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The NHS vs Private Health Care

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      22.01.2011 13:18
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      The end is nigh

      The NHS is a paradox. It makes people better so they can get sick all over again; meaning it has to be bloated and extremely expensive to care for us all. Throw in the fact that we are living longer and half the world comes to Britain to join us for free healthcare you can see the costs and access needs to be reigned in, the budget sure to double in the next ten years as we get older and the national debt grows. But no politician has been brave, or indeed stupid enough to do that - yet!

      They say that 90% of our lifetime National Insurance contribution is spent on the last six weeks of our lives, for many our first and last visit to hospital since our birth. Watching my old man experience that grim time in the NHS in the final stages of his dementia wasn't pleasant and not the treatment you would expect for someone who has worked all his life, paid in his stamp, his reward for staying physically fit and living well into his eighties this horrendous illness, but had expired his usage to society and so a less than befitting send off. Once you stop paying taxes when you get old in Britain you soon become a drag, the type of people all governments hate, even though it's the age group that is most likely to vote for them!

      But dignity and death aside the next big problem for the NHS is the Tories accelerating Labour plans to privatise big chunks of the service while they are in power and we are going to lose out big time. Once private providers get their foot behind the door they will be in there like rats rampaging in the sewer. The only purpose of private healthcare being introduced is to get more for less, meaning massive job cuts and poor service. If a company, for example, get £2 billion to run all the hip surgery in Britain that previously cost that amount under the NHS, the profit margin for the private company is the money they can cut from the £20 million, simple as. It's the same with the Department of Work and Pensions, the savings to be made there done by cutting staff and forcing people to sign off who are deemed not to have been looking for work hard enough in recession. And the type of people on Cameron's committees who suggested that health privatisation was the way to go? Why private providers, of course, many ex ministers and MPs already consultants for those companies.

      In America the predominately private health service is expensive for all, many paying $400 per month health insurance and super annuity, the basic public free service not where you want to be, the major selling point to insure you get insurance cover over there. Those wards are full of gunshot wounds and drunks. I know that because I have been in one or two on my travels.
      If any of you saw Michael Moore's film 'Sicko', you will know the American health insurers have a bad reputation for not actually wanting to pay for treatment, even when customers have never been late with payments and yet to have needed to actually use the service. They will find all manner of retrospective reasons not to cover your treatment and by the time it's gone through court to get the money for the care you will probably be dead, a normal tactic there. Hundreds of decent people die every year because of this type of filibuster. But this has been happening here too, private contractors cherry-picking those they treat, reasons like being slightly obese enough to not sanction a needed hip replacement, the obesity usually the reason why the patient needs it. If a health provider is stating you have a western lifestyle so you can have treatment in the west then no one will be eligible.

      We don't need to threat just yet as it looks like The Tory private model will not be visible at the start at the point of delivery under current plan, the first task to get rid of the Primary Healthcare trusts. But eventually market forces will take hold, meaning some hospitals will come out of this badly and so be closed down for not performing, purely because they are in a bad area full of unhealthy people. A good example of this is Papworth, the famous heart hospital, last year seeing two surgeons suspended from surgery because of abnormal death rates. But all what was happening was the top surgeons at the unit were getting the private and so healthier patients because of their reputation because they were least likely to die from the surgery, further building their reputation to attract the best candidates even more, meaning the other two guys had the unhealthy leftover patients, seeing their death rates spike. That is the same principal that will occur when the marketplace is crow-barred into the health service. Patient choice will see people try to go to the hospitals with the best survival rates and so the other hospitals neglected, further increasing their death rates. And who is going to complain if bad hospitals are closed? They are bad hospitals, right? It's just like what we see in private and comprehensive education. Middle-class parents want their kids go to the best schools and so those schools become even better and the comprehensive system is full of the left overs from sink estates and so bad schools. If the Tories don't want to pay sick benefit to the poor then why would they want to make changes to the health services to benefit the poor?

      But in defence of Cameron we do take the NHS for granted and many people are reckless with their health for that reason alone, smoking and drinking an example. It's a quirky fact that the poorer you are in the West then the fatter you are, certainly not the case in the third world. Because of our health apathy the NHS is currently the world's third biggest employer behind the Indian railway and the Chinese Army. But giving GPs control of the health budget is the wrong way to go about getting people fitter and get those improvements, too much workload for professionals who take themselves rather too seriously at times, and so they will just employ unaccountable private providers to do that work now that Health Trusts are to be abolished. Hell, GPs don't even want to work weekends for their £100 grand plus!!! And it will be a surprisingly smooth transition to those private providers as the primary trusts are already haemorrhaging staff to fill the private jobs as those guys know they no longer have jobs two years from. It was exactly the same deal when British Rail was privatisation, ex managers buying the franchises dirt cheap and making millions by job and carriage cutting. Any 'dooyooers' working in the NHS will no all about this exodus. Interestingly, although there is resistance to the changes by some GPs, most plan to handle the budget and are well advanced in their deals with private providers, presumably because of incentives. Private companies already overcharge the NHS for drugs we don't need and so why not services that were once free? We have seen dentistry go that way and if your tooth hurts and there is no NHS dentist around you will either go private or see off the pain and let your mouth go as more and more teeth chip and rot.

      The Flu hype is an example of how the big drug companies operate. They tell certain hacks in the media to pump the hype and people get scared, meaning they want the flu jab, meaning supplies run out quickly as all the posh people take more than they should, meaning the people that need protection, poor pregnant mums and children, go unprotected, hence the high death rate. The Swine Flu hype was way over the top, purely to get governments to buy vaccinations they won't need. At no point in 2008 was Swine Flu the threat it was made out to be, most deaths coming from pneumonia and chest infections with people who had other illnesses. The flu death rate this winter is no higher than any other year when it snows a lot. Drugs companies rely on people thinking they will get ill or more serious than they (especially women) are and so shift lots of drugs, a mind boggling one-in-three America adults on some sort of anti-depressant and one-in-seven kids!

