Double post
And all this “choice” nonsense ignores that any insurance system also takes choices away from the patient.
30 seconds in :
And all this “choice” nonsense ignores that any insurance system also takes choices away from the patient
Yes
The NHS is essentially health insurance that is compulsory and can't be topped up. We're told that we need to pay 10.8/9.8 more in for it to work properly. (Currently the premium is about £3k per person, so if you could you'd top up with £300PA and you'd be happy.)
I'm saying get rid of the compulsory state insurance system and let us choose our own with a basic state subsidy for the first "9.8pc" component. Then we can choose our own cover and top it up.
That way we all get the cover we want and if we want to change it we change it effortlessly instead of complaining on a cycling forum about how crap our state provided health cover is.
My evidence this is a good idea is that everyone in the UK agrees the NHS is a disaster (and could be fixed with a tiny top up which never comes) and everyone abroad chooses a different mechanism to us.
Perfect isn't available. But a solution that gives us each the best we can have without binning the "state funding for fairness" component is easily available. ....and we can take the emotion and politics out of things and just concentrate on the best heath outcomes possible. (...if your car insurance is crap, do you campaign to the government, post on Singletrack or just quietly sort it?)
This morning, when I dropped Mrs Baron off for work at Stoke Royal, there were 15 Ambulances queued up outside.
It is not unusual to see such a splendid display of idling ambulances.
'Parrently the crews now get Uber Eats et al to drop takeaways off.
I have to drop her off because she's had her 2 NHS MRIs, come to the end of her "we'll put you in a wheel chair" MICATs sessions and is "too difficult to diagnose".
However, the private sector offerings have pretty much been similar.
TBH, if the paramedics and nurses wanted to riot or indeed conduct an armed uprising, I'd be hard pushed to "meh", never mind condemn them.
The thing is, those missing out on care are also those who for years have voted for governments that are running the system into the ground, so sod em.
And those who are also missing out on care but didn't vote for the governments that have ran the system in to the ground?
Are they just collateral as well?
(and could be fixed with a tiny top up
It’s not a tiny top up. It’s an increase in budget of 20%, and given that the distribution of payments through NI and taxation is not based on utility (pensioners pay little NI or income tax), the cost to those who do pay is politically impossible.
It’s not a tiny top up. It’s an increase in budget of 20%, and given that the distribution of payments through NI and taxation is not based on utility (pensioners pay little NI or income tax), the cost to those who do pay is politically impossible.
You said 10pc earlier. From 9.8pc of GDP to 10.8.
...but even if you think it's 20pc you've got more chance of finding an extra £600 yourself than convincing over 50pc of voters and a government that they should raise your tax by £600 and spend it on your health.
...and as you say it wouldn't go down like that - you'd be hitting your tax payer baseload with a massive hit.
finding an extra £600 yourself
That £600 isn't going very far.
20% is the absolute increase in budget 11.8/9.8 = 1.2). France just spends a lot more on healthcare than we do for what is basically the same sized but high tax take economy. Of course spending more on salaries would be castigated by politicians as that is not buying more scanners or treatments. Missing the point that you need people to run the scanner and administer the treatments.
That £600 isn’t going very far.
If you didn't think it's worth it you wouldn't have to pay it. That's the beauty of making your own choices rather than getting Sunak to take these decisions for you.
My evidence this is a good idea is that everyone in the UK agrees the NHS is a disaster
That sounds very much like Suella Bravermans claim yesterday that 'the vast majority of people' support deporting people to Rwanda
Absolute twoddle, in other words
I'd say that its a small but vocal minority who would describe the NHS as 'a disaster' and I'm sure its purely coincidental that those very same people support privatisation
If you didn’t think it’s worth it you wouldn’t have to pay it. That’s the beauty of making your own choices rather than getting Sunak to take these decisions for you.
You misunderstand. You as an individual choosing to pay X more will not have a transformative effect on healthcare in the same way as a government choosing that we pay X * 30,000,0000 more as a country. It might help you jump queues to access the treatments available... but it won't do anything to increase the number or quality of treatments available in the UK as a whole.
