Andalucia Health Service

[katy]

Everyone speaks highly of the Health Service here but I have just been talking to a neighbour. His Doctor has told him he needs a "new" knee but he cannot have one because he is too young, he has to wait 2 years until he is 70 Does rationing happen in the UK?

Some things do seem to have long wait lists here. My Doctor said I needed to see a specialist for possible glaucoma. Normally the hospital call you in a few days. Didn't hear so called at the CDS hospital and they gave me a print out. The appointment was 8 months later so I went back and asked them if they had made a mistake, he said that waiting time in the eye Dept. was normal. I went private as I was worried, turned out to be ok. but could have been serious.

[Don]

I would say there is a kind of rationing in the UK yes Katy, but I am sure it depends on the area. My Dad needed 2 new hip joints but was told that he would have to wait 2 to 3 years so he paid privately (no insurance to help out) and got the first hip done within a month. Somehow the same NHS trust found a slot for his second hip 6 months later. He was in his mid 80s and was losing mobility so couldnt really afford to wait. Mum had a new knee when she was 88 and that went through the NHS OK although they did give her the wrong type of anaesthetic which wrecked her short term memory. Saw her at the weekend on a quick trip back and 10 years after the new knee it has at least allowed her to walk again.

[HKM]

we live in Spain pay into the the SS here but Hubby works in the UK. I have had problems since I was a child with my joints, I had hip replacement in the UK 7 years ago I was 22. For the past 2 years since we came to Spain my other one has given me so many problems, I have had scans, X-rays on Morphine, Vallium in a wheelchair on crutches. Then they took me to theatre and gave me an injection straight into joint pain went straight away! Now the pain is coming back.. they will not consider an operation and will not give me another injection will not tell me exactly what is wrong. Just keep printing out those prescriptions..

So I contacted a top consultant in the UK who says I need a replacment straight away I will have this done in the UK in Feb (time from 1st appointment with him and operation will be 3 months), his theory is when do I want my quality of life now or when I am 70 and live the next 40 years an invalid?

I have been so depressed about the treatment I have recieved for my hip here.. Yet my husband had an accident and needed an emergency operation and got excellent treatment.

So as for your neighbour that to me is inhumane, disgracefull.

[Julie]

On the last two occasions that my husband visited his doctor in the UK, she has advised him to go see a specialist private, she hasn't even mentioned the NHS, AT £350 a time i think its wrong, my own doctor in the UK, would of, in the same situation I think have rang the hospital to push for a appointment, I think that a lot of it must come down to how your doctor reacts.

[Troglodyfae]

Obviously I can only speak from our experience here in Granada, but up to now we have been very impressed. My mother was diagnosed with breast cancer a few weeks ago. From the first moment the lump was detected everything has been done at break neck speed. The lump was found during a routine check up and she was at the hospital the next day. They are scheduling surgery via local anaesthetic after Christmas as my mother cannot have a general due to a heart condition. They have been brilliant and treated my mother with a great deal of care and respect. Her consultant is hilarious and is always cracking jokes with her, and we have been kept fully informed about her condition and treatment

I do not know if this is peculiar to this particular area but we have nothing but praise for the health care my mother has received.

So sorry to hear that others seem to be getting such shoddy treatment.

[geegee]

Assuming its the same for knees as hips, yes rationing certainly does occur in the UK. I believe you can have a maximum of 2 hip replacement ops and they don't like giving them to people under 50. A partial, less invasive hip replacement op called the 'Birmingham' where only the ball and socket are replaced, is often performed on younger people instead. I know 2 people under 50 who have had this done with great success.

However, I believe the reason for the limitation on the operations is driven by medical/age-related concerns, as your bones cannot take being knocked arround too much and the component parts of a hip replacement have a limited lifespan, so they prefer to wait until you really need it and/or make sure you don't run out of options in your infirmity. This would apply equally to NHS or private care.

Nevertheless chronic underfunding/funding being diverted away from operations to pay for endless new management posts/massive demographic growth of elderly folks needing ops are sadly much more likely to be driving the delays in the UK. I don't know how well the Spanish system is funded but it seems to me that caring and competent health professionals the world over are struggling in the face of unpalatable economic constraints.

Katy, your neighbour having to wait until he is 70 implies the rationing over here is one new joint per person per lifetime...but ideally they prefer you die first thus rendering the op unecessary

[HKM]

geegee is correct, after the first replacement the 2nd will not work so well and so forth but not that many people have had hip replacments at young ages mine is 7 1/2 years old and the doctor said it has a lot of life left in it. But then again when it comes to the next one the way technology is changing who knows how long it will last.

My personal experience is that here in Spain they want me to wait hence live the next 40 years in a wheelchair, when in the UK a 2 1/2 op can give me another 20 years walking, living a normal life... I will figure the rest out when the time comes but want my life now when I need it for my young family, for me..

It is all down to the doctor and fortunalty I have a very good one!

[katy]

Yes, apart from the once with my eyes we have found the spanish system excellent. Husband had kidney stones and he saw a specialist and had scans two days after going to urgencias. I was shocked when I heard that this morning though. Another thing our GP treats us like private patients, meets us at the door, shakes hands, bit of small talk.

I have not been impressed with the private hospitals here, well two of them. We always used to have a private yearly heath check here and every time they always said something needed further investigation. It can be scary too. Always we were clear, the last time I was in the waiting room to see a specialist I bumped into a friend, she had been told by a private Doctor she needed to have heart checks, and she was only 34! Needless to say (after tests costing about 1000E) there was nothing wrong with her. So, I don't really trust private medicine here.

