of a condition. Perhaps it would have got better in it's own time but it didn't last time it appeared and her regular GP seems to agree with that assumption.

I think you seem to have a misconception, management are accountable. If I'd ignored the issues I raised and had been found out chances are I wouldn't be working in the NHS any more and even lost my registration.

Again, I'm not questioning the dedication, hard work, and ability of the majority, just trying to point out that not everyone shares those qualities. Bad apples need to be removed for the good of the system as a whole, wether that's in a private sector corporation or an area of the public sector as emotive as the NHS.

theyEye - Member

@adamw

Real competition coupled with complete information leads to better, more efficent, more customer centred services.

What utter rubbish - in health care privatised services are more expensive every time if full costs are included. The NHS is actually very efficient especially compared to private care.

Its simple - we get our healthcare cheap - the US you so like spends almost twice as (as % of gdp) much for worse outcomes. ~Competition
does not work in the NHS, cannot work, has been tried and failed badly

Slide side note so apologies, but is it just me or does anyone else think that Penny Valentine bird off of Holby City is a minx?

[img] [/img]

"in health care privatised services are more expensive every time if full costs are included. The NHS is actually very efficient especially compared to private care."

Completly agree, as do quite a lot of private health care providers who are apparently deciding not to bid to provide NHS services come the NHS reorganisation as they can not see any profit in it.

TandemJeremy - Member

Its simple - we get our healthcare cheap

No argument there. Refer to OP.

TandemJeremy - Member

in health care privatised services are more expensive every time if full costs are included. The NHS is actually very efficient especially compared to private care.

Sigh...

'Private' is usually a precursor of competition, but doesn't always lead there. Equating 'private' and 'competitive' is naive at best, and disingenous at worst. Furthermore, competition doesn't always lead to efficiency, quality, etc. because it needs complete information to work -- i.e. educated consumer choice.

And another thing -- efficiency isn't always the same thing as cheapness.

So we're not talking about the same things at all.

TandemJeremy - Member

Competition does not work in the NHS, cannot work, has been tried and failed badly

Sniff Sniff. What is that smell? A vested interest in the status quo, perhaps?
does not work -- It doesn't work because it doesn't exist.
cannot work -- 🙄
has been tried and failed badly -- really? In the NHS? I don't think NHS has even a vague idea of what real competition is.

TandemJeremy - Member

the US you so like spends almost twice as (as % of gdp) much for worse outcomes

I'm not saying that the american system is perfect, or even good. It's not. But the fundamental idea of choice and competition is right, and would work like a charm if implemented properly. It's a matter of philosophy, and unfortunately will be for the forseeable future. Judging the market on the basis of what happens in the States is like judging socialism on the basis of what happened in the USSR.

FunkyDunc - Member

...quite a lot of private health care providers who are apparently deciding not to bid to provide NHS services come the NHS reorganisation as they can not see any profit in it.

Don't know the details, but this is likely a problem created by the government/health service through price interference. If the private sector cannot provide the same service as the NHS at the same price, this to me sounds like an indicator of the NHS 'undercharging'. That leads to cutting corners or not paying people what they're worth, i.e. reduced quality, brain drain, etc. Again, refer to the OP.

"If the private sector cannot provide the same service as the NHS at the same price, this to me sounds like an indicator of the NHS 'undercharging'"

Maybe your thinking about it from the wrong angle. A private company wants to make profit/pay share holders therefore needs to make its margin. The NHS doesnt have to do this in every transaction it makes. The NHS each year is over spending more and more compared to budget, I'm not sure this is the same as undercharging.

Judging the market on the basis of what happens in the States is like judging socialism on the basis of what happened in the USSR

Has true socialism worked in any country? As far as I'm aware, the socialist philosophy culminates in dictatorships. Therefore, if we're comparing private healthcare in the USA as a bad example, can you provide a good example of where it works well (or is it the same problem as socialism, where the system is exploited to benefit those at the top of the pile)?

And genuinely interested, by the way, as beyond the American model, no one has mentioned any other private healthcare model.

Mastiles, what do you do for a living? Just want to know so that I can dredge up any incidents from my life when I've had to interact with someone else from that line of work and been less than satisfied, and then tar all of you with the same brush.

