I love the NHS but is it broken?

There’s a long tail of damage from Covid, you wouldn’t expect excess deaths to be zero in this period we’re calling “post pandemic” which isn’t really “post” at all. And Labour have promised to investigate anything left outstanding from the already ongoing enquiry, and specifically how money was spent and who it went to. Now pull your anti-vax tinfoil hat on tighter and shut up now please, there’s a good fellow.

Many countries seem not to have the long tail of excess deaths from Covid, Sweden being one of these.  Sweden with the lowest excess mortality in Europe throughout 2022-23.  So how do you square that circle?  Yet Sweden is also a heavily vaccinated country, so is it the vaccines?  Maybe not, although we do know that since Sweden did not lock down to anywhere near the extent that many other countries did, then the lack of collateral damage from not shutting down the country and it’s health service could be balancing the books here somewhat.

Saying that Labour will investigate in 2027 when the enquiry looks likely to conclude is a bit late don’t you think for the 150 people a day needlessly dying?  What if one of those deaths was from your family?  Would you be so blase about it all then?

Still, you sound like you know exactly what is causing those deaths, so why don’t you give us your reasons backed up by data, even though the actual data shows that only a small proportion are related to Covid.  But wait guys, no need to investigate – kelvin on the internet knows!

As for being anti-vax, you are clutching at straws.  I’ve had two plus my booster.  I needed to with work as I travel on an almost daily basis.  I just want to get to the truth – so why don’t you?

I can’t help but wonder which one of the previous trolls have registered here again as alex22…

  By far the biggest consumer of prescription medication in the world per person is the USA.  So they should be by far the healthiest population right?  Wrong, they have some of the worse levels of serious chronic illness in the world.  Sure, much of it is diet related, and some is probably due to the poorest not having the same level of access to healthcare as the more well off, but facts are facts, so perhaps ask yourself how is this the case with so much access to pharmaceutical treatments?

I mean, correlation certainly does not equal causation.

There’s SOOO many factors in play here. Many have already been mentioned. Inequality to access to healthcare probably being the biggest in the US, along with massively differing ‘incentives’ regarding the payment system.. Basically, the poorest and illest DON’T get any meds (ok, over-exageration, but you get the gist) and get iller and die.. whilst the richest get (probably) far too many meds..

Additionally, it could be argued that the iller one is, the more medication/treatment one requires, and NOT the other way round..

DrP

And the vast majority are not Covid related.

But the report points out that excess deaths are of people who’re vulnerable to covid effects, those being cardio-vascular disease, other heart diseases, acute respiratory failure and diabetes, all of which are known risk factors of covid, and says that more research is needed. You can’t just say they’re not covid related.

I can’t help but wonder which one of the previous trolls have registered here again as alex22…

A troll, on a bike forum, are you serious?

Rather than calling people you clearly disagree with trolls or tin foil hat wearers etc, why not just engage with the discussion at hand?  If you think I am wrong just say so, but be prepared to back this up with evidence.  In this way we can keep the discussions civil.  Thanks.

But the report points out that excess deaths are of people who’re vulnerable to covid effects, those being cardio-vascular disease, other heart diseases, acute respiratory failure and diabetes, all of which are known risk factors of covid, and says that more research is needed. You can’t just say they’re not covid related.

Same would be true in Sweden too surely.  But they, and a few other countries do not seem to have much in the way of excess death.  But then again some do.  According to the Euromomo data, Germany for example has a higher spike is excess death in 2023 (14.44%) than it did in the first year of the pandemic (12.06%).  This is very strange.

And anyway, we have all (well mostly all) been vaccinated now against Covid, so surely this should be dramatically reducing risk factors for those who are vulnerable.

Many ways of looking at it, many potential factors at play, but which is correct?  This is why it very urgently needs looking into, but no-one seems to want to do this., least of all the media.  Why is that?

And anyway, we have all (well mostly all) been vaccinated now against Covid, so surely this should be dramatically reducing risk factors for those who are vulnerable.

Vaccine take-up has been patchy since the first roll out when most folks were (obviously) super keen, and folks often think that one shot and they’re done. Patients IME don’t understand that there have been different variations of the vaccine, and it often has side effects that are uncomfortable and unpleasant. Our last vaccine drive (September -onwards) had a very poor take-up with folks opting for their regular flu, but often refusing the COVID despite being in risk groups. While I’m not going to say that all these deaths are COVID related, I’m not massively surprised that after a world wide pandemic that challenged the capability and capacity of healthcare around the world that there’s a tail of excess death, in fact I’d be genuinely surprised if there wasn’t.

least of all the media.  Why is that?

Covid like Brexit is yesterday’s news and todays chip wrapping, and there’s more interest in BoJo’s text messages. C’est la vie. I doubt it’s a massive conspiracy TBH. 