      As I say, in America the health service is non ambiguous. If you don't pay or carry a card then you don't get treated, dumped at a run down inner city ER ward to fend for yourself. Some say the reason why the Tea Party movement has sprung up so quickly in America over issues like free healthcare is that the predominately white middle-class Republicans do not want free health insurance to be expanded to all who need it as those who need it are mostly black or Hispanic, which the rich whites don't want to pay for, whether they admit that or not. The claims of racism are supported by the fact you don't see any black faces at those huge Tea party rallies. The core ethos of the democratic tax system is the strong help pay for the weak to become strong and so pay for the old and infirm but America exposing that as to be nonsense, why institutions like the NHS set up for that very reason.
      .

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        12.08.2010 02:33
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        A privilege.

        I once watched a television program about plastic surgery in the USA. Private practitioners that make vast amounts of money correcting imperfections that perfectly health people perceive themselves to have. The surgeon made a statement that really hit home with me. He longed to do operations that actually helped someone, day in day out breast augmentations were performed so that they could perform a cleft lip operation free of charge to implement new research.

        Why did this hit home? I was born in 1977 with a cleft lip and palate. In this year an American doctor called Dr Millard was teaching the surgeons in Britain about the amazing leaps they had made in plastic surgery and corrections of this disfigurement. I was lucky enough to benefit from this research.

        The NHS has been nothing but a life saver to me, literally, born premature weighing less than a bag of sugar with this condition, without the funding of an NHS I dread to think where I would be or what I would look like, or whether I would have even survived.

        The funding and misuse of the NHS will always be a matter of political outrage, but the NHS is a privilege and we must never forget that.

        Private healthcare has a place in society as much as the NHS.

        If you can afford to pay for your treatment and can receive it faster than on the NHS then that is your right. If you believe it to be better then that is your right too after all some of us are more fortunate than others. That is the way of the world, and it is necessary.

        But it is the others that we have to consider. But we never do. We moan and whinge and whine, is that because we are not fortunate enough to be able to pay for private healthcare? Or is it because we consider ourselves to be more deserving? or is everyone equal?

        That is the downside to the NHS isn't it? Who gets treated and who doesn't? A mother who has worked all her life, paid her taxes and only been sick just this once can't get the cancer drug to save her life, but a petty thief and drug addict can receive drugs to help him beat his addiction, to go back out and repeat the cycle over and over again. What about the boy who grew up wanting to be a girl, should he get the funding to become a woman while so many people are dying because the NHS can't afford the drugs?

        I can't answer these questions. If I try to I feel like so many, angry about the unfairness of it all. I appreciate the rage that must flow through people, but just think of all the good the NHS does.

        The NHS must go hand in hand with private healthcare. Otherwise where will the research come from? The race to find the cure for cancer and HIV is propelled by greed, and if that greed saves even one life how can it be wrong? Because we object to people profiting from life saving techniques and drugs. But when we are asked to put the money into a big pot so that everyone can use it, we moan, and whinge that it is unfair. The truth is, that we can never have it all ways because everyone is just as deserving as another to live a happy and healthy life.

        So back to the beginning, without those over paid plastic surgeons who donate their money and time to find new ways to correct disfigurements and improve surgery, to find new cures and treatments, and without the NHS and the taxes that funded a child that had never worked or contributed to it. An NHS that learned from those doctors and worked tirelessly to perform those operations and treatments under a government that promises free healthcare at the point of entry. I wouldn't be where I am today. A tax payer who, donates to medical research, has over paid for private healthcare to get surgery that the NHS would not fund and proudly pays into a system that is not perfect, but provides hope for everyone and saves lives everyday.

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          29.10.2009 23:15
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          Worth it.

          Having worked for a private medical insurance provider, I have been exposed to a lot of stories in relation to health services provided by people who have insurance with regards to consultants and private hospitals.

          Firstly when considering this debate it's important to note that a lot of the time with private health insurance, quite a lot of the time you will be receiving your private treatment in NHS hospitals. This is largely due to the fact that MRI/CT scanners and other complex diagnostic tools are more commonly found in publicly funded hospitals. The main benefit therefore with private healthcare is that you get these tests much quicker than you otherwise would - you'll still be exposed to the same conditions that NHS patients are in many cases.

          In terms of surgery it's a different story, you can choose to have your surgery in a private hospital - BMI or Nuffield hospitals are a good example. In these places, levels of MRSA are much lower and again, you can have the surgery much quicker than normal and at a time largely of your choosing. There a few detracting points however. Medical insurance companies will only pay for you to be in the hospital for a certain amount of time, depending on what operation you have. If you don't feel you are ready or it's inconvenient for you to go back because perhaps there isn't someone to look after you, the medical insurance company won't make allowances. There has to be a medical necessity for you being there. For example, if you've had a knee replacement and you can't walk for a few days or cook for yourself, the insurance company won't pay for you to remain in private healthcare - it's your responsibility to take care of your 'social' needs. On the NHS, you may get the extra few nights you need. The best point of Private insurance is that the aftercare you get in terms of the level of therapies (i.e. physio) that you can get is much better than on the NHS. After a hip replacement, you may get 2 or 3 follow-up physio sessions with the NHS - with private healthcare you normally get at least £500 worth which will normally buy you at least 10 sessions and with a physio of your choice.

          A really good point of orivate healthcare is that you can choose which consultant performs any surgery you require. Generally the list of surgeons you can choose from will contain surgeons that have at least 5 years experience working for the NHS and will have been reccomended by 2 of their peers. It is important to note that these consultants will be working for the NHS as well, no consultant can solely take on private patients who are claiming on their medical insurance. Particular issues come into play here - firstly fatigue and secondly you may have to accomodate their schedule rather than vice versa.

          Overall, private healthcare is a must if you can afford it simply on the basis of convenience, causing the least disruption to your work and getting the tests you need as quickly as possible to ensure you get the most effective medical treatment as timely as possible.

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            30.09.2009 17:25
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            The private sector won.

            NHS versus Private Health Care: Hearing aids

            A year ago I had became concerned about the apparent deterioration in my hearing, which had never been perfect and which may well have suffered adversely from all the rock concerts I attend (despite wearing earplugs.)

            My NHS doctor arranged for my hearing to be checked at the local hospital, under the NHS. My appointment was changed a couple of times, but nevertheless the waiting period was quite short, a matter of a month or two. The technicians, nurses and specialist seen were polite and helpful and conducted the checks using up-to-date equipment in a sound-proof room.