Nursing should be seen as a profession to aspire to and be proud of. If you compare to salaries of say an optometrist, it’s no where near, yet the responsibility and breadth of knowledge seems to me far more for the nurse. My recent stay in hospital confirms nearly all were from overseas. They were all incredible, but if uk kids don’t want to join, then simply, they aren’t paid enough. If the overseas talent steal ended there would be no-one left.
Getting the right numbers of staff in place would streamline all other parts of the puzzle, and have a positive effect on costs.
As for the cost, it’s all going straight back into the economy anyway.
Uk Healthcare spending as a % of gdp is 11.9%, France is 12.4% according to OECD figures.
Thankfully justification for the existence of the NHS is not an issue for the overwhelming majority of people
From Nye Bevan, 1948, talking about the BMA opposing the implementation of the NHS:
We are not now dealing with a body which is seeking to bring about the modification of principles in what they consider to be the legitimate interest of the members of the medical profession. We are dealing with a body organising wholesale resistance to the implementation of an Act of Parliament.
Also in the same speech he had mentioned the BMA's lack of toleration of previous Health Ministers:
I am a Welshman, a Socialist representing a Welsh constituency, and they find me even more impossible. Yet we are to assume that one of the reasons why the doctors are taking up this attitude is because of unreasonableness on my part. It is a quality which I appear to share in common with every Minister of Health whom the British Medical Association have met. If I may be allowed to make a facetious transgression, they remind me of a famous argument between Chesterton and Belloc. They were arguing about the cause of drunkenness, and they decided to apply the principles of pure logic. They met one night and drank nothing but whisky and water, and they got drunk. They met the next evening and drank nothing but brandy and water, and they got drunk. They met the third night and drank nothing but gin and water, and again they got drunk. They decided that as the constant factor was water it was obviously responsible – a conclusion which was probably most agreeable to Bacchic circles.
Let's remember that people with money, even the BMA, didn't want us to have an NHS from the very start! 😀
Keep it up, NHS staff. You're doing good things, in every sense.
Uk Healthcare spending as a % of gdp
That page shows $5387 per capita for UK, $6115 for France... so that's about 14% more per a person. Mostly state mandated still in France as well (higher per a head than UK)... so much for choice. Ultimately, we need to put more total money in, and paying around with "top ups" is more about the rich "choosing" to jump queues and get preferential treatment... and they can already do that in the UK anyway... so many calls for reforms are just about trying make it more tax efficient to use your own money to jump past those without the same means... dressed up as "choice".
How much more does the nhs need then. Forget 19% as thats never going to be possible after covid, brexsjit and kamikwaze.
In terms of ££££ per week. Staff, beds hardware, drugs, new wings, pay rises, Consultants
Amd then, that amount we need, as a percentage of weekly spend now.
Eg each person's drain on the pot as an average is say £5500, but we need £6000 per patient for staffed, efficient system.
Tgen you have to buy insurance to cover the cost of the nhs you want, as opposed to the nhs we have, with ambulance queues of entire shifts, bed blocking oldies who arent discharged as they lie waiting for a prescription and a lift home.
Then actuarial persons get involved and you have to pay an insurance co £9 per person per month or pay the £555 direct top up fee. Cant pay, or chose not to pay, then its coming out of your benefits weekly, child benefits or pension or jobseekers allowance.
Then if you use the system you want, get an ambulance within 12 minutes and a nice nurse and a bed in a clean, warm hospital it has to cost. Now we already pay in direct and in direct taxation but its not enough. And the government wont tax the 20 million or so taxpayers heavily enough to cover the needs of the patients / potential patients.
So the ultimate end users havevto top up their stay or buy insurance should they need to be hospitalised. Not a percentage of treatment cost, but a lump sum toward the running of the system on a day to day basis.
All the pan clangers who were out there showing solidarity will have to put their hands in their pockets.
Unpopular, unwanted, unaffordable, unworkable but unfortunately necessary.
