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TJ, that NICE really are a pain! No wonder the present government are dimantling them.
-how are [s]the government's friends and relatives[/s] errr, big pharma and private hospitals offering simple and low risk elective elective surgery supposed to cope when you have an organisation telling us how to get better value overall for taxpayers? 🙄 and indeed 😉
So would "NHS trusts are changing to comply with NICE guidelines on fertility treatment" be better?
Bravissimo; I've already sorted it:
You smash yourself up doing something like mountain biking, which is a 'lifestyle choice'. You sustain serious injuries and need ambulance/helicopter, ITU, operations, after care, physiotherapy etc.How much does that cost?
Should you be just left on the mountain, as it's your own stupid fault cos you chose to do something dangerous?
Oh well, that's that one sorted. Pint, anyone?
🙂
It all depends....
Are we going to judge or apportion treatments by outcome? Or are we just going to offer them regardless?
I don't know the success rates of IVF, but I do know that we aren't offering it to 18 year olds from less privileged backgrounds, because the human body is designed to be fertile from that age, not at 35-40-45 when we have careers...
The success rates of emergency Aortic aneurysm surgery are somewhat dismal, but we seem to have no problem in trying to fix them.
The success rates from Out of Hospital Arrests are laughable, but we still put these people in ITU for 24-48-36-72 hours at a cost of £2-4-6-8000 just in case.
It's complex and emotional, and I suspect we aren't going to solve it here.
It's complex and emotional, and I suspect we aren't going to solve it here.
Nope, you're right. But we can have a good old barney. 🙂
DD - the example was of course a ridiculous one, but it demonstrates that you can never make a hard and fast rule saying that you must never consider lifestyle as a relevant factor.
As Mrmo says, [i] Where that point is, is open to discussion[/i] - and to be honest, the thing that riles me about Fred's approach on this thread was that straight out the bat he started calling SBZ arrogant and offensive for even daring to have an opinion that was one side of a very long series of shades of grey.
The example of mountain biking is a good one, since its just another of those "lifestyle" options somewhere between smoking crack and being a Jehova's witness (both of which can have pretty drastic effects on your health outcomes) where you cannot draw hard and fast lines.
..and the problem still remains that even with private medical care, the NHS still has to pick up all the pieces when it doesn't go well.
Go into private hospital for elective surgery, pay, go home.
Go into private hospital for elective surgery that then goes wrong, the NHS will give you ITU care, HDU care, rehab and all with no cost to the private side.
If private Healthcare had to pick up the tab for everything resulting from private medicine we would start to see the real costs emerging.
This will require a more sensible debate on whether a state monopoly on the provision of healthcare is the best way of allocating scare resources.
Debate is over. state monopoly is best. It provides more treatment for less money. well proven and known.;
The again this could all be a dream!! It can't be that simple!
Correct - it isn't that simple - adding different revenue streams in requires complex financial management which costs a lot on money.
If private Healthcare had to pick up the tab for everything resulting from private medicine we would start to see the real costs emerging.
Now that's an interesting quote, but probably not in the manner intended. I agree with the point, but find the hidden aspect also intriguing ie, the concept of "real costs emerging". Free-markets have their failings, but a real benefit is better transparency in pricing. This is lost in a command system. In this example, the fact that the NHS provides an opaque backup is all part of the problem, surely?
It provides more treatment for less money
Doesn't necessarily provide better treatment, or better health outcomes though.
I agree wholeheartedly, teamhurtsmore, the problem with the NHS and it's policy of treating everything and everyone is that we end up treating everything and everyone.....whether that's the right thing to do or not. This means that lots of people end up in critical care facilities being 'treated' for what is essentially death.
A less emotional and more outcome focused approach to all healthcare would improve everyones experience and save money.
Z-11, but your example of a 60 year old woman being infertile is hardly down to her lifestyle is it? Anyway, that's done and dusted. Infertility for many people isn't a matter of "lifestyle". Saying it over and over again does not make it so. As has the argument about IVF here may times. As for Effin's attitude towards glupton/Smee/TZF/SBZ, well I'm afraid he asks for it.
OK TJ - we will remain with a system that is poorer than in large parts of the rest of the developed world in most senses of the word. Great. Of course, the folly of your suggestion is that those that can afford it, will continue to be able to bypass and (to take crikey's comment) abuse the system, leaving the rest to face the consequences. Very smart?!!?