[El Cid]

. So, I don't really trust private medicine here.

Private medicine in Spain, and most other places, is designed around people with health insurance. If you pay the list price it can be very expensive but the insurance companies get very large discounts.

Like any other commercial business they will sell as much product as they can and this is kept under control by the insurance companies who decide what treatment they will allow.

Like anything else, if you are paying for it, buyer beware.

Sid

[Campo Kenny]

Couldn't be doing with that Katy. As the biggest and most total hypochondriac ever to step foot on this planet I'd sod that for a game of soldiers,

Still it must be better than Sweden



http://www.thelocal.se/9388/20071212/

[palmtrees]

In response to Katy's original question, yes there has been rationing in the NHS for many years. But it is not overt, or even organised. When I worked for the NHS we tried to look at options for rationing some services, fertility treatment and amniocentesis for Down's Syndrome were the two I remember. Everyone backed off because it was too difficult. We must have had more focus groups than the Labour Government. At the end of the day, people (ie the public) don't want to make or take part in a difficult decision, they want everything, and the money isn't there.

I had no involvement with artificial joints, so I can't say about that. I was involved with drugs, particularly for chemotherapy. Funnily enough, we actually tried to budget and fund these as soon as they were medically proven. But it was mega-bucks, seriously big money. NICE (National Institute for Clinical Excellence) was meant to standardise the situation across the country, but the problem is that it acts too slowly, and many health service professionals (including managers) feel morally obliged to approve and authorise treatments when the clinical results are proven.

By the way, I would not use private health care if I could avoid it. I think the NHS is good by and large, it tries to do too much. I have (touch wood) no experience of the Spanish system, although I have only heard good things from British and Spanish neighbours.

[aligato]

Don't get me started on hospitals. Despite believing fervently in the principle of the NHS as opposed to private my experiences with the NHS are poor. Nearly killed my father TWICE following a simple hernia op. Did kill my father in law. Hospitals filthy. Staff being asked to wash their hands! Can you imagine a mechanic being asked to not leave parts muck inside a rebuilt engine? These are the same people no doubt who don't wash their hands after using the toilet.

They could save some money straight off by withdrawing ALL fertility treatment. There are already far too many people on the planet.

rant over

[karandjon]

Always we were clear, the last time I was in the waiting room to see a specialist I bumped into a friend, she had been told by a private Doctor she needed to have heart checks, and she was only 34! Needless to say (after tests costing about 1000E) there was nothing wrong with her. So, I don't really trust private medicine here.

Katy, I was only 24 when i was told i needed heart checks, (i was in as a day patient for something else, non related)....found out i have a heart murmer/leaky valve. This is not serious, i have the odd palpitation, but is good it was spotted as i need to take a tablet before dentistry etc.

My sister who is 31, was rushed into hospital last week with her heart beating over 200 times a minute!!She was hooked up in intensive care as they thought her heart was gonna give in, any minute!!! She is now undergoing tests.

I dont think heart problems are only related to those who are older, and it is better your friend to have her heart checks if advised to, rather than ignore and have something happen to her.

[katy]

Interesting comments. I suppose when your health is at stake nothing is ever going to be perfect! I was not impressed with Carlos Haya hospital (málaga). My Husbands treatment was excellent but, maybe because the building was old it didn't seem as clean as it should be. CDS hospital is/seems better. They do have better systems here which cut out a lot of the admin. and I like the idea that on some wards patients cannot take their own pj's and personal stuff, I think this is a good prevention for MRSA as you never know what some people are bringing in!

I do not think after speaking to my neighbour this morning that to tell someone who is in pain they have to wait for 2 years is great, it's just not right is it? We were in BUPA in the UK but I have not much confidence in the private system here, seems fairly corrupt...and the small print

[Paula]

Thats the problem with the NHS in the UK, there is no standard. You can experience anything from excellence to downright disaster.
I've no idea what the answer is but agree that a trustworthy NHS service can provide far superior diagnosis/treatment to a private one.
Agree with Sid on the problems with private healthcare and what it can lead to, have numerous friends in US who are borderline hypochondriacs brought about by the constant tests they undergo on private healthcare.
I've no experience of the Spanish healthcare system, I am reliant on private healthcare, it's okay for getting fairly quick appointments and tests, but I don't feel as confident as I would do if covered by a state system.

[Miro]

Some things do seem to have long wait lists here. My Doctor said I needed to see a specialist for possible glaucoma. Normally the hospital call you in a few days. Didn't hear so called at the CDS hospital and they gave me a print out. The appointment was 8 months later so I went back and asked them if they had made a mistake, he said that waiting time in the eye Dept. was normal. I went private as I was worried, turned out to be ok. but could have been serious.

A year or so ago an elderly friend of mine needed an urgent eye op. (can't remember the name of the op, but it was on an eye that had previously been operated on for cataract, but the new lens had dropped and the pressure in the eye was high, which was potentially dangerous). The condition was diagnosed at the emergency eye clinic in Malaga University Hospital (Social Sec.), and he was scheduled for an op one week later at the Hospital Marítimo in Torremolinos. He had private insurance through Mapfre, but the earliest they could find a clinic to perform the op for him was 10 days later. He had the op in Torremolinos on the SS as a day patient and it went very well.
I think, probably as with the NHS, it all depends on the relative urgency of the condition.
Incidentally, the same friend, who is an American citizen, has just returned to live in the USA; whilst trying to find out what his entitlement to healthcare under Medicare is, I have come to the conclusion that the system in America is so complex and confusing (not to mention expensive), that it is surely the best cure for hypochondria ever?