@mefty my figures were their 2019 data. The GDP has had some “issues” due to a severe health event since then. Spending on healthcare didn’t change though.
My personal view is that social care is the challenge that’s clogging up the flow of patients, causing a challenging working environment that’s not worth the salary and stress. This feeds into poor retention, emergency cover from bank and inflated prices for labour services. And we don’t want to spend on social care.
For balance il also takes weeks to see a gp in France, queues in AE are longs, and it takes months to see a specialist gp.
And we pay gp then get the money back later. To get 100% back you need a private insurance.
My personal view is that social care is the challenge that’s clogging up the flow of patients, causing a challenging working environment that’s not worth the salary and stress. This feeds into poor retention, emergency cover from bank and inflated prices for labour services. And we don’t want to spend on social care.
My aunt has been working in social care for 15 years (she used to be military and then NHS)... and our attempts to force the caring professions to accept lower real term wages, and the resulting understaffing and reliance on agency workers, is much the same story there as it is in the NHS. We take advantage of the caring nature of people who go into these careers, and if we don't turn that around there is no way to improve the care system or the NHS. But there's Sunak... trying to make paying nurses a wedge issue to turn around his political fortunes... "Labour's strikes"... and all that nonsense, rather than addressing the effects of his own party's decision to suppress wages.
I’d say that its a small but vocal minority who would describe the NHS as ‘a disaster’
Pre-covid, ie 2019, the UK apparently ranked 4th highest globally for satisfaction in its healthcare system:
https://www.statista.com/statistics/1109036/satisfaction-health-system-worldwide-by-country/
It is hard to discribe that as a "disaster".
If there has been a significant change in global ranking in the last 3 years then responsibility must ultimately lie with the government - it is they who have been making the decisions which affect healthcare provisions.
And as outofbreath helpfully points out it is Sunak who makes the choices.
The problem is the government not the system.
The solution is obviously to replace the government, not the NHS.
Just to support Ernie's post:
https://www.kingsfund.org.uk/blog/2022/03/public-satisfaction-nhs-falls-25-year-low
Pre-covid, ie 2019, the UK apparently ranked 4th highest globally for satisfaction in its healthcare system:
Well that's great it's all gone brilliantly all along. 🎉
Not sure what all that grumbling was about.
Oh dear:
the basic problem is that 12 years of neglect has left the UK with a system that isn’t fit for purpose and is increasingly intolerable to work in.
NHS Strikes…..an appeal.
Just do whatever needs to be done after all NHS workers are also human.
As for blaming the current govt or political parties I think that is shortsighted. They are not the only one to be blamed even when they have been in power for a while. Not saying they, current govt, have done a good job but all the previous governments are also part of the problems.
The system really needs revamping. Incremental change/"improvements" can only last so long before the entire system needs to be updated. Then after a while it will return to the same incremental process until such time as an entirely new system is in place again.
The situation of NHS is not unknown in other countries and although they may look as if they have a better system, they just have not faced the "critical mass" or the breaking point yet.
In SE Asia, people just find alternative ways of dealing with their own illness and by relying on traditional remedies or knowledge to cure themselves and in cases where the traditional remedies do not work they just suffer a slow death if their illness is life critical. Life is short and the only hope for the people there is for quick and peaceful death.
It strikes me that this stuff about only paying for a basic service, and then paying an optional topup is real fairyland stuff.
If you don't pay your 600 extra or whatever what are you prepared to give up? Mental health care - not a basic service? Physitherapy when you have a big stack ? Long term care when you get cancer aged 30 and then find you can't afford treatment? Or are you thinking that would be a good time to opt back in. Healthcare only works if you're in or out.
The issue isn't migratnts, or the famous middle management (bacuase god knows every other multibillion industry dones't need managers.).. the basic problem is that 12 years of neglect has left the UK with a system that isn't fit for purpose and is increasingly intolerable to work in.
70% satisfaction when the Tories first came to power?
What went wrong?