I will add to the list of absurd quotes (" we are an undertaxed economy") this one:
Debate is over. state monopoly is best. It provides more treatment for less money. well proven and known.;
Ok - Time for a fun Saturday - goes away shaking head!!
Infertility for many people isn't a matter of "lifestyle"
With huge respect to anyone involved, concentrating on a career and subsequently waiting till you're 40 years old before trying to conceive, given that it is known that fertility drops so significantly at that age, is very much a lifestyle choice.
[b]TJ:[/b]
Although survival rates for different cancers are improving in the UK, most other OECD countries achieve higher rates. The UK does well in avoiding hospital admissions for people with uncontrolled diabetes, but could improve the treatment of people with asthma and chronic obstructive pulmonary disease.
Details:
? The 5-year relative survival rate for breast cancer during 2004-2009 was 81%, up from 75% during
1997-2002, but still lower than the OECD average of 84%. For cervical cancer, it was 59%, also lower than the OECD average of 66%. And for colorectal cancer, the 5-year relative survival rate in the UK during 2004-2009 was 54% for females and 53% for males, compared with an OECD average of 62% for females and 60% for males.
? Avoidable hospital admissions for asthma complications and chronic obstructive pulmonary disease are higher in the UK than the OECD average. For asthma admissions, the rate was 74 per 100 000 adults in 2009, compared to an OECD average of 52. For COPD it was 213 (OECD average 198). On the other hand, admissions for uncontrolled diabetes in the United Kingdom are less than half the OECD average (24 vs. 50 admissions per 100 000 population).
Teamhurtmore - I suggest you go and do some research on this. The nhs is as good as most systems and is cheaper. Some things it does very well indeed - some not so well. However it is significantly cheaper than most. So in terms of treatment per £ it is among the best in the world.
And yes - we are undertaxed which is why our public services are underfunded.
Have a look at a comparison with Germany and the Netherlands and remember that in Germany you pay for your healthcare on top of tax. The german system is a social insurance funded model - admin costs are twice as high
They pay more tax than us and then have to pay for healthcare on top out of the income left.
It may not sit well with your ideology but it is the truth.
La sécu c'est bien, en abuser ça craint.
How about means testing the winter fuel payment (or whatever it is called today)? One of the most disgusting things I've ever heard was Ken Clarke's response when asked whether he needed the however many hundreds of punds the government gave him through this payment. "I think of it as a tax rebate" was his answer. It's not meant as a tax rebate though is it Ken? And do you not claim for gas and electricity via expenses?
With an attitude like that no wonder the country is screwed.
The translation for us doesn't work too well, Edukator, but I think I get the idea.
A supreme irony being that even as the public sector gets slagged off, the likes of Circle are [s]leeching off[/s] entirely dependent upon NHS capacity and workforce training.
At its best, acute care in the NHS works because of co-operation - I'm willing to bet that the [url= http://www.pulsetoday.co.uk/newsarticle-content/-/article_display_list/12859822/evidence-for-greater-competition-in-the-nhs-flawed ]political fetish for "competition"[/url] is actually going to push both costs & bureaucracy [i]up[/i].
Would love to stay and chat, but I'm on me break. 😕
Teamhurtmore - I suggest you go and do some research on this.
Of course, silly me. Never thought of that.
The nhs is as good as most systems
If only
Some things it does very well indeed - some not so well.
True
However it is significantly cheaper than most.
Partly because we underpay (patronise?) those who work in the industry.
in Germany you pay for your healthcare on top of tax. The german system is a social insurance funded model
Sounds pretty good so far...
- admin costs are twice as high
So needs better admin, next? As I say learn from others - copy their successes, avoid their mistakes.
With huge respect to anyone involved, concentrating on a career and subsequently waiting till you're 40 years old before trying to conceive, given that it is known that fertility drops so significantly at that age, is very much a lifestyle choice.
Jeez, there you go again, choosing examples on the edges of the curve to suit your argument. No matter how many times it's pointed out to you, you'll continue to do it. Ah well, TeeJ has arrived for you now, and I have an engagement party to attend. The two of you can spend Saturday evening posting links at one another. 🙂
By the way, that party - it's for two lesbians. I hope they get help from the NHS to conceive some time in the future.
Have a read of this
http://www.guardian.co.uk/commentisfree/2011/nov/24/reform-bad-for-nhs-oecd
One of the Key things from that oecd report is that the NHS outcomes improved rapidly over the last decade as the money we spend on it increased. Far more quickly than others
When labour came to power we spent around 3/4 of what most comparable countries spent on healthcare and thus it was not great we now spend around 9/10 as much and outcomes have improved rapidly - matching or close to matching the the best in most areas despite still spending significantly less
The other issue with the selective quoting from Zulu is that we have higher rate of some of these illnesses in the population.