            Unfortunately the follow-up appointment a year later revealed significant deterioration in one ear. As such uneven deterioration is relatively unusual, the specialist booked an MRI Scan. Just to be sure that there was no structural / nerve damage. Again, the waiting period for the scan was quite short. Worryingly, there was a long delay before I received feedback about the results, which fortunately did not show any significant cause for concern. The specialist showed me the scan (I was not allowed to have a copy) and took the time to talk me carefully through what was to be seen...And yes, there WAS a brain!

            I was very depressed to learn that a hearing aid would be necessary. Measurements and impressions were taken, the order placed, and in due course I returned to the hospital to collect it.

            Up to this point, I was perfectly happy, indeed very grateful, to the NHS for their care and attention.

            But what a pity there is no voucher system! I was given no choice re style, cost etc. I was issued with the NHS basic (digital) model and that was that. It WAS the newest technology, being digital rather than analogue. And it WAS free. Indeed I felt like Bionic Woman. I could hear the conversations in the room next door, loud footsteps down the corridor, etc. and (later) the dog barking down the road. The nurse carefully explained how to care for the aid, how to turn it on / off in the event of loop systems in public places, where to get the batteries from, etc. He couldn't have been more helpful. All of this treatment was on the NHS. I was truly fortunate.

            But I felt devastated. From having had a slight problem hearing children speak, and having the tv on a little too loud, I suddenly was exposed to a world where everyone and everything was extraordinarily noisy. The thing was, the aid magnified sounds indiscriminatingly. My loss was in the middle range but the aid just caused me to feel bombarded with noise because the full range was being amplified, and I didn't feel that my brain would ever adapt to the strain. I just KNEW I wouldn't use it!

            This is where the Private Sector came in. The Boots Chemist hearing specialist considered the problem carefully, did appropriate checks, and explained what my options were. There was actually a BIG range of digital aids to choose from! Not just the one! Further discussion showed that the Phonak Micro eXtra model was the one for me.

            Now this was where my wish for a voucher system came in. Fortunately I am working. Fortunately I could afford, albeit reluctantly, to pay the cost... £1095! WHAT??!! But there was a discount of £219, bringing the price temporarily down to £876. And it was guaranteed for five years, which brought the price down to an average of £175 per year, not so bad compared to the cost of running a car or buying spectacles.

            The NHS model was sheepishly returned to the hospital so that it would not be wasted, and the staff thanked for their trouble.

            So, NHS or Private?

            The NHS staff could not have been more caring or thorough. I am really grateful to them. It was not their fault that they could not offer the full range of aids that are available in the private sector. The money is not there. But how thorough they were with what resources they had!

            But it was the private aid that won the day for me.

            (Cross-posted to ciao)

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              12.09.2009 20:41
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              You would have to pay ME to go private.

              The NHS has been under scrutiny and has had bad press for as long as I remember and I myself have had a few bad deals with them but I owe them my life.

              In November 2004 I was the suvivor of a vicious glass bottle attack which has left me severly scarred and fighting for my life. I was out celebrating my partners birthday when a young, drunken girl started screaming at me. As I turned to walk away I was struck on the head with a Smirnoff Ice bottle which she then used to stab me in the face, arm and the left side of my chest. As I lay on the floor I knew this was a serious situation and I was losing alot of blood.

              Within minutes an Ambulance crew was putting a Saline drip into my arm and starting the blood transfusion that saved my life. I was bandaged up with a box around my head and within 20 minutes I was in an Xray room at our major local hospital. We live in a rural area and our local hospital for A&E is around 50 miles away.

              Once the Xrays were taken I was transfered to the resusitation room where I was placed on a heart monitor, BP monitor and another three litre's of blood pumped into my body. A doctor and nurse cleaned my wounds to determine the damage done and proceded to arrange the treatment that I needed.

              As my face was severly cut (to the extent where you could see my cheek bone) I needed a Max Fax facial surgeon to stitch the cuts. This type of surgeon is only found in the countries Major hospitals so I had to wait a while for my face to be stitched up. Once she had started however she took four hours to complete my treatment of 56 stitches in four layers and stood up for the whole time, leaning over me. The poor woman must have had such a bad back. I then had my arm and chest stitched which totalled 14 stitches. A routine nurse did this for me and she made a brilliant job.

              As one of the cuts to my face was so close to my eye, in the early hours of the following day I was taken to see an eye specialist that confirmed my tear duct was severed and I would be under treatment until I had a new one placed. I was completely devastated.

              I just cannot express my gratitude to the doctors and nurses that night who stayed beyond their shifts to save me and make sure I had the best treatment possible. The ambulance was at the scene in two minutes, a fully staffed team of doctors and nurses awaited me at the hospital with xray staff, a max fax facial surgeon and an eye specialist which had been called out on a Friday night to assist with my treatment.

              I have since had ongoing treatment for my eye as I now suffer with infections and I am unable to have an artificial tearduct put in. I am still under the same specialist who saw me in the early hours after the incident and can see him within a week if needs be. I have also had a nose operation to smooth the jagged edges of a broken nose.

              I do admit the waiting times have been long for my Rhinoplasty surgery but I do not think I would have had better treatment under private care. I have dealt with the same doctors since the incident and seen the same Victim Liason Support Worker on numerous occasions, some on a days notice.

              We are very lucky in this country to recieve free NHS care and free perscriptions and I think alot of people take this for granted. We need to apreciate the doctors and nurses in the fight they have to ensure this country recieves the best care possible.

              I will never go private.

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                12.09.2009 04:13
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                In a nation claiming to be the world's leading democracy, healthcare ought to be a human right.

                First things first: I'm an American, and as most of you already know, we do not have anything that rises to the standard of being a national healthcare program. Oh sure, we have Medicare (for seniors 65 and older) and Medicaid (for those meeting specific state and federal criteria for low income), but neither of these programs is truly comprehensive.

                In the United States, we have about 47 million people--16 percent of our population--who do not have healthcare coverage, including about 10 million children. Most of these uninsured represent what has come to be characterized as "the working poor." They make too much (often working multiple jobs) to receive benefits through the so-called "safety net" and too little to afford health insurance (even when it's offered by their employers). In my country, healthcare is simply not a right: it's a privilege from which too many are excluded.