It’s funny, isn’t it, how the very people advocating free market economics baulk at the idea of daring to allow free market economics loose on the labour markets. If NHS clinicians were allowed to negotiate their salaries at a local level, and simply leave and work at a neighbouring provider who was offering a few grand more if they didn’t like their current terms and conditions, salaries would escalate significantly. Those who advocate for the removal of national pay bands and privatisation, be careful what you wish for. You think healthcare is expensive now? Nurses in the US get $100k+ salaries, and we are in the midst of an unprecedented clinical labour shortage right now in the UK.
19% (not that I think we’ll get that) actually represents remarkably value for money if we were in a free labour market.
Not saying they, current govt, have done a good job but all the previous governments are also part of the problems.
Take a look at the graph I posted. I didn't vote Labour during that period of rising satisfaction rates, but, in hindsight, it's pretty clear that previous government was doing something right in aggregate (not claiming they got everything right, or that some of their mistakes don't impact on the service still now, but hard to argue against the idea that overall they were improving things... and a lot of that was about funding and staffing). It is clear that the government of the past 12 years hasn't had the same positive effect as that previous government. And Sunak's poor handling of this pay dispute is unlikely to have a positive effect either... to put it mildly.
My personal view is that social care is the challenge that’s clogging up the flow of patients
That can't be right - Boris Johnson had a plan to fix social care. Are you saying he was lying?
... the basic problem is that 12 years of neglect has left the UK with a system that isn’t fit for purpose and is increasingly intolerable to work in.
No, it is not 12 years but more than that. The problem did not start 12 years ago but it just hits the break point in the current climate.
It is an accumulation of incompetence over decades by all govts. I still remember very well that NHS is referred to as the "poisoned chalice" for political portfolio.
No previous govts saw this coming? I think they do but so long as it is not them they are not bothered hence the incremental approach until the breaking point.
In the far east the millionaire careers are: Politician, doctor (private but also consultants for govt), dentist (same as doctor) and lawyer. Wonder why.
Are you saying he was lying?
I believe the political weather changed 😉 . Everybody says they want to pay more, but nobody votes for those who plan to raise taxes. Plus ca change...
unprecedented clinical labour shortage right now in the UK.
As I said before, the answer is now a GCSE economics one. And quite a simple one at that.
It’s funny, isn’t it, how the very people advocating free market economics baulk at the idea of daring to allow free market economics loose on the labour markets. If NHS clinicians were allowed to negotiate their salaries at a local level, and simply leave and work at a neighbouring provider who was offering a few grand more if they didn’t like their current terms and conditions, salaries would escalate significantly. Those who advocate for the removal of national pay bands and privatisation, be careful what you wish for. You think healthcare is expensive now? Nurses in the US get $100k+ salaries, and we are in the midst of an unprecedented clinical labour shortage right now in the UK.
I can't believe I'm biting at this but if a nurse can individually negotiate a $100k salary why is that bad? They won't be getting that in a remote bit of Wales but they might actually need more than that to recruit in Westminster.
...and is $100k really that high anyway? What does (say) a nurse practitioner get? Back when the dollar was worth 50p that feels a little over the average for many nurses but not extreme. Amd since they get around the problems of pay banding with temps those staff must be costing *way* over $100k.
But so what? Calm individual negotiation has to be better than strikes and pay bands which ensure someone *has* to be unhappy somewhere because one size does not fit all with salaries and not everyone wants to strike.
I'm not seeing anyone opposed to letting the market decide and if you don't want the market to decide you should still be happy because the NHS can't be far off a monopoly so they can squeeze salaries down as much as they want if that's what you want.
My wife isn't a nurse, but a consultant therapy radiographer on a large cancer ward, the hours she works are ridiculous. She is paid for a 35 hour week, yet works 70-80 hours week in week out since COVID. She got a warning from HR as there was only one day last month she hadn't logged into her laptop, being responsible for timetabling patients, trying to find staff to treat them etc, and her and her colleagues are completely burnt out.
