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Comment by dazc | Hacker News Reader

I haven't seen a GP for years although, because of age, I probably ought to just to get a few things checked out. The last time I tried to make an appointment I gave up after encountering a phone that just wasn't being answered - except for the time I got a message saying they were busy and to call back later.

Anecdotally, in the UK this now normal. Apparently you have to beat the system by calling at a certain time and saying your problem is urgent. Obviously, all the people you are referring to know all about this; it's just suckers like me who have to suffer.

The NHS is free at the point of use in the UK - except for dentistry which is only free if you have a low income, etc.

Most folks (in my experience) go full on private and pay a monthly fee plus insurance. It isn't expensive (unless you need some major work doing) and the standard of dental care has improved many fold as a consequence.

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You highlight an interesting problem with the NHS that quality is extremely variable based on your location.

For example I can book an appointment online at my GPs, so never have to phone anymore. I can normally get an appointment within a week.

Also a number of years ago I needed an MRI and CT scan. I had these 2 weeks after seeing my GP, whereas I know family members that live in a different area and have had to wait months for similar scans.

Edit: For some more data on UK NHS GPs see

* https://www.england.nhs.uk/statistics/statistical-work-areas...

* https://www.gp-patient.co.uk/

> Obviously, all the people you are referring to know all about this; it's just suckers like me who have to suffer.

Absolutely, but that's exactly why these barriers exist: because dealing with the hoggers sucks up all available resources. It's not like GPs sit around, their time is still allocated for the most part. In a context where central government keeps squeezing GPs (forcing them to work longer hours for less pay than before), they have no incentive to do anything but to deal with the high-maintenance types. Some sort of external shock is required.

I had a similar experience with my local GP surgery, in a working-class area in the North of England. Doctors kept rotating (they would hire kids and other practitioners with no experience, who would then leave very quickly after they realized what the workload was), it was impossible to get an appointment, and more often than not one would just be dismissed with paracetamol. Then people discovered the feedback tool at https://www.nhs.uk/service-search , and inundated the surgery with bad reviews. This seems to have kicked the right asses in gear, and now it's much better. Mind, I still have to log on Patient Access right after midnight to get a same-day appointment, but at least I don't get dismissed once there...

Dentistry's an odd one. In some parts of the country it certainly used to be essentially impossible to get an NHS dentist, and in others it's easy. There are multiple dental surgeries accepting new NHS patients in Oxford, for example, which is by no means a cheap place to operate.

Although NHS dental treatment isn't generally free for adults, it is pretty cheap. I've been lucky enough to find an NHS surgery everywhere I've lived and the standard of care has been generally excellent.

I have heard similar elsewhere, NHS dentistry used to be pretty awful when I was a kid - many people developed phobias that they never got over with obvious consequences.

Maybe the growth of private clinics has had a positive effect on standards overall, though I know a lot of NHS dentists do a bit of both.

I'm told by my dad that his (private) dentist as a kid also used to be awful; whereas my (NHS) dentist was great. Though I'm told that surgery went downhill when our dentist retired. Very hard to separate out what's going on.

And I think essentially all NHS dentists do private work as well these days. The one bit of private work I've had done was a rear filling: standard amalgam was covered on the NHS tariff, but a cosmetic 'upgrade' to a white composite one was private and at cost.

As a general principle, be wary of any practitioner who doesn't also do NHS work. The CPD and peer-review keep them on the straight and narrow.

I'm not sure about this since my dentist is a dental surgeon way above the grade of an average practitioner.

May be good advice in general but I don't think that not being part of the NHS should be seen as something negative.

This mirrors my experience and stories from friends. The GP system just isn't designed for people who work. The only GP I can actually see is a private one near work, which I pay for directly (not covered by insurance - fortunately I rarely need to go).

> Most folks (in my experience) go full on private and pay a monthly fee plus insurance.

I have private medical insurance paid for by my employer, but as far as I'm aware no one else I know has private insurance because despite its shortcomings the NHS gets the job done.

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