Then if that theory is to hold water, why no excess deaths in Sweden?  They had less critical care capacity than the UK at the start of the pandemic?

And believe it or not, Sweden has a denser population than the UK (89% of the population of Sweden live close together in towns and cities, compared to just 84% in the UK).  So this has little to do with it.

And normally following a deadly pandemic we would expect a period of positive mortality data, since many of the old and vulnerable have sadly already succumbed.

So this is highly unusual.

Then if that theory is to hold water, why no excess deaths in Sweden?

Have you forgotten that COVID was really really poorly managed in this country? That there’s an enquiry going on right now becasue of that failure? That out of most developed nations bar Italy and some others; we had the worst outcomes and the worst excess deaths? That the Chancellor actively devised a scheme to help spread the disease? that the people in charge vacillated daily between lock down and “letting it rip” that our doctors had no PPE etc etc…

Comparing the UK with pretty much any other developed nation is going to see us coming off worse I’m afraid.

So this is highly unusual.

COVID is still a factor, I’ve had 2 GPs off work because of it, speaking to one last night he sounded like an 80year old with a 40 a day habit, that vulnerable people keeping dying of it, or complications arising from it doesn’t seem that unusual to me.

Have you forgotten that COVID was really really poorly managed in this country? That there’s an enquiry going on right now becasue of that failure? That out of most developed nations bar Italy and some others; we had the worst outcomes and the worst excess deaths? That the Chancellor actively devised a scheme to help spread the disease? that the people in charge vacillated daily between lock down and “letting it rip” that our doctors had no PPE etc etc…

Comparing the UK with pretty much any other developed nation is going to see us coming off worse I’m afraid.

Comparing Covid deaths is problematic as all countries counted and measured in different ways.  In the UK for example it was initially any death within 60 days of a positive test.  Later this was dropped to within 28 days.

As for ‘eat out to help out’, there were identical upticks in cases after the summer of 2020 in almost every European country, so I think we can say that this isn’t even a factor worth considering.

So the only real comparable measure between countries is by measuring excess mortality.  It is not perfect, and there are several ways of doing this, but it is the best we have.

Sweden has come out not just better than the UK, but better than every other major country in Europe in terms of excess mortality between 2020 and 2023.

I think we can therefore agree that it was Sweden, who treated it’s population like adults, and did not impose strict and damaging lockdown measures, or ineffective mask mandates, that has proved to have had the best approach at pandemic management.

But perhaps going slightly off the original NHS topic now so maybe I’ll move this to another thread.

I think we can therefore agree that it was Sweden, who treated it’s population like adults, and did not impose strict and damaging lockdown measures, or ineffective mask mandates, that has proved to have had the best approach at pandemic management.

Given that there’s been more or less uninterrupted debate since 2020 and a Wikipedia page devoted to the controversy generated by Sweden’s response to COVID, I’m unsurprisingly going to disagree, but it is thread drift.

Given that there’s been more or less uninterrupted debate since 2020 and a Wikipedia page devoted to the controversy generated by Sweden’s response to COVID, I’m unsurprisingly going to disagree, but it is thread drift.

You disagree because Sweden has had the best excess mortality in Europe between 2020 and 2023 and perhaps a country with more deaths did better?

I believe that there are also now very high levels of excess deaths in Australia and New Zealand if it was these countries you are trying to compare to.

Very strange, can’t quite get my head around your reasoning that less deaths is somehow worse, but let’s agree to disagree and leave it there.

yawn.

did someone close the covid thread, or were you not getting enough attention in there?

I have recently been discharged from hospital having been laid up for 5 days.  Having little conversations here and there with various nurses and staff and they all said the same thing, its really down on its knees.

One of the nurses described the NHS as being a third world environment.  I have nothing negative to say about the NHS.  My treatment whilst in hospital was really very good.  They all worked very hard, constantly up and down the wards.  They always smiled, had a laugh and loved helping and looking after people.

I have the utmost respect for the nurses and other hospital staff and I have no doubt its a very difficult job to work in given the current situation.

I don’t think this is the place for more covid nonsense.

We’ve enough threads on that.

Yes its broken.

Most here will blame the tories.

I think its a systemic failure of our absolute inadequate politions across all parties.

NHS shouldnt be controled by one party and used as a campaign tool.

It should be protected and a cross party board with people from the actual NHS being utilised.

Spending needs to be upgraded and protected.
Whilst at the same time ensuring procurement and management are held responsible.

is today D3 of the junior doctors strike?

i appreciate that means its no longer ‘news’, but the lack of coverage is a bit odd… i cant even see reference to it on bbb/news/uk and even the Guardian has it now relegated to an OpEd piece looking at the political impact.