                There are also a great many "underinsured" like myself. In my case, I am retired but too young for Medicare. Therefore I have no employer to provide insurance, and private coverage is very expensive because of my age. I have what is called a "discount program." It provides for a percentage of my costs on doctor visits, medications, and procedures. For about $220/month, it will cover $75 per doctor visit for up to ten visits a year. After that, I'm on my own. It pays $5 per perscription. (The only prescription I have costs $75.) It will pay other expenses as well, always on a discounted basis and always very limited. So for every procedure or emergency I experience, the policy will pay a percentage of the cost, but always with very specific limits. Naturally, discussions with my provider before I bought the policy happily told me all the advantages and referred to it as "insurance." Since signing on the dotted line, every conversation I've had with my representative regarding coverage emphasizes that I do not have insurance, but rather a "discount program."

                I could get a different policy, of couse--and I will likely do so if our current healthcare reforms do not pass. The cost will range somewhere between $600 and $900/month. The lower price will get me a policy with about $5000/year deductible. That means that the first $5000 will be payable by me before coverage kicks in. Even then, depending on the policy, pre-existing conditions may not apply. That means that if I seek care for medical conditions already identified, the insurance provider will NEVER have to provide coverage. But if something new goes wrong, they will pick up some of the costs--if they can't somehow link the new problem to an old one. A higher monthly premium will lower the deductible before coverage kicks in, but none of these policies will replace the employer-based insurance I enjoyed before retirement.

                Healthcare in the United States is largely tied to employment. Most of us share our medical insurance expenses with our employers, who arrange for coverage through one or another of the major health insurance companies. Coverage under the resulting network of programs varies greatly, from very good to very poor. Still, it's fair to say that premiums tend to be expensive, and that the exculsions, exceptions, and qualification requirements for receiving benefits actively discourage many Americans from receiving preventive treatments they ought to have.

                In my country, health insurance companies are profit-making corporations, with the emphasis on profit. It is their job to return profit to their shareholders, and that sometimes means either depriving patients of quality healthcare or forcing them to pay for services they expected their policies to cover. I could cite a long list of examples, but suffice it to say that the fundamental realities of medical care in the United States have been known to lead to death and financial catastrophy for patients and their families--though the corporation profit margin manages to remain healthy.

                In the past government's role in medical care has been limited. With the exception of Medicare, Medicaid, and a handful of other programs, medical care has been left to market forces--with a largely hands-off policy by government. Thus, for the most part, the pharmaceutical industry sets prices for drugs. Health insurance companies determine what care we receive, how much we will pay, and the process whereby we will receive care. And physicians regulate the conduct of their fellows through the auspices of the American Medical Association--successfully limiting effective oversight by government at all levels and often sheltrring colleagues from the consequences of misconduct. All this means that, on average, Americans spend a higher percentage of their income on medical care than do Europeans, and in return they receive less care.

                The overall impact in all this makes itself felt in every aspect of American healthcare. Despite the fact that we pay, on average, more for of healthcare than anyone else in the world, key metrics--such as life expectancy infant and mortality--are relatively low on the world comparison chart. Opponents of national healthcare have much to say about how national health care will mean rationed health care. In fact, as many of us already know, our healthcare is carefully rationed--by insurance companies who determine who will pay for what, and how much.

                What does all this have to do with Britain's National Helath Service? Suffice it to say that the United States has finally begun to waltz around the idea of univerisal healthcare coverage. As part of the debate on this issue, all sides tend to point toward the NHS as a key case in point, Depending on the political point of view, the NHS is either an example of how national healthcare can work, complete with a list of lessons learned for a nation considering such a program, or it is an example of how "socialized medicine" can lead to the downfall of a great civilization. As usual, our rhetoric is polarized at either end of the continuum, and the slurs from our political right have been particularly onerous.

                For my part, I yearn for the day when my children and grandchildren (not to mention Himself and Yours Truly) can enjoy healthcare as a right, not a privilege. You can count me among those who look with admiration (and a bit of envy) toward Britain's success with national health. It may not be perfect, but from my vantage point, it looks darn good.

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                  26.02.2009 22:48
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                  Private is cleaner, quicker and in my opinion better - you get what you pay for!

                  My son has tongue tie and we were referred to NHS hospital. The consultant said that it would be a fair wait till they could perform the quick procedure and as I was heavily pregnant I wanted this done ideally before baby number 2 was born. I was advised that going privately would be a quicker option. As we had private health cover through my husbands work then all that I had to do was check this procedure was covered under our policy and make a private consultation. We did just that! The consultation was great and the date for the op was for 2 weeks later he would just get his team into place and confirm it with me. I waited a few days and had to chase them up myself to be told that as my son was under 3 they were not covered and as such if I wanted this done before my son was 3 I 'd have to go back on the NHS list.

                  So I called the receptionist of the NHS consultant I'd seen asking to be put back on the list. She advised me that she couldn't put me on the list and that I had to write a letter in to ask to be put back on the consultants list. 5 days later I called to confirm they had recieved my letter and they couldn't tell me whether they had or hadn't. It's now been 4 .5 months since the initial NHS consultation and I haven't heard a thing. I haven't got the energy to speak to people who can't even check if a letter has been sent. It's just ridiculous. As the procedure is not urgent but in my sons case needs to be done we are just going to have to wait until he is 3 and go privately.

                  I have experienced both NHS and Private and I have to say it goes with out saying that the Private hospitals are 100x cleaner and more comfortable. The care is first class as you are paying for it and the staff are friendlier. I had my kids in an NHS hospital and there were severe staff shortages and the midwives on the post natal wards were rude and moody. My experience on the NHS post natal ward was an experience I will never forget and would not want to relive - the midwife had me in tears for telling her that my baby had been sick and I couldn't get out of bed to clean him because I had just had a caesarean section and was not able to get out of bed at that point.

                  In my opinion if you have the choice or have private health cover then use it. You get what you pay for! It can be expensive if your not covered but at the end of the day your health is paramount and you can't put a price on that!

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                    23.12.2008 21:35
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                    both NHS and private sectors equally as good as each other.