The problem really relates to the "modern" provision of out-of-hours services. In the olden days you would have spoken to / been seen by a GP from your own practice. Now-a-days it's a mish-mash of GPs covering huge swathes of the population. Locums are often involved and I think quality is sometimes "variable". That's not to say that everything was spot on in the olden days, and to be fair back then expectations from patients were a good bit lower I think.

We ended up in this pickle because when the GP contract was renegotiated about 8 years ago the governement valued this antisocial work at only £8,000 per annum per GP. Most practices decided to take the hit and ditch this unpleasant side of work. Can't blame them since most would have endured years of antisocial hours and ruined family life, not to mention the years spent as juniors working 80+ hours a week and being paid 50% of the hourly rate for all hours over and above the first 40 per week. Yes folks that's overtime at HALF the standard rate. When I was a junior the cleaners made more than me on nights and weekends!

Hospital medicine is also sliding into the same cess pool of mediocrity thanks largely to the European Working Time Directive. Traditional firm (team) structures have been broken up by shift working, patients get passed from one team to the next with huge potential for cock-ups. The need to save money results in reductions in bed numbers so the patients are shuffled from ward to ward, the bed barely cool from the departure of the last occupant. And people wonder why hospital infection rates are on the rise.

The medical profession is doing it's best to hold the whole show together. I am amazed by the enthusiasm of many of my colleagues and their efforts to engage with management and politicians in order to try and safeguard patient services. I gave up engaging with them long ago. It seems to me that as quickly as you fight off one stupid re-organisation on initiative they think up another one. I just focus on looking after the patient in front of me and sod the bigger picture. It's the only coping strategy I have.

Just to complicate matters, demands on the service are increasing due to an ageing population and the exponential rise in the cost and complexity of medical technology, while funds are in short supply.

How did we end up here? We voted for successive bunches of idiots who think health care can be run like any other factory. It can't.

As for the private sector, those who have said it will cherry-pick the easy stuff are quite right (I should know I sometimes work there too). The private sector has no interest in those with serious chronic health conditions, they want healthy patients having discrete interventions such as arthroscopies or hip replacements. The last labour government negotiated contracts with private firms which paid them 15-30% over tariff and guaranteed them quantities of work. When the patient numbers going to the private hospitals didn't materialise the private firms were still paid for the full contract. Meanwhile those too complex or sick for the private sector still had to be done by the traditional DGH. Hardly a level playing field, but a great way to make the private sector look much more efficient than the NHS proper.

Be careful what you wish for - you might just get it.

Consultant Anaesthetist
17 years NHS service

Gasman Jim - Nice post

Mastiles, what do you do for a living? Just want to know so that I can dredge up any incidents from my life when I've had to interact with someone else from that line of work and been less than satisfied, and then tar all of you with the same brush.

Answer the question. What do you do?

But what does it matter? Your 'argument' is based on my tarring everyone in the NHS with the same brush when I commented hours ago to the contrary so anything you could say is irrelevant anyway.

But heyho, to give you your chance in the spotlight I work in the creative industry, mainly involved in designing and building websites.

Ohh, and we have done several for both the NHS and surgical organisations as well as lobbying groups and specialist disorder sites 😉

.....on 2nd thoughts

As far as I'm aware, the socialist philosophy culminates in dictatorships.

Not quite.

I suspect tyou're thinking more of revolutionary sociaism (what we called communism). On the revolution - the overthrow of the ruling system - the proletariat necessarily have to become a command organisation in order to ensure that socialism is planted. This is the dictatorship of the proletariat.

What you have then is a dictatorship lead by the rulers of the revolution and the continuing existence of a nation state.

The next phase - and the one no socialist state has ever got beyond - is the dismantling of the state and the removal of a ruling structure. At best, all that should remain is a self regulating bureacracy. Each person is to contribute what s/he can and receive what s/he needs.

Unfortunately, while a wonderful philosphy, the experiments have demonstrated that in practice it is not possible to move beyond the dictatorship of the proletariat.

