What do people believe is so special about the NHS?

richp007

I wonder if that could be turned around? The message could be "Some of the people that have died from diseases such as cancer and heart disease in this country would have survived if they had been treated by other health systems"

However, such a message is probably too blunt for many.

Even if people do agree that there are problems with the NHS then the argument then seems to turn to "Just spend more money on it". The NHS has average funding but gets below average results which indicates that funding isn't the real issue.

GadgetObsessed

That's a really odd comment to make. Why would anyone with a story to tell about their NHS experiences automatically assume that any other health care system would have failed them? Nor should you assume that everyone gets emotive about the subject.

GadgetObsessed

Screening of healthy people is a complex and widely researched area in medical economics. Very often, screening of healthy individuals causes as much harm or even more harm, than good. For example, there is still ongoing debate on just how beneficial breast cancer screening is. The key issue is the number of false positives with screening.

From the Cancer Research's review on breast cancer screening.
"for every breast cancer death prevented through screening, about 3 women will have treatment for a cancer that would not have caused them problems."

(I have seen other research/estimates that has much higher ratios such as 10 to 1.)

And breast cancer is one of the best cases for cancer screening - it is easier to screen for and treatments are more effective than for many other cancers.

So if someone says that screening has saved their life because screening caught an early cancer then in fact it probably has not - but nobody can be certain if it has or has not in their individual case.

The problem here is that in the majority of cases cancerous cells do not go on to cause you to develop a dangerous cancer. Unfortunately we simply do not have the technology to be able to tell whether a scan that reveals cancerous cells means that the patient will actually end up getting a dangerous cancer.

Another good example is MRI scans for healthy people - often referred to/sold as health MOTs. There are lots of people in the medical profession who feel that such MRI scans are a bad idea.

For example, apparently about 1% of people of people will die because they have a brain aneurysms that bursts. So it seems like a good idea to see if you have this problem before it kills you. However, scanning of healthy people show that around 3% of people have them. Most people with it will live a full life and die of another cause without it ever having caused them a problem or ever even knowing they had it. If a scan finds a problem it is very difficult to know if a particular aneurysm will actually cause an issue for the patient i.e. whether they are one of the one in three where it will burst. Additionally because it often involves brain surgery, treatment carries severe potential side effects and many cases are inoperable. However, once you have been told you have one, then know that you are at high risk of a sudden death - causing significant stress and issues with life insurance.

richp007

The poster isnt themselves saying that they are emotional about it. Mentioning that the NHS has saved someone or a loved ones life does seem to come up quite often when talking about the NHS and people quite often do get emotional about it. Even within this thread, you yourself mentioned that the NHS saved your Dad 3 times and another poster said "I owe my Life to them." (Just to clarify in neither case am I saying this is an emotional response - only that lives being saved by the NHS are mentioned.)

As you say though - just because the NHS stopped someone dying does not prove that the NHS provides good care compared to other systems or that another system wouldn't have saved them . Unfortunately, given the stats on amenable (i.e. preventable) deaths it is the other way round - some people that died when being treated by the NHS would have been saved by other health services.

Pacifico

I realise that, I just don't get the implication that someone lauding the NHS would assume they'd be failed elsewhere in the world.

If my dad had another heart attack whilst we were abroad, I wouldn't immediately think it was game over for him because it wasn't the NHS I'd have to call on.

And by no means is it an obstacle to conversation anyway.

Fortunately I've been well enough personally not to have had to experience any other health services whilst abroad. So I can't really comment on how any would compare to the NHS, other than from sources I've read regarding worldwide care.

I just think it's quite clear the NHS do tremendous work under increasing pressures, and no doubt this winter it will be tested to the limit once again.

InvisibleDuncan

There was a survey by the Commonwealth Fund that declared the NHS to be the best health system in the world. It did very good in all the criteria apart from one - unfortunately that one criteria was healing the sick..   

Health Care System Performance Rankings

richp007

I realise you were responding directly to the thread title of "What do people believe is so special about the NHS", so your comment about your father was simply an answer to the question. Nevertheless, this kind of statement always comes up as a defence of the NHS and it's invalid. People often use it as an argument for why the NHS  is "the envy of the world" and should be left alone; it's a way to shut down debate about the NHS's failings. The fact is, of course the NHS has saved millions of lives - that's its raison d'être. The question is whether it could or would save more if it were to be restructured to work more efficiently.

And I never said that everyone gets emotive - I said it's an emotive subject.

GadgetObsessed

Doesn't the fact that the NHS has worse outcomes than other health systems indicate that the NHS is failing?

I am not sure that I can say that overall the NHS does do 'tremendous work' if you compare it to other systems - which to me is the only real way to objectively look at the NHS. The doctors and nurses may work incredibly hard and be very committed - but that does not on its own create a great system.

To me the failures of the NHS also massively negatively impact the staff as well as patients. It seems like staff morale is poor and staff are overstretched. Because we do not have a significant private sytem NHS staff do not have the choice of leaving the NHS to work in another institution if they want to continue in the profession.

To me the size of the NHS isn't really relevant.
For example, the health system in this country is smaller than the health system in say, Germany.

The only reason why the NHS is one of the largest employers in the world is that we have a system where pretty much all healthcare is provided by a single state owned and run organisation. In other countries the state run proportion is lower and the private companies that provide treatment that is paid for the state, are split across a number of providers. So they have lots of separate employers and systems rather than a single monolithic employer.

Bl4ckGryph0n

Which allow them to move, adapt and change much better in their areas. Hence it being so large and everything to everyone in the case of the NHS makes it problematic in my opinion. Especially as it is often referred to as one.

Ruperts slippers

I would be more inclined to manage peoples weight (Obesity), alcohol, drugs, smoking, stress, depression, anxiety. I'm sure a regular check up could pin point issues, everybody should at least attempt to be healthy.

The Staff do leave and move to private hospitals, my ex wife moved to a private hospital, she poached staff from the NHS and built a team. Generally staff are in a pool moving between private, NHS and agencies. Even surgeons are like guns for hire.
She's back now in the NHS, the main difference between the NHS and private is, staff are fired pretty quickly in the private hospitals, NHS staff are nearly impossible to remove.