                    We are one of few countries which actually have a good free National Health Service, and i think that we are incredibly lucky that we do. For example in America, it is pretty much essential to have health insurance, as there is no free health care.

                    The NHS gets a fair amount of stick in the media, and in my opinion unjustly. There's always some horror story about a 'superbug', complaints about waiting lists, a rant about how a new drug isn't available on the NHS. This is the reason why many people have a bad opinion of the NHS; because of the media writing about stories which have no basis and they know very little about.

                    Personally, I think the NHS is absolutely wonderful, I haven't had a huge amount of experience with it but the little I have had had been excellent- The wards, the doctors, the nurses, physiotherapists- I could go on.

                    I have also briefly encountered private health care, and in a sense of speed, it is much quicker. The consultation rooms are larger, and there is a free coffee machine in the waiting room. However, the standard of medical attention is equal to that of the NHS, and in some situations, the NHS is even better than the private sector.

                    The thing with private health care is that is that if you don't have insurance, it's going to cost a bomb. If you have health insurance and never use it, you're going to think, what a waste. However, if you are unlucky enough to acquire an illness or injury, your health insurance will be put to good use.

                    In terms of treatments, it really doesn't make much difference; if there are drugs which are available privately but not on the NHS isn't not purely because the government are being stingy. A lot of consideration is put behind which drugs the NHS will buy, but the media don't seem to appreciate this, or understand the reasons why particular drugs are not available.

                    So overall I think that both sectors of health care are equally as good as each other, if you have health insurance then that's nice, but if you don't, I don't think you're losing out.

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                      06.10.2006 19:25
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                      I don't want to be a number! I am a person.

                      The NHS - What a great idea! Everyone pays some money into a big pot each month, and in return you get cared for if you are ill. Well, that's the theory, anyway. Sadly in my experience it hasn't quite worked out that way.


                      My experience of the NHS

                      I had to see a rheumatologist. I waited 6 months for my first appointment. I parked at the NHS hospital and duely fed £1.50 into the parking meter for 2 hours parking. It couldn't possibly take longer than that, could it? My appointment was for 09:10, and I was on time. I arrived in the waiting area to be told that the doctor hadn't arrived yet, and nobody knew where he was. He eventually turned up half an hour later (no explanation), but then he had to see all the people who had been waiting since 8am.

                      He didn't really explain what could be wrong with me, but sent me off for some blood tests. The trainee vampire massacred both my arms in an attempt to find a vein. Eventually he succeeded, with help from someone else.

                      I got the letter for a follow up appointment. Six months later. When I turned up for that appointment, I was told they were running 2 hours late. I just couldn't wait that long, so they said they would put me on the list for an appointmen in the near future. This turned out to be another 7 months. I'm still waiting to find out what might be wrong with me.

                      Then I needed an appointment at my GPs surgery. I was told I would need to see a particular nurse, and there was a 5 week wait for an appointment with her. So I had to wait. When I got there it turned out that she was in fact on holiday, and the nurse I did see couldn't help. I had to see a doctor instead. Cue another wasted hour...

                      The list could go on. I have ongoing treatment at an NHS hospital in London. The therapists just seem bored and disinterested - I am just a number to them. Once they have "treated" me, they can add me to their list of figures, regardless of how ill I still feel.


                      My experience of Private Healthcare

                      I have a policy with BUPA. I have had to use it twice. The first time was for minor skin treatment. One consultation within a week of first getting referred, treatment a couple of days later. Friendly doctor, helpful nurse.

                      The second time I had to have my wisdom teeth out. Despite the fact I was in severe pain, the NHS waiting list was 9 months. Thank goodness for PMI. I was referred straight to an excellent consultant by my dentist, he sent me for X-rays straight away. Then I had another consultation where the procedure was explained to me, and any questions I had were answered. I had the operation the 2 weeks later (Christmas got in the way or I would have had it sooner), followed by 3 more check ups. Everyone was friendly and helpful, and I got a private room in hospital, which was very comfortable - my own bathroom, Sky TV, a nice window, no set visiting hours.


                      It's quite a contrast! I'm not entirely sure what has gone with the NHS. How can they be short of money?
                      I pay more into the NHS each month than I do for my private medical insurance. So how can the standard of care be so different? Yes more people use the NHS, but an awful lot more people pay into it as well. The NHS also make a lot of money out of extra charges like car parking (over £1 million pounds a year at some hospitals). I suppose the NHS have A&E units, but I would gladly pay a bit more to go to a private one of these as well. Maybe they could discount my National Insurance then?

                      I believe that the NHS has been ruined by bad management. Ridiculously complicated scales of charges mean that some doctors that are good at doing paperwork make a fortune, while the hospitals spend money on pointless things like art for the foyer. How am I supposed to see the art? I can't even get an appointment to see the doctor!

                      I think it would be interesting if the people who run private hospitals did a job swap for a month with the people who run the NHS. Maybe the NHS managers would learn what it's like in the real world.

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                        30.04.2005 13:09
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                        I have always believed in having a strong National Health Service and feel that the NHS promotes an egalitarian society by providing healthcare to the masses and not just to the lucky few who can afford to pay as is the case in some countries. I also believe that the vast majority of NHS staff are working their absolute hardest to make the best of an underfunded and oversubscribed service. I have always believed it is morally incorrect to use private healthcare and up to this point would not have considered it. I am only 25 in any event, the NHS can meet my needs right? Wrong. I have realised that the NHS is imperfect and if I could turn the clock back a couple of years I wouldn't have relied solely on the NHS to treat me.

                        I first went to the doctors a couple of years ago with strange and odd symptoms, without going into too much detail, I had signs of bleeding in the digestive tract. I naively imagined as a 23 year old girl I would be taken incredibly seriously at this time and plucked up the courage to see a doctor. Maybe I was just unlucky in my choice of doctor, but I was examined and given the all clear - "absolutley nothing to worry about". No blood tests were done, no repeat appointment made, no "come back if your symptoms don't improve".

