[mikeramseyer]

I have just read the account of the cyclist who hit a pot hole in Twickenham and his resultant NHS experience. I was hit by a car in Italy last September. My beloved Colnago C60 was destroyed. Every part of it was broken. Now note my order of priorities in mentioning the bike first! I hit the car windscreen, was carried forward 30 meters and dumped back in the road. An ambulance arrived with 10 minutes, possibly quicker. Once in the ambulance the female paramedic jumped back out and, unasked, retrieved my Garmin Edge 830! In hospital I had CT scans to my head and legs and was kept in all day for observation. Luckily I had no long term damage
Luckily because 4 people have been killed at the junction where I had my accident. In fact I was able to race in the Prosecco GF 10 days later on another bike. More importantly my treatment was immediate, of the highest standard of professionalism, care and expertise, and finally, the hospital did not charge me. We sometimes joke about the chaos of Italy but my experience tells a different story. Unfortunately after many years of underspending by the Government on our fantastic NHS, the result of that underspending is coming home to roost.

Topic

[Rich_cb]

Firstly, I’m sorry to hear
Firstly, I’m sorry to hear about your nan and I agree that culturally we, in the UK, probably don’t engage with healthcare as much as we should.

How much of that is due to messaging like ‘Protect the NHS’ is hard to know but I don’t think it helps.

Secondly, no measure of health outcomes is perfect but if you look at most measures of health service outcomes the NHS performs very poorly compared to our peers. This is true even when compared to systems that spend less than we do.

The Commonwealth Fund tries to aggregate the different measures of Outcomes together and, whilst this is not perfect either, the NHS tends to rank bottom or near bottom out of those systems that have universal health care.

If we could emulate Australia, New Zealand or The Netherlands we could save thousands of lives per year without spending any more.

All other countries in the ranking have a mix of private and public health provision yet in the UK private health care is vilified. See Sunak and Starmer’s recent exchanges as an example.

If we want to see an improvement in our health service we need to look at those countries which are significantly outperforming and emulate their systems.

That means a far greater role for the private sector.

[AlsoSomniloquism]

Quote:

Avoidable mortality was not intended to serve as a definitive source of evidence of differences in effectiveness of healthcare systems. While a specific condition can be considered avoidable, this does not mean that every death from that condition could be averted. This is because factors such as lifestyle, age, disease progression at diagnosis and potential existence of other medical conditions are not considered. Instead, this measure was designed to highlight areas of potential weaknesses in healthcare that could benefit from further in-depth investigation. Therefore, a degree of caution is recommended when interpreting the data.

(I’ve marked in bold some bits about using that stat, and italicised the bit you might be using it for).

I know my nan could have lived longer if she had decided to tell her GP or even her family she had bad stomach pains. However she was afraid of hospitals so when she did end up there, the twisted intestine (volvulvus) had burst and atrophied due to lack of blood so not much could have been done. I’m guessing that probably comes under Avoidable Mortality. I’m mentioning it as I’m sure as a population, too many of us decide to “soldier through” issues instead of going to a GP etc compared to other countries.

I would also point out that we are one of the highest in europe for obesity which might have a knock on to some preventable deaths, although I’m sure Europe beats us in other high risk activities. 

 

[Rich_cb]

The main point I’ve been
The main point I’ve been trying to make is that Health Outcomes are much better in other countries which spend a similar amount to us.

The graph you were discussing relates to the Commonwealth Fund’s own ranking relative to spending.

If you look at the spending axis of that graph and compare it to the attached graph my point should become pretty clear.

[Rendel Harris]

To my eye their dot looks

To my eye their dot looks slightly to the right of ours on the spending axis, but happy to cede that, making the UK third best of eleven on the performance vs spending comparison, rather than the worst of anyone bar the US as rcb is trying to claim.