A troll, on a bike forum, are you serious?

Rather than calling people you clearly disagree with trolls or tin foil hat wearers etc, why not just engage with the discussion at hand?  If you think I am wrong just say so, but be prepared to back this up with evidence.  In this way we can keep the discussions civil.  Thanks.

Interesting reply from someone who’s just joined a bike forum and spends all their time on threads about the NHS then starting threads about the “manmade climate crisis”

If it looks like a duck…

can’t quite get my head around your reasoning that less deaths

*fewer

It should be protected and a cross party board with people from the actual NHS being utilised.

The trouble with that is that the NHS – or rather the universal provision of free healthcare by the state – is a very socialist policy. Probably the only socialist policy we have left in this country. For that reason the non-socialists will always want to destroy it and replace it with a private system because there’s an enormous amount of money to be made out of it.

Id like to think its the vocal batshit minority of the tory party that think that

And moving it over takes it out of their cross hairs.

Been in an A&E today and its bursting

Alex, you’ve gone way off topic, the response to the pandemic was primarily directed by Govt, SAGE, PHE not the NHS, they had to responded to the dictats from the above. So conflating the issues around the pandemic with the NHS is at best disingenuous, at worst a **** insult to those who had to try and keep people alive whilst also living the same experience as the rest of the country under lockdown and all the bullshit that entailed.

Do better.

I posted this when the chat was active

My mrs pal has been suffering with sciatica for the past few months. Over the past few years she’s also been treated for breast cancer. All on the NHS

The sciatica has been causing huge problems for her to the point she’s on the verge of a mental breakdown. Her parents paid for a private consultation for her yesterday at a dedicated private hospital. The consultant there was absolutely horrified by the lack of care from the NHS consultant. Essentially it was “you’ve got sciatica, here are some painkillers, go away”. No MRI, no tie in with her previous cancer diagnosis, no treatment plan other than the painkillers.

Following on from this, the person has received the results of their private consultant and battery of tests which has shown that despite her breast cancer being in remission, she now has spinal cancer and not sciatica like the NHS fobbed her off with.

30 seconds on Google taught me that those who’ve had breast cancer are at significant risk of spinal cancer. Struggling to understand why a fully trained and qualified NHS consultant wrote this off as sciatica with absolutely no diagnostic tests.

Our friend has now been admitted to the Beatson for radiotherapy and other treatment. Had she not gone private, what would have happened?

@BoardinBob, that’s shit, sorry to hear that.

The USA, worth a read…

‘At the private hospital, the disrespect was just more subtle’: a tale of America’s two healthcare systems | Well actually | The Guardian

I’ve worked in the US and their healthcare is a simple 2-tier system – rich or poor, that’s it at the end of the day.

And based on the possible sheer cost of healthcare, 99% of us are actually poor.

I’ve worked in the US and their healthcare is a simple 2-tier system – rich or poor, that’s it at the end of the day.

And based on the possible sheer cost of healthcare, 99% of us are actually poor.

Is it that much different to the UK now, where the rich have access to private healthcare, so quicker and more convenient access to healthcare over those using the NHS?

The NHS is at breaking point unfortunately, i’ve never seen it so bad in my life, try and get a doctors appointment is basically pot luck on a phone call at 0830 and beating the hordes, A&E is a panic for most with the waiting times, operations are years in the making, etc, etc, i just don’t think the NHS is able to deal with the level of demand this country puts on it, we just never thought that increasing life expectancy without increasing health with it was going to end up costing us way more in the long run.

i just don’t think the NHS is able to deal with the level of demand this country puts on it, we just never thought that increasing life expectancy without increasing health with it was going to end up costing us way more in the long run.

If we actually were serious about having a GP led service, rather than repeatedly paying lip service to it, then it’s almost certain that things would be better. As it is, funding keeps on being diverted from GPs to hospitals which keeps making things worse. Now we’re unfortunately in the position where it’ll take 10-15 years to undo the damage and neglect and make things better.

Incidentally, it’s one of the steps that the last Labour government started to take, but got absolutely pilloried for it in the right wing press, so then shied away from. “Lazy GPs” are a tenet amongst certain sections of the public unfortunately.

One last point to make, and this applies to many things outside healthcare as well, you cannot fix a demand problem purely with increased supply because of the issue of induced demand. There has to be some demand management too. Again this is something that we as GPs used to do, but rarely have the time for these days.

Yeah, my GP is great, it offers GPs, physios, nurses, etc so you can get a range of cover, but at present they are understaffed and getting an appointment is nigh on impossible, that’s both due to lack of resource for the GP, and more problematic, customers who just use the service when they could use 111, the pharmacy, common sense, etc, but instead they will use up that resource.