                        So on I went, beginning to feel gradually more strange, seeming to have a permanent sickness bug, feeling a bit tired, headachy. I didn't feel I could go back to a doctor who had told me i had absolutley nothing wrong with me. In the end my mum got so perplexed by my change in health one morning I heard her on the phone to the surgery booking me in. I had no choice, I had to go back to see a doctor. Luckily it was a different one to before. Again, I was told that my symptoms were not particularly abnormal and could be attributed to stress and that bleeding from the digestive tract was not something which granted a person a referral to hospital. However, on this occasion, a blood test was performed and the results showed anemia. I therefore was called back for more blood tests "but the surgery couldn't fit me in for a few weeks". Queue one angry mother. She went and basically stood in the surgery until they offered to do some blood tests the next day. And on this occasion, I repeated all my symptoms, stated how odd I found my change in health frightening and how I KNEW there was something wrong with me. The dcotor who did my blood test therefore referred me to hospital ...but that is not where the delays ended.

                        I have now found out that that referral letter got to the hosptial and I was immediately branded as a "soon patient" which basically means that a consultant had looked at my results and had said I needed to be seen within one month. But that letter telling me this never landed on my doormat. So again, off I trudged to me GP who said I should hear soon. I didn't, so in the end I had to do my own detective work, I had to find out which consultant I was due to see, phone his secretary, only to be told I was due in two months ago but hadn't turned up for my appointment. Well, you can imagine my feelings about this. I hadn't actually been notified as to this appointment so how i was expetced to turn up is a mystery.

                        When I finally got to see my consultant he was fantastic, he did a numebr of tests and called me back to say " we have found some Crohn's" - an autoimmune diesase effecting the digestive tract. Yes, it was unpleasant finding out but after more tests I was put on very good medication and after a year of taking drugs am completley in remission. Now I have been diagnoised, the NHS is fantastic, I have the number of a nurse specialist who i can call at any time, my consulatant has said he will see me within a day on the NHS if I feel I need to.

                        The shame is it took so long to get diagnosed, a year to be exact. I could have phoned up to see this same consultant privately, paid £100 and been diagnosed a year earlier. I underwent a year of conufusion as to my health and a year of illness which i think could have been avoided. £100 seems like a small fee to pay to avoid that. The problem seems not to be not in treating those who are genuinely ill but in picking up on and referring genuinely ill patients. I don't understand quite why it took me three visits to be referred to a hospital. I also don't understand why intial blood tests were never performed. Apprently when I was ill I had a high platelet count, something indicitive of inflammation or infection.

                        All i can advise people to do is to be a bit more pushy and not to take a passive role if you genuinley believe something is wrong you need to seek second or even third opinions. GPs will NOT definately pick up on an illness, the NHS is not without its flaws. I am sorry to say that yes, if you can afford it I would advise parting with that £100 for an intial consultation. I wish I had.

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                          27.02.2005 08:48
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                          Rather than debate the ethical issues, I’ll first give you my personal experience. 14 months ago, I found a lump in my chest. I was only 27 but this lump felt huge. I was scared, worried, nervous, tearful and an absolute waste of space at work. I went to my local GP (who was great). He agreed that the lump was worrying and in front of me he wrote a letter referring me for an emergency appointment at the hospital. He told me that he was that concerned; he wanted to bypass the normal delays. He explained that they’d take a sample with a syringe (called fine needle aspiration) and check that for cancerous cells. They also may use an ultrasound but this was more helpful for older patients.

                          Heck. I was 27 and my GP felt I needed to see a specialist within days. Imagine how that feels? However much anyone tries to console you that you’re not going to be the unlucky one, you know it is possible.

                          After a day I called up my Doctor. They couldn’t find out what the problem was, why I hadn’t been rushed through. Two days later, they called saying the Hospital had disagreed that I would need an emergency appointment. At this point I was off work because I was no good and in tears, proper eyes and nose streaming tears on the phone. I called up the hospital and tried to explain that if my GP thought it was worth an emergency appointment, surely it was worth it…? The receptionist on the end of the phone (who’d never met me and wasn’t a medical professional) said no. She said they weigh up the age and family history (despite the fact 2 aunts have had breast cancer and I had a lump), I was low risk and wouldn’t be seen for weeks. Try telling someone with a breast lump they’re at low risk of cancer. It just doesn’t wash with you at all. It’s not just your health you think about either, I was thinking all kinds of vain thoughts about how I’d look if I needed the lump removed and whether my boyfriend would still fancy me.

                          I called my sister (who’s a Doctor) in tears. After I put the phone down, she called up the Nuffield hospital and got me an appointment 5 hours later. My boyfriend came along and held my hand. 5 hours later, a specialist felt my lump, told me he thought it was a combination of cysts and fibroadenoma (neither of which are cancerous) but he did a fine needle aspiration and sent off the results to the lab to make sure. At midday the next day, I’d been given the all clear.

                          So the NHS receptionist was actually right, I was very unlikely to have cancer but that underestimates the emotional and mental strain of having the potential diagnosis hanging over you. I’m not a person who takes time off ill but I physically couldn’t work. I was bursting into tears all the time.

                          I was fortunate. My parents picked up the £200 bill to give me peace of mind. What if I’d been on a low wage and couldn’t afford it? Without my sister, I don’t think I’d even have thought of it either.

                          The NHS is like insurance. We all want it to cost as little as possible and don’t think about the consequences until it all goes wrong, then an extra few pounds a year seem like a measly cost. The other, unseen cost of NHS waiting times is as I’ve stated above. I took 2 days off work because I was mentally unable to be there. How much is this sick leave costing the country? In the company I work for at the moment, they actually take the view that paying for private treatment is a sensible business decision if it means the person is back to work more quickly. Unfortunately I would have had to have been irresponsible and a masochist and stayed off work for 2 weeks before they’d consider it in my case.

                          Maybe the government and we as a country should take a similar business decision. How much does it cost us in terms of sick pay to have waiting lists and delays in treatment? (Answer a.) How much would it cost the country to put that right? (Answer b.) If b is less than or comparable with a, you know the solution.

                          As for the people who work for the NHS. I know there are lots of fabulous Doctors and nurses who are doing their best but I do wonder sometimes (and I also wonder this with Universities) whether they’re really managing to have the most streamlined and effective management possible. Just because someone is a good Doctor or Academic, doesn’t make them a great manager.

                          If you’d like more information about breast cancer and what a lump might be (other than cancer), a great website is:

                          http://www.breastcancercare.org.uk/Breasthealth

                          They also have a phone line (0808 800 6000) which can help if you need to talk about anything.