[chrisonabike]

To be pedantic – NL appears
To be pedantic – NL appears significantly “better” for the same money. I probably shouldn’t say that though as I don’t want to be a total fanboy for them… oh, wait, their Christmas is possibly racist. Have that, NL!

https://www.opensocietyfoundations.org/voices/parliament-debates-ending-holland-s-christmas-blackface-tradition

[Rendel Harris]

So what’s really quite

So what’s really quite amusing, and I’ll reshare it as you might delete it as you have done in the past when you’ve accidentally shared statistics that don’t favour your case, is that your chart there shows we have a higher health system performance than Germany, France, Sweden, Switzerland and Canada, of all whom have higher health care spending than us. The only country on that chart that has lower health care spending than us but higher health system performance is Australia. Hope the NHS will be able to get you treatment for that self-inflicted gunshot wound to your own foot.

[Rich_cb]

Overall 10th out of 11. On
Overall 10th out of 11. On the particular metric in that graph we were at the giddy heights of 9th.

The very tired argument against fundamental NHS reform is to compare us to the US. Realistically universal healthcare is politically non negotiable in the UK so we will never go for the US model. It’s simply disingenuous to imply that the ‘right want us to emulate’ the US model when no significant political party is calling for anything of the sort.

There are many countries that have universal healthcare and achieve far better outcomes than we do, ie more people survive cancer/heart attacks/strokes, they do this on similar budgets to ours.

Why on earth shouldn’t we try to emulate those models instead of persisting with a model that has consistently failed to deliver good health outcomes regardless of the party in power?

Wes Streeting appears to be edging us towards that conversation so it may well be that Labour spearhead that movement. That would be welcome and, simultaneously, quite amusing.

[AlsoSomniloquism]

Although very noticable the

Although very noticable the country we should be emulating according to the right were below us by a considerable margin in 2014. Also isn’t it 9th out of 11th for the table you used. 

[Rich_cb]

What’s the source for that?
What’s the source for that? Edit: Commonwealth Fund report 2017.

Would be interesting to compare actual health outcomes. Edit. NHS health outcomes 10th out of 11. One example of poor outcomes given below.

IIRC the NHS has performed consistently poorly on that metric for decades.

[Rendel Harris]

I know you love a sealion but

I know you love a sealion but the sources are literally written at the foot of the table.

[Secret_squirrel]

Also worth noting that both

Also worth noting that both fewer drugs and fewer long term conditions are covered by the Italian Health service. 

Since we’re playing Healthcare Top Trumps it’s worth reminding everyone how the NHS was doing before the Tories fucked it and social care over. 
 

[Grahamd]

Sorry for your bike, but

Sorry for your bike, but pleased about your health provision. Your experience vastly differs from my wife’s last year. She had a head injury and I took her to hospital, time taken to see triage nurse, over 3 hours. Time taken to see a doctor, over 12 hours. Only then could she be X-rayed. Fortunately no broken bronzes and she has only minimal lasting effects.

The really scary thing was that it seemed everybody in the overly full waiting area, including those waiting outside seemed to have similar experiences, including the lady  who was there following a seizure and had a further seizure whilst waiting to be seen. This scenario went unnoticed by the staff who it appears have become conditioned to viewing such chaos as normal, it took other Ill patients to draw their attention to the situation.

Having discussed the situation with the health board it is apparent ours is one of the worse, and if a similar situation happened I would drive to a different part of the U.K. for treatment.

 

[Rendel Harris]

If we’re going to have to put

If we’re going to have to put up with this cycling website being hijacked by the right’s new hobby of blaming NHS bureaucracy, could we at least be honest about the healthcare systems we are comparing it with please? In Italy for all but the very poorest any visit to a hospital consultant costs around 40 Euros and if diagnostic tests etc are undertaken the patient pays more. 

[Rich_cb]

Well said.
Well said.

It’s interesting that the OP automatically assumed that the reason for the good care they received was more funds rather than more efficient use of funds.

[Jippily]

Italy spends a lower
Italy spends a lower proportion of their GDP on healthcare, they just don’t have the disastrous management and buracreacy of our NHS.

[Author]

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