However some people are so idealogically wedded to the idea that private is best that they will never be convinced of the truth which is that the NHS provides more and better care on average per £ than any othe rsyutem.
The only one I know of that is significantly cheaper is the japanese - and I don't know enough about it to know why.
to be honest, the thing that riles me about Fred's approach on this thread
I'm glad it riles you. 😀
As for Effin's attitude towards glupton/Smee/TZF/SBZ, well I'm afraid he asks for it.
This, quite frankly.
If someone's gonna post up deliberately provocative crap, then they shoon't be surprised if they provoke a response. And SBZ's said his onion isn't going to change, which means he isn't actually open to debate or discussion, from which he might actually learn something, which strikes me as pretty narrow-minded and blinkered tbh. But then, that's his 'lifestyle choice'...
DD - all they need is a volunteer and a turkey baster 🙂 if you were a gentleman ....
I ain't gonna argue with the right wing idealoges any futher.
DD - all they need is a volunteer and a turkey baster if you were a gentleman ....
😆
Now TeeJ, do you not think that joke has been done over and over (sensitively of course, as befits a liberal hand-wringer like myself). Thing is, they're both very pretty. 🙂
Teamhurtmore = the reasons the german system is more expensive to administer is because of the complex funding - which is what you propose. here - ie you want to make the system more complex to administer thus creating more costs.
Kings fund is a good place to learn a bit more
As the OECD points out in its report this week, the NHS has been changing, introducing innovative models of care that have been associated with some of the fastest improvements in health in any industrialised country. Our experience, and that of other researchers – such as those who have shown how hospital mergers set the new organisations back several years – confirms the OECD view that what is needed is institutional stability: and that this is what gives rise to effective innovation.
It's a publicity campaign our governement ran a few years back, Crikey. The idea was to ask people to make responsible use of France's health care system to keep costs down aand thus assure the survival of the system.
The problem with free health care is that it encourages bad habits that compromise the efficacity of treatments as well as increasing costs. The initial campaign has since been followed with more specific campaigns such as "les antibiotiques, c'est pas automatique". French people now know that most colds are viral and that antibiotics won't help. They also know it's best to stay at home if they get flu for themselves and everybody else.
TJ - my final point tonight will be a more concillatory one - thanks for the link. Skelton's comments are worth reading in that Guardian article.
{....especially for someone who never does any reading or research!}
[i]The problem with free health care is that it encourages bad habits that compromise the efficacity of treatments as well as increasing costs.[/i]
Oooooooh yes, this I agree with completely. The clientele of A&E on a Friday night are a stunning self selected example of this, and in my town they even put on an inflatable tent, a kind of ersatz A&E during the 'festive' season, so people don't even have to get to hospital for treatment.
A longer term idea would include cigarette consumption, alcohol, drug abuse, obesity and so on.
We do need to move away from a 'It'll be ok, the NHS will sort you out, so drink, shag, smoke, snort, drive, eat' exactly what you want to idea.
A longer term idea would include cigarette consumption, alcohol, drug abuse, obesity and so on
Those very themes have been covered by more recent TV campaigns. Food adverts for junk food have to be [url= http://www.eurojuris.fr/fre/entreprises/marketing-ventes/publicite/articles/les-mentions-sanitaires.html ]legally[/url] accompanied by a warning like cigarettes "Pour votre santé, évitez de manger trop gras, trop sucré, trop salé".
To answer the original question: "Say the NHS get privatised - what happens then?"
Kaiser Permanente say "jump" and the Secretary of State for Health asks "how high?" and then bends right over for them.
Be afraid, be very afraid everyone.
This is just the personal opinion of a Consultant Anaesthetist with 17 years service, so feel free to question my authoritaah (South Park mode).
TJ - just got in and couldn't resist a bit of research from the Kings Fund and found the first quote on what we can learn from Europe quite illuminating:
The UK has a lot to learn from other countries. The most revealing index is the European Consumer Powerhouse Health Index. To say the UK has a 'high-performing' health system is misleading; [b]we have a mediocre one [/b]- 13th out of 29 in Europe (2008). Holland is top 3 years in a row. All the top ten have insurance-based systems. As the report says, [b]'Bismarck beats Beveridge every time'! We must wake up from this notion that we're the envy of the world.[/b]
Only one point of view of course, but interesting nonetheless!