She is often sat on her laptop at 10pm on a Sunday night, if she hasn't completed all the volumes for her clinic the monday morning, she will be back and working at 4am, into the hospital to run clinic from 7.30am and finish and come home for 7pm, have tea and be back on sofa on laptop.
For this she just accumulates time of in lieu, yet then cannot take it.
The issue is that on her cancer ward, amongst the nurses, the midwives etc, they saw good staff leave after Brexit and return home or leave to do other jobs from Eastern Europe, being made to feel unwelcome.
Now following COVID and the hours they have all worked, staff are just simply burnt out, and tensions are really high. These staff just aren't being replaced, the bursaries and other funding to recruit new staff has been cut right back too.
Being selfish, for me its meant our whole life plays second fiddle to the NHS, my wife would not have it any other way, but she is dog-tired, we rarely have any sort of social life, I have had to place my studies outside of work on hold as we don't have time, and I have to be the sole person getting up to my type 1 diabetic daughter each night, as i try to allow my wife the 5-6 hours sleep she sometimes gets.
The issue is an uncaring government, who have chronically under-funded the NHS for a long time now. They were the first to ride the wave of love for the NHS and stand outside clapping their hands in first lockdown, when the NHS comes to government asking for help, its not been a hand clap, its been a clear 2 fingers stuck back up at them.
If the problem isn't fundamentally the government's issue I'd like to know what is. Under labour the waiting list for definitive treatment came down from 18 months to 18 weeks. What is it now?
Local authorities fund social care and council tax is capped as is the amount they can provide the care homes per patient.
There was a small event a few years ago that caused a mass emigration of staff causing the shortfall of staff within the NHS to size from 60,000 to 100,000.
Restore bursaries for those training in healthcare.
It’s funny, isn’t it, how the very people advocating free market economics baulk at the idea of daring to allow free market economics loose on the labour markets
Because, there is only a rigged market.
What's downright pathetic is this can all be fixed with the government purse.
No tax need be involved. But they don't really want you to know this do they?
and is $100k really that high anyway? What does (say) a nurse practitioner get? Back when the dollar was worth 50p that feels a little over the average for many nurses but not extreme. Amd since they get around the problems of pay banding with temps those staff must be costing *way* over $100k.
are you on drugs? The dollar hasn’t been worth 50p for 15 or more years. At the same time as arguing against a 4% plus inflation pay rise for nurses you say “is $100k really that high for a nurse salary?” If the NHS had to pay US salaries it would be broke. National banding of salaries works massively in the favour of national employers, but only if you don’t spank the arse out of it, like we are seeing now. Tories need to see that they have a good thing in national pay bandings because the alternative would be unaffordable, unsafe for the areas that couldn’t afford to compete and unfair on the taxpayers.
Being selfish, for me its meant our whole life plays second fiddle to the NHS, my wife would not have it any other way, but she is dog-tired, we rarely have any sort of social life, I have had to place my studies outside of work on hold as we don’t have time, and I have to be the sole person getting up to my type 1 diabetic daughter each night, as i try to allow my wife the 5-6 hours sleep she sometimes gets.
Look after yourselves. If the system breaks let it breaks because it is impossible for your (both) own health to suffer because of the system and still try to care for others.
The issue is an uncaring government, who have chronically under-funded the NHS for a long time now. They were the first to ride the wave of love for the NHS and stand outside clapping their hands in first lockdown, when the NHS comes to government asking for help, its not been a hand clap, its been a clear 2 fingers stuck back up at them.
Not sure why people buy into the governments' (all of them) propaganda when the reality is very different.
Under labour the waiting list for definitive treatment came down from 18 months to 18 weeks. What is it now?
No more money.
Not sure about the waiting list but I have been waiting for 8 to 9 weeks now just to get a rely.
the NHS had to pay US salaries it would be broke.
The NHS can only be broke if the government decides not to fund it.
That is the only reason.
That is the only reason.
Ideology. Absolute, evil, pathological hatred of people that are socioeconomically beneath them, and a deep rooted belief that they are fundamentally better and more deserving than the people they serve.
