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The solution might be simple
Raise tax and fund the NHS and social care properly?
Can you not retire from the NHS and then come back part time and increase private activity?
The elephant in the room here for consultants is the new contract negotiations.
At the moment a surgical colleague of mine is doing NHS waiting list initiative work at the local spire. Better T+C's there apparently, better kit and most of his old theatre staff. He does his straightforward cases there (lack of ICU/sick person support as alluded to above) and saves his complex cases for the NHS hospital where ITU is waiting if it gets messy. Presumably both paid on the same tariff?
Buy Buy Buy Spire healthcare shares - its like being paid the same price to service a brand new car v and 20 year old banger thats never had any work done on it. Systematic destruction of the NHS.
HoratioHufnagel - Member
The solution might be simple
Raise tax and fund the NHS and social care properly?
Isn't that the tried and tested which has never worked properly?
I am trying to find the data of the average NHS cost of a person per life time.
A quick search only managed to find a piece of news from [url= http://news.bbc.co.uk/1/hi/programmes/breakfast/4898158.stm ]BBC 2006[/url] regarding the charges ...
Anyone has the average cost of a person per life time?
Anyone has the average cost of a person per life time?
What's that going to demonstrate. I seldom visit hospitals or GPs, a problem I have had is the first time I've visited a hospital for treatment that I can actually remember.
I am happy to give up this time which I have paid for in order that less healthy people can have access.
I am still happy to pay into a system that provides help for those who ordinarily wouldn't be able to afford it.
Nothing wrong with having private medical insurance if you can afford it. Whether the net effect of it is to reduce waiting lists elsewhere, I'm not entirely sure. But at least *you* are no longer on that list. You're still paying your taxes to support the NHS whether or not you use it.
Mind you, do bear in mind that, even when you do want to use your PMI, you might not be able to. I wasn't when I needed it. I had to sit in a waiting list for 14 months...
Rachel
How much does a person cost NHS in his/her lifetime?
I seldom visit hospitals or GPs
The more interesting question is [i]when[/i] does a person cost the NHS. Spending your healthy working life complaining that the NHS isn't quick or convenient enough for you is moot. Most people will get by far the largest portion of 'value' from the NHS in the weeks before they die. Nobody seems all that interested in the votes of the dying though.
NHS is underfunded [url= https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/health-care-spending-compared ]Health care costs[/url] so how about we have a referendum and see if people are willing to pay a bit more ?
Labour may have bankrupted us but at least they did raise the amounts going into health care over the time they were in power, the conservatives seem to want us to go backwards to a private system like the americans (twice as expensive and worse than ours !)
No, I wouldn't pay more when the NHS is poorly managed. Look at what is going on:
That's not poor Nhs management that's multinational corporations having more power than mere nation states. I agree it's wrong but it's bigger than the NHS/department of health
yup, nhs is cheap in world term
CG - that's not the NHS being poorly managed.
That's drug companies holding the NHS over a barrel.
That's (almost) similar to blaming crime victims for the crime they suffered!
I'm hunting for the newspaper article written by one of our CCG GPs berating and challenging Phizer for overcharging our CCG for several million for epileptic drugs, and winning!
I think they are having to backdate 'overcharges' for quite a bit...
DrP
[url= https://www.theguardian.com/business/2016/dec/07/pfizer-fined-nhs-anti-epilepsy-drug-cma ]This is the story, but not his article...[/url]
The more interesting question is when does a person cost the NHS.
The most interesting question is why are we doing a cost ananlysis on the NHS.
Did you know..if 'full seven day working' in the NHS was a drug, NICE wouldn't deem it cost effective?
DrP
How true DrP, and yet the promised extra money in the GP forward view is being wasted on it for purely political purposes. I estimated it cost the tax payer £400+ for each contact with the local prime ministers challenge fund service, but it will be deemed a success because a few people saw a GP who wasn't employed by the preexisting out of hours provider on a Saturday morning. Just not my patients as we work hard to see everyone that needs seeing in the 56.5 hours we are open every week...
The mismanagement in the NHS starts at number 10 Downing Street.
What about a Singapore style system where everyone gets an allowance (say £1000 per year) to spend as they wish on healthcare. If not spend it is kept and the amount in your healthcare account just mounts up until you do need it (when older for example).
This then brings in true patient choice so we can see the value of the various NHS offerings to the people that want them whereas today it is guess work. All at the same cost.
It also acts as an incentive to maybe not rely on healthcare and do a bit more personally to be healthier.
Catastrophe insurance (paid by government) covers the very large medical costs
Not exactly a vote winner tho is it?
Much better to stoke the expectations of the public - ref 7 day nhs, Skype your GP 24 hours a day, demand more all the time, tightening regulation(Cqc) and demonising the workforce in the media, until the inevitable happens - the " GP led" ccgs have to balance the books with some savage cuts and bingo you've got your fall guys for the demise of the nhs.
You have to remember a majority of the electorate believed the brexit pitch so the idea of operating the nhs 24-7 on less money and with less staff that the nhs fails to operate at now seems very reasonable to them.
Turkeys Christmas.
[quote=kerley ]What about a Singapore style system where everyone gets an allowance (say £1000 per year) to spend as they wish on healthcare. If not spend it is kept and the amount in your healthcare account just mounts up until you do need it (when older for example).
This then brings in true patient choice so we can see the value of the various NHS offerings to the people that want them whereas today it is guess work. All at the same cost.
It also acts as an incentive to maybe not rely on healthcare and do a bit more personally to be healthier.