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                            14.11.2003 21:13
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                            Having read a few of the opinions on this subject, I feel I want to add my two bits. I know i've been rather prolific on this website of late, but browsing the site, I just didn't want to wait to offer this perspective on an issue which I fel is very important. Firstly a bit of background: The idea behind the NHS is that all should have access to free healthcare. The problem is a lack of resources. So as it stands we have the conflict between a human desire to provide what many think is a basic human right and a resource-allocation dilemma about who has priority access to treatment. As it stands, the NHS is available to evey person who is a UK citizen. It is paid for by taxation, graded according to earnings. The private healthcare system is run separately, it is significantly more expensive and is the reserve of those on a higher income. I will now outline many of the objections to the current system, and to free and private (oops, I almost wrote privet then!) healthcare in general. 1. I've never been ill a day in my life? Why should I pay for someone else's treatment? This is essentially a capitalist argument against the NHS. The individual would like to lower taxes so that he does not have to fund other peopl's treatment on the NHS. This may befelt particularly strongly by the rich and healthy, or by those rich people already paying for private healthcare, as they still have to pay the same amount of taxes. There's no simle answer to the question really, other than to point out that if they were to get ill, they would benefit from free healthcare, which is a risk open to everyone. It may also be useful to point out that they are being selfish, not considering what would happen to the system if everyone thouught in this way - those in greatest danger statistically are the group which is most unlikely to be able to pay for their own treatment, and should the system be changed to be more capitalis
                            t, these people would suffer greatly. 2. Should people who deliberatly put their lives at risk (i.e. smokers and drug takers) be forced to pay more? This is a good idea, and one which is very appealing in theory. While we may be comfortable helping those worse off than ourselves by paying taxes, we are not willing to subsidise the life-threatening actions of others. However, when one considers the practical implications of this point of view it simply becomes unviable to act upon it in any meaningful way. For example - how do you tell if a person is smoking r drinking sufficiently to damage their health? I go out on a friday night and have a few drinks, but i wouldn't expect this to ruin my chances of free and decent healthcare, and I don't think that it should. This leads me on to another point. how are we to decide when someone deserves treatment on the NHS if we are differentiating between those "good" and "bad" members of society? If one person smokes 10 per day and gets lung canceer, should she be refused treatment, what makes her different from a 1-a-day or a 50-a-day smoker, should we make a distinction between those too? In mymind, it goes against human nature to refuse health treatment to anyone, if you are offering it at all. Aside from the practical implications, there are several philosophical difficulties which make this unappealing, not least the reluctance to "play god" with people's lives. 3. We should get rid of one or the other, having both systems is just silly. Maybe from an ideological point of view, yes. But here is where the conflict betwen the human and economic arguments is most easily resovled. The system that we have at the moment is the one that is the most fair to all sides. The idealists are satisfied since free healthcare is available to everyone, and the richer people in the country have access to higher quality healthcare if they are prepared to pay for it
                            . It may seem unfair that thses people have access to higher quality care than those who are unabe to afford it, but remember that they still pay the same amount of taxes as the rest of the country, so in effect they are subsidising everyone else's healthcare, if they want to go private they are in effect paying twice, which seems to me a fair price to pay for getting preferential service - since others benefit. 4. What are the advantages and disadvatages of both systems? Well, the advantages of the NHS are obvious, free healthcare for those who need it and can't afford to pay, a nationally regulated (and therefore safer) and organised scheme which forms a coherent whole etc. However, the advatages of a private system are that efficiency and quality are improved due to the profit incentive. There's really no way to get around this, since private schemes motivated by money are always going to do better than the cash-strapped NHS, often used as a political tool rather than what it was originaly designed for. In conclusion then, a mixture of both private and public healthcare is probably the best way for things to be organised. While philosophical and practical problems abound with an all-encompassing free healthcare system, the thought of replacing it with a totally private one is unthinkable with the ideals we are used to in this country, and no access to private healthcare would disadvantage those who would be prepared to pay more.