Thing is though, with this country's record of privatising stuff, the last thing we should allow is the privatisation of the NHS! We pay more for stuff like transport, gas and leccy and telecommunications than most countries on Earth, yet get a poorer service than many other countries. With the greedy self-serving imperialist nature of our rulers, together with their far too cosy relationship with the US, means that any move to privatise our NHS will result in disaster.
It's [i]our[/i] NHS, it belongs to [i]us[/i]. It's not the Tory scum government's to sell off.
A government introduced it and a different government can take it away....loving the emotive language people use when discussing 'their' NHS!
I work in the NHS and for what its worth some areas would benefit from a massive kick up the arse and the involvement of the private sector would/could achieve this....but a completely private health care system is something i'm against.
It is 'our' NHS though. We pay for it. Therefore it belongs to the people; it is not something a bunch of greedy self serving individuals can sell.
And if they try to, we should lynch the scum...
We pay for it because a government decided we should have it and fund it....their was no 'people power' revolution that led to the creation of the NHS....it was a decision taken by a government and if a government wants to remove a tax funded service or organisation then they can do so....put a consortium together and with others in your local area buy a part of the NHS or the primary care trust in your area, then it would be 'your' NHS.
their was no 'people power' revolution that led to the creation of the NHS....it was a decision taken by a government
Do you make that drivel up to wind people up, or are you really that clueless ?
Please tell me you do it to wind people up. It's depressing to think that anyone can be that clueless.
buy a part of the NHS or the primary care trust in your area, then it would be 'your' NHS.
Eh? Buy something we've already paid for?
How does that work? Is it like if you buy a sandwich then get charged for eating it?
You've already paid for the roads too....go and claim a bit, see how that works out for you?
Tax funded services are not the same as owning a service....in reality the NHS would belong to the people far more if it was privatised and people held shares in it....not saying i want this to happen but it does make me laugh when people think that paying for a service via tax means they 'own' that service....while you're at it why dont you go and claim some MoD property that you will have paid for through tax....in fact next time you're cycling on MoD land and come across soldiers training on 'your/our' land tell them to leave....again, see how that works out for you.
Ernie lynch....the NHS came about from the EMS (emergency medical service) that was formed during the second world war, these EMS hospitals were dependent on government funding and would be in trouble once the war was over....the need to guarantee their existence after the war led to the reforms that created the NHS....effectively war led to the NHS.
it does make me laugh when people think that paying for a service via tax means they 'own' that service
Erm, I don't know anyone who thinks they "own" the National Health Service. You know some strange people.
The NHS belongs to the nation/state/government/country whatever you want to call it. I think most people understand that. Except a few people you know, apparently.
.
Ernie lynch....the NHS came about blah, blah, blah,
The NHS came about because the British people gave a landslide victory in 1945 to a government which was committed (under intense pressure from the trade unions) to creating it, as part of a 'cradle to grave' welfare state.
well if some bastard comes along and ****s with my MY nhs, which I truly think is one of the better parts of our bullshit society. then I don't think anyone mostly will be aware or care. which is truly sad.
You've already paid for the roads too....go and claim a bit, see how that works out for you?
I can use them whenever I want.
Tax funded services are not the same as owning a service
The NHS belongs to us as a [i]society[/i]. Not to us as individuals, which it would if it were privatised and shares sold. The difference is that currently it belongs to Britain, whereas privatising it could lead to all kinds of foreign interests having a stake in it, with the people of Britain, who have funded the entire project since it's inception, no longer having any say in how it's run. We do currently at least have some influence in this area, through our vote, and our right to lobby our MPs and that. Privatise it, and we won't.
Cuba has a fully nationalised health care system, and in spite of Cuba's economic difficulties, it still remains a model of how such a system can work very well.
It's loads better than the US system in delivering necessary healthcare to all it's citizens, as and when they need it, regardless of wealth.
The NHS was being planned long before 1945....like i said, voluntary hospitals that came about because of WW2 were going to go under once the war was over....creating a state funded NHS was seen as the best way to keep them once the war was over...the lead up to the 1945 election was about selling the idea to the electorate....hence the slogan about a welfare state that looks after people from cradle to grave....all politics, or maybe i'm too cynical?
Yeah but maybe, just maybe, some of those politicians back then actually gave a toss about the people they were elcted to represent in Parliament, unlike the vast majority of the current shower of scum, who quite frankly should be tried for treason. 😐