A few years back the GP did try a triage service, so call backs to work out if an appointment was necessary, which was bookable online as well, but this disappeared unfortunately, partly because of a lot of people complaining about not getting to physically see doctors, so we end up with a poorer service because of public demand.

GP’s have saved more lives then they will ever get credit for. My local GP has been a lifeline for a good friend of mine, whilst Op Courage had failed him, our GP has been fighting hard to keep him talking, signposting to other support whilst encouraging him to engage with it and then if he struggles.

I can’t imagine the strain that puts in him and the service.

Worth their weight in gold, seems others don’t feel the same.

I find the variability in GP services odd.  Would we have more consistency / control with them being brought into the NHS?

My GPs if you phone before 930am you will be seen that day and even if you phone after you probably will if deemed urgent.  9 doctors ( most part time, 3 still in training?) working out of a newly refurbished building with proper disabled access.  Polite helpful reception.  Their own MH nurse who gives counselling, 3 practise nurses ( part time)  Not perfect as they don’t use IT as much as could be done but for example if you have blood tests you get a text with results / asking you to make an appointment to discuss.  This is in an area with both middle class housing and a lot of poverty with all the issues that brings

Very much a patient friendly serviceanother local practice is in a ramshackle building, no proper disabled access, urgent appointments hard to get

Huge variability in service

Is it that much different to the UK now, where the rich have access to private healthcare, so quicker and more convenient access to healthcare over those using the NHS?

Oh yes, very different – here you’ve a right to the healthcare and will get it, may be on a list but you’ll (eventually) get it.  There…

Private healthcare, with the exception of a few hospitals, mainly in London, doesn’t the systems, expertise nor volume that the NHS does – example; get run over and you’ll go to an NHS A&E unit.

And those without access to healthcare in the USA still pay more than we pay (per capita) as even their Medicare/etc costs more per head than the NHS costs us.

There are probably better systems than both, but the folk with influence are pushing for a USA-style system – vote Tory in the next GE and you’ve helped sign the death warrant of affordable healthcare, be proud of what you’ve done and tell everyone!

US is around 20% of gdp on healthcare, UK around 10% and our GDP per capita is lower.

tories are deliberately creating a two tier system by stealth here and its working.  folk with any access to money often go private to get appointments in a reasonable time.

@tjagain

I find the variability in GP services odd.  Would we have more consistency / control with them being brought into the NHS?

I doubt it. Micromanaging doesn’t work well for complex tasks like being a GP. Also secondary care, which is within the NHS, in general is about half as cost effective as primary care which traditionally have been independent contractors.

IMV, as a GP, the problem with quality in General Practice is down to two main things, which is an excessive workload, and repeated attempts to skimp on General Practice by getting things cheaper, and so losing quality.

In general, if you want a quality primary healthcare system you have to pay GPs very well (to make it an attractive career choice), and not overwork them. This is expensive, but generally cost effective, and has benefits for the wider healthcare system by reducing workload.

Fair enough

I just wonder how my GPs can provide such a great service – I got a text from them this morning reminding me to book a blood test for example and others provide what appears to be a substandard service

another example – my GPs have one day a week with appointments from 7 am to 7 pm for those who cannot take time off work easily

Lots of people do complain about their GPs for various reasons, not always associated with a bad service.

There is a perception that what makes the patient happy is a good service, and that is not always the case, antibiotic prescribing for example.

There’s also a perception that if there’s a bad outcome then the GP must have done something wrong.

GP practises are businesses in their own right, they have to make a profit, which benefits the partners.  Well run ones do well, poorly run ones the opposite, hence the variability in service levels. Sounds like you have one of the well run ones tj.

Or is it that poor ones are taking more profit from providing poorer services?

Most of the “poorer” ones tend to be relatively underfunded.

Would we have more consistency / control with them being brought into the NHS?

I don’t think so, there’s an argument for the NHS looking after properties that are currently owned by GPs, but even that would need very careful consideration. The 08:30/09:00 ‘rush’ is a function of over-demand and patient expectation, and needs solving with more GPs that are not killed by workload, demand management and patient education. We triage all patient enquiries, and despite some (boomer) patients complaining bitterly about it, they get seen quicker and by the appropriate clinician. The days of phoning your practice and getting an appointment with a GP are mostly over. 

I have recently been in hospital and talking to some of the nurses, you get a real sense of survival and just getting on with things as best as they can.

Chatting to the nurses one of them described the current state of the hospital and the NHS service as ‘third world.

Very sad to hear and see, as all the staff are working so hard on 12 hour shifts to do the best they can. I don’t have a negative thing to say about any of the hospital staff that helped me during my stay, only praise.

As with everything else that’s falling apart, GPs’, dentists, schools etc its down to lack of funding and just too many people. The population is growing all the time, not just in the UK, but all over the world.