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                              13.03.2003 01:07
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                              There are many complexities in our National Health Service, and the way we choose to fund healthcare as a nation. 17 years of Conservative rule apparently destroyed the NHS. This is perhaps misleading, as under Thatcher and Major NHS spending did indeed increase significantly more than retail prices. Every single year. 6 years of Labour rule, and more money than ever is being thrown at our public health. It isn't really any better is it? The financial record of accomplishment of both parties is, perhaps, exceptional. Where we have failed in health is in the way we manage those funds. What we prioritise. What really matters. The patient! We have wasted years spending your taxes on management consultants, political ideologies and a horrendous number of expensive QUANGOs (special bonus prize if you can tell me what QUANGO stands for), forcing rapid change on a health service that needs love and support to bring it in to the 21st century. First off all, there will always be a trade off to be made between funds available and care available. As our scientific knowledge develops, so will the opportunity to save lives with new treatments. This inevitably leads to increasing cost. So, how do we release for money for health care? The first one is to reduce spending in the health service bureaucracy. Rotate this spending to patient care. Strip out the layers of managers. While management is essential, it only works when you have clear lines of accountability that are not distorted by top-heavy structures. The NHS is a burden on itself. A bureaucracy of change for change sake, paperwork and waiting lists and appointment systems from hospital down to GP. All this costs money to manage. Money that could be better spent on treating patients in GP surgeries and pharmacies around the country. A job in my local health authority to manage "travel to work" for employees - in other words to free
                              up car park spaces by encouraging use of public transport or car sharing - paid more than the wage of a senior nurse! The second one is to break down structures that rely on a referral system from GP to specialist. SO much more could be done at well-equipped local clinics, without having to create a waiting list on a referral process. The stress reduction that quick and local treatment will save a patient cannot be underestimated. In the same way, allowing pharmacists to issue repeat prescriptions, instead of burdening the GP should be extended to the norm. Bring the service to the patient faster. The range of treatments that nurses can be trained (and paid) to give can be broadened. This will free up doctors. All these measures would unwrap the NHS. Make it more responsive. Free up funds. Improve morale. This will not solve the whole problem though. Private medicine can help. As a nation, we seem to think this is dirty. How dare we consider using private medicine? Disgusting! We spend less per person on health than any other nation in Europe. That said, the amount of government spending on health is around the average for EC nations. In other words, European Nations spend more on private healthcare than we do. Why? Well, we tax employees for receiving private health insurance from their employers. We have reduced the tax relief given to the elderly for insuring themselves. But above all, politics. Politicians have dominated the health service for too long. The way the workers have been kicked around as political footballs has destroyed morale. This reduces their efficiency. This reduces the quality of care they can give. This makes the service a waste of money! We need to open up private medicine. Encourage people and employers to use private medicine, ideally with positive talk about the benefits together with tax incentives. The debate needs to be held as to what treatments
                              should be NHS or private. Non-essential plastic surgery. Define the line as to where fertility treatments have to end on the NHS, but be available privately. Regrettably, there will always be a line. But give people the private choice where they have the means to pursue it. Let them free up NHS resources for the rest. Let the private sector help out the NHS at times of crisis. Close old hospitals at a faster rate. Manchester has two children?s hospitals 3 miles apart. There is no doubt that the modern one should survive. Booth Hall has an excellent heritage and history. But the buildings are old and cost a fortune to maintain. It is time to admit that modern is better for patients. We need care to be patient driven. GPs must not refuse to see patients for two days. If I am ill today, I need my doctor to see me today. It will enable me to get the treatment I need today. This will get me back to work faster. This will mean me paying more tax. To fund the service!! Businesses that make customers wait lose custom and fail. The NHS is failing in many respects, but it does give us a superb foundation for delivering better healthcare using resources already available. We have a shortage of doctors and nurses. The only way to plug the gap short term is importing them from abroad. But where are the training programmes to solve this gap over the next 10 years? And where are the reward structures and respect cultures that encourage people to stay in the NHS? This is where the money is probably needed most. Not in layered management systems. · Cut out unnecessary layers of management and administration · Allow local GP clinics to deliver a wider range of care services · All pharmacists to be able to issue repeat prescriptions · Nurses to be trained and paid to administer a wider range of treatments · Incentivise and encourage private medicine. · Provide patients with a same day service at GP surg
                              eries · Develop Sunday GP surgeries, perhaps operating out of hospital sites · Remove politics completely from the debate · Make patient service the reason for doing things · Develop a sustainable training and reward programme for nurses and doctors There is probably a lot more we could and should do on top of this. But we need to destroy the political nonsense surrounding health and ensure the money is spent wisely to deliver the care the patient needs. Patients meanwhile, show health workers respect. They are fantastic.

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                                28.11.2002 16:40
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                                • "Overworked staff and poor facilties"

                                ALTHOUGH THE CONTENT AND CONCLUSIONS ARE VERY SIMILAR THIS OPINION HAS BEEN REWRITTEN AND EXTENDED HAVING REGARD TO THE INITIAL ADVICE AND COMMENT When my partner and I commenced our private medical insurance in 1993 with Norwich Union Healthcare our joint premium was £26.90 per month. Premiums for the same policy have, due to inflation and our age band changing, increased to £155.36 a month. During the period of insurance we have made one claim the treatment costs for the operation concerned about £5000. The claim did not affect our premium and there are no discounts on premium if you do not make a claim. Changing from our current Norwich Union policy (fully private) to their Trust Care Starter would reduce our premiums to £94.47 per month. One thing that worried us is whether or not general staffing standards in the National Health Service could affect medical and nursing care under the Trust Care Starter scheme and perhaps result in a reduced quality of service compared with a fully private option. The King Edward VII Hospital at Midhurst is on the Norwich Union list of approved hospitals for the Trust Care Starter policy and when visiting the King Edward as an outpatient the standard of facilities and support were found to be excellent. One of Speciality Hospitals for Cancer Treatment in the Trust Care Starter Scheme is the Royal Marsden at Sutton. Should we be unfortunate to suffer from cancer we are wondering about the pros and cons of travelling to a centre of excellence such as this rather than a local facility. With an impending retirement we were interested in the quotation by a newcomer to health insurance. ?HealthNow? would that would cover the two of us for £66.30 a month. The premium for a couple in the most elderly age band in the ?HealthNow? scheme is £87.10. I have completed a full review for ?HealthNow? in the product section of dooyoo. ?HealthNow? state tha
                                t the reason for their being able to offer such low premiums is:- ?The NHS offers you quick and excellent treatment for conditions such as cancer. So we don?t consider it necessary to include this in our cover. But remember you are covered for immediate diagnostic consultations- you can see a consultant straight away so you will immediately find out if there is something wrong. We will also give you free help and advice on how best to move forward? ? We are aware that the Government has targeted cancer treatment for major improvement because our record here is one of the worst in the EC. How well are the Government doingy doing and how soon will it be before we reach European standards especially those of France? It is also cause for concern that poor NHS standards will affect the quality of service available to private patients. We understand that although it is possible to jump the diagnosis queue by using a private consultant the specialised treatment needed is available to both private and NHS patients on an equal basis.

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                                  15.08.2002 03:11
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                                  Although many people, myself included complain about the NHS we take it for granted and dont know just how lucky we are. I lived in the States for 11 years and worked in a hospital for 4 of those years where I was asked plenty of times if it was true that the English didnt have to pay for their health care, Americans wish that it was the same there as they pay high insurance rates for Health care, although America does offer free health care to low income families, the level of care is the same whether you pay insurance or it is free. If you went to the Dr in the States and needed any kind of blood test or x-ray, you are given a slip and sent straight to the hospital to have the test done that day. In England you can wait anywhere from 3 months to a year and in some cases longer. 2 Years ago i was told my daughter needed her tonsils out as they touch and are considered dangerous, she is still waiting. The problem as i see it is not the service but the Dr's themselves, some of the best Dr's and Surgeons are trained in this Country but move to other Countries for higher pay, leaving the English health care to be understaffed and over worked. Last week my Grandmother had a massive stroke, we took her to casualty where she sat for nearly 6 hours before a bed became empty to transfer her to. The reason I say that the English are lucky to have the NHS is that we are the only Country to offer the level of health care we do for free, sure we have to wait sometimes but in the end we get the treatment we need and if our illness is life threatening we are dealt with just as quick sometimes as paying private.

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