Tories need to see that they have a good thing in national pay bandings because the alternative would be unaffordable, unsafe for the areas that couldn’t afford to compete and unfair on the taxpayers.
You are technically incorrect.
The government can afford what ever it desires. You are stuck in old school lies of government spending and it doesn't reflect reality.
Tax payers are not on the hook for government spending. It doesn't work that way - they want you to believe it so.
Ask yourself the why the private sector never bails itself out in economic crisis?
Please, I’m begging you, don’t believe the media stories regarding militancy.
I don't.
From my limited view I think that these strikes have a lot more average man in the street* support than I have ever known. Certainly a lot of the allegations of militancy are meeting with robust replies from people who you wouldn't necessarily expect it from.
Let's face it, we all** clapped for the NHS when we were scared. We all saw how the government was laughing at the rest of us as they had their gatherings and parties. We all see how clapping achieved nothing to actually help the NHS and that derisory pay increases are leading to trained professionals leaving and working in supermarkets instead. The pay is often better, the working conditions are often better, the flexible working options are often better and you don't have to pay for staff parking(!) Plus myriad others. My wife has worked for NHS since she started work (27-odd years ago) - she has never been one for action, threat of action etc and believes (much to my bemusement) that directly serving members of the public is a reward in itself. However, she has been saying for the last few years (particularly during covid) that they are so under-staffed it is dangerous and that hastily trained agency staff are uneconomic and also bring obvious dangers with them.
We are four-square behind you.
*Other genders of person in streets are available.
**Obviously not everyone did, but the gist is that most people did.
You are technically incorrect.
oh, I know, but we are veering into complex economic theory which is not readily accepted by the public, who prefer the ‘economy as a household budget’ analogy, because they can get their head around it. Taxation as the means to control free capital, rather than as a means to pay for stuff blows the mind of most people; it’s just too abstract.
I was intrigued in what the leader of a political party which was founded by trade unions to represent them in parliament might have to say about an critical labour crises concerning an institution created by Labour to provide free universal healthcare, this was all I could find:
I would be grateful if someone could provide me with something more topical, I struggle to believe that Starmer hasn't said anything in the last couple of days concerning the issue.
It is all well and good to sit back an enjoy the spectacle of the Tories's political kamikaze strategy unfold but I am sure that healthcare workers would like to see a bit more public support from the next prime minister, as they engage a callous Tory government.
Labour's shadow health secretary publicly announcing that a Labour government would not give nurses their inflation plus 5% pay rise demand doesn't seem enough to me.
If the longer term solution to the crisis in the NHS is to vote out the current Tory government then Labour should perhaps be a bit more hands on.
When he is prime minister Starmer won't be able to enjoy the luxury of ignoring topical issues, he ought to get used to that now.
Please, I’m begging you, don’t believe the media stories regarding militancy.
You need to do what you need to do.
Media? Trust them at your own peril.
I based it on my own experience.
If the longer term solution to the crisis in the NHS is to vote out the current Tory government then Labour should perhaps be a bit more hands on.
Why offer solutions when you (Labour etc) could see Tory kamikaze in action? Why rock the boat? All politicians know they are in trouble if they become the govt in this two years. No money and energy crisis. No govt will last long or have a "honeymoon" period. The next govt will be in deeper trouble because people expect instant change or improvement. People want it yesterday.
The knock on effect from Covid-19 and energy crisis are enough to put all govts in trouble.
are you on drugs? The dollar hasn’t been worth 50p for 15 or more years. At the same time as arguing against a 4% plus inflation pay rise for nurses you say “is $100k really that high for a nurse salary?” If the NHS had to pay US salaries it would be broke. National banding of salaries works massively in the favour of national employers, but only if you don’t spank the arse out of it, like we are seeing now. Tories need to see that they have a good thing in national pay bandings because the alternative would be unaffordable, unsafe for the areas that couldn’t afford to compete and unfair on the taxpayers.
I think you may have my posts mixed up with someone else's or misunderstood something I've said. Or maybe I'm misreading your words. Either way there seems little point in continuing. Have a good afternoon.