Catastrophe insurance (paid by government) covers the very large medical costs
You're pretty screwed if you're on expensive medication though.
The most interesting question is why are we doing a cost ananlysis on the NHS.
Because we say we can't afford it, when what we mean is 'I'd rather have a bigger telly' and because most people put the biggest part the NHS will play in their lives outside their frame of reference. Its a service they don't want to think they'll need for a person they don't want to think they'll be.
^Up there ^ we're talking about 'little old ladies' as if they are someone other than ourselves.
Once the majority of people believe it is acceptable to have to top up the NHS with their private insurance then there will be no one pushing for a better NHS because they already expect it to be ineffective. IMO this is not a good thing.
Also where does it stop? If you have enough cash what else should you pay for? It's already accepted that the best educations need to be bought (with monetary or cultural capital) once health is segregated like the USA, perhaps people can have their own private police...
If people are prepared to pay for private healthcare then they are prepared to pay more tax for the NHS...
DrP did a long thoughtful piece and then proclaimed not to know the answers.
Others have steamed in with solutions.
I suspect DrP would get to a sensible answer sooner than some of those who steam in.
And I certainly don't know the answer to this one.
I have not read the whole thread.
Overall no - the private sector leeches of the NHS because it does not pay for the trained staff it poaches and often outcomes are worse - and if you get complications you end up in the NHS anyway.
some consultants also game the system - deliberately racking up delays or telling patients porkies to get them into the private system as the consultant makes more money
However for individuals it can often be a very good thing - my mother had her hips done privately after having her NHS date moved back 3 times. she was reluctant for ethical / moral reasons but I persuaded her to do so as at 82 she doesn't have much time to spare and delays lead to muscle wastage and slows recovery and she had the money - £25 000 for two hip replacements
Sometimes pragmatism trumps ethics
You're pretty screwed if you're on expensive medication though.
Indeed or even quite basic care. There should be no limits.
Haven't read through the whole thread but what the OP is asking about (and it's an excellent question to debate) is means testing of health care (voluntary or otherwise).
The problem with means testing is that there will always be a large number of people on the margin of "qualifies for free health care"/"pay for it yourself, you scrounging bastard".
This would lead to a large degree of preventable suffering among those people, huge opportunity costs - "I couldn't go to university because Dad needed a new kidney" - leading to wasted potential and stunted lives.
On a national level, such a policy would lead to worse health outcomes, particularly among the "squeezed middle" who would most likely be on the margins of the means test.
This would then provoke a very divisive debate:
"Why does that chain-smoking, sedentary unemployed person get free health care, whereas I lead a healthy life and pay my taxes and NI but get nothing?"
It would be an enormous step away from the principle of universal health care.
kerley - Member
What about a Singapore style system where everyone gets an allowance (say £1000 per year) to spend as they wish on healthcare. If not spend it is kept and the amount in your healthcare account just mounts up until you do need it (when older for example).
This then brings in true patient choice so we can see the value of the various NHS offerings to the people that want them whereas today it is guess work. All at the same cost.It also acts as an incentive to maybe not rely on healthcare and do a bit more personally to be healthier.
Catastrophe insurance (paid by government) covers the very large medical costs
That's what I have in mind but must be customised to the British society because Unions will go up in arms citing danger to lives etc ... defend their jobs whatever.
If this looks viable then all parties will want to claim credit or try to sabotage it depending on whether the idea works well and usually nobody should come out smelling full of roses because nobody should succeed. NHS is everyone's political football where it is both their strength and the weakness.
Therefore, the must be very strong political will as well as letting the people see the benefit of another system otherwise nothing change.
Besides, there should be a number somewhere that shows the amount a person cost in their entire NHS lifetime. Funny this is not available.
I think that's the way it's going.
I have private health cover as a work benefit. I've used it twice and each time, I reasoned that someone else would get the benefit of "my" nhs time if I went private.
I also pay extra for my family.
Sadly, a work colleague hasn't and is now regretting that decision .
You're pretty screwed if you're on expensive medication though.
Indeed or even quite basic care. There should be no limits.
But there are limits though. I have a client who works in the medical supplies industry and according to him there are a lot treatments routinely available in Germany that aren't in the UK becauae of cost.
Yes - but only if there are alternative treatments that are available and work.
When you have a system that provides care to everyone at no cost to the individual then there has to be some mechanism for capping costs otherwise it would be completely unmanageable - and those decisions are made on a clinical basis. For example some of the cancer treatments that are often mentioned in the papers - the drugs an be tens of thousands or hundreds of thousands for something that is not a cure - but prolongs life / dying by months only.
also Germany spends more per head of population on healthcare - significantly more. 12% of ( a higher) GDP compared to our 9% of GDP
Ideally I would like to see us matching German levels of spending on healthcare. this would lead to a vast and noticeable improvement in the NHS. then some of these rationed treatments could be made available. But in a cash limited system then if you spend £250 000 on one persons cancer treatment thats 25 hip replacements you cannot do. Thats the sort of horrible judgement NICE has to make
But there are limits though. I have a client who works in the medical supplies industry and according to him there are a lot treatments routinely available in Germany that aren't in the UK becauae of cost.
Did he also tell you that there are often cheaper alternatives or that there may be no benefits to these routine treatments?
Having said that my brother in law had prostate cancer treatment in Germany that is not available on the NHS and has are better outcomes than the NHS treatments. But then if the NHS budget increased by 30% to meet german spending levels we could have the latest state of the art treatments as well.