Oh, and as for the concept of competition in public services, all this tells me is that politicians are incapable of taking responsibility for the fair, equitable and efficient distribution of the nation's wealth to those who need it.

docrobster

Just looked up the local guidelines:

With sinusitis, about 30-40% are bacterial, and 70% resolve in 10 days.

In a STUDY comparing antibiotics with placebo (and both groups used decongestants and steam) antibiotics showed no benefit over placebo, and caused harm.
So best practice is to consider antibiotics only after 10 days of symptom

So actually best practice was followed

So out of office hours medical attention was sought. A Doctor was seen and best practice guidelines applied. A prescription was given for medication. No money changed hands.

It is not certain or even likely that the antibiotics prescribed at the second free visit to a doctor actually will do anything to alter the course of the illness.

So - what was the problem again? Overprescription of antibiotics?

Right back at you AdamW -- utter rubbish.
The hard stuff will end up being priced properly. At the right price, the market will be happy to provide the service, and there will be competition to provide it.

The system in the states would work well with just a couple tweaks -- tort reform being the major

Yeah, right. [b]Your proof being?[/b] My proof is adequately shown by looking over the Atlantic. If you have money or can afford insurance all is cosy. If you can't, well, tough.

Any market tries to form itself into monopolies. Health provider A comes into the market, undercuts the NHS with nice cherry-picked stuff as a loss-leader. Hospital loses services and hence money and is denounced as crap. Oh look, a private hospital opens. Oh look again. All the prices have gone up. Compettition? Well yes, if you want to travel 50 miles to their hospital to get it done. Oo, can't afford that out of taxes, everyone must have personal insurance. Haven't got it? Well, we'll have a 'safety net' NHS. Lets call it, ummm, 'Medicare?'.

The US spends far more than us on medicine (and it's as corrupt as hell) and overall gives a poorer service.

I went to A&E last night

Wached Jaws 3 in the waiting room (total cost so far £1.5 parking, total saved £15 cinema tickets with the missus)

Saw locum doc (Russian, no beside manner, minimal chit chat*), poke wrist, ask questions, x-ray, check x-ray, nothing wrong with bones, points out which tendons connect where and most likely to be a bit sore for a few weeks, just keep it still for 48 hours, 2iburprophen 2paracetamol, 3x a day, and I'm off.

*I'm an engineer, I like this doctor

Should I have demanded antibiotics? I feel cheeted now.

Damn, Mastilles, I was really hoping you were a mechanic (particularly a VW mechanic) or a builder or a banker or an estate agent then I could have got my tarring brush out good and proper. But the "creative industry"! How am I supposed to use that to my advantage? That's just not fair. 😉

So - what was the problem again? Overprescription of antibiotics?

The problem is applying consumerist principles to a state run tax funded health care system. M-F didn't get the service he thought he should, so he has come on here to moan. The fact that that the service was in the best interests of the patient (no antibiotics) and the state (very cheap) has been overlooked.

Again, I'm not questioning the dedication, hard work, and ability of the majority, just trying to point out that not everyone shares those qualities.

I said that way back there somewhere but like I say no budget change will make that any different.

Gasman Jim a nice post up there.

Gasman Jim,

An excellent post.

I recently attended the Bristol Royal Infirmary and received what I considered to be a very efficient and satisfactory service. I'm aware that we ought to retain a sense of perspective on matters in the public sector.

Nice username - a derogatory name for your trade!

All the best.

The US spends far more than us on medicine (and it's as corrupt as hell)

It is a bloody racket. The hospitals bill the insurance companies for procedures, so the more they do the more money they make. So they do loads of stuff to you that you don't need and bill your insurance company for it. So then your premiums are huge.

To make the premiums affordable for employers they offer a sliding scale of cover. Most people are only covered up to a certain amount. If you have a big problem you have to stump up yourself, many tens or hundreds of thousands.

You might find that childbirth is not covered on your insurance, so you have to pay all the bills yourself to have a kid. And everyone gets the full medical works - operating theatre, doctors, nurses etc. You don't get a room and a midwife like you do here (if there are no problems).

The NHS tries to economise wherever possible, which can actually result in better treatment since the impetus is to only do what's needed and to get it right first time.

Answer the question.

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What do you do?

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PAXQUEEN!!!!!! 😀