[Closed] What to cut to fund the NHS?

Tom_W1987 - Member
NHS's current advice of anything from 5-30 days (at varying dosages of varying antibiotics depending on the consultant) won't cure Lyme because frankly, the NHS and other medical research agencies simply haven't done the research yet
Yes. Yes there really is. This is like saying that there has been no research done into man made climate change.

Hi Tom,

again, we weren't talking about climate change: you made the assertion that there is no proof that courses of antibiotics longer than current NHS pot-luck guidelines have any effect on Lyme, and that their supposed over-use by these patients diminishes the overall effectiveness of these medicines.

Here is a list of 700 peer reviewed medical papers that all support the claim that tick-borne diseases can persist and survive short term antibiotic use, all state the need for further research and large-scale sample groups:

Please show me just one paper that states Lyme is comprehensively cured by a sub-30 day course of antibiotics, and can prove that longer term use is unnecessary. If you can't do that, perhaps better to wind your neck in when talking about a subject you appear to know very little about. Just goes to show, all you need is one shit in the wrong woodpile and the whole house starts to stink.

The public aren't aware that not all EBM sees the light of the day. All depends on who pays the piper ...

good god 6 pages! what have I started.

good god 6 pages! what have I started.

You used keywords such as:

Tories, NHS, Corbyn and Trident.

Guaranteed 10 page thread.

...and privatisation 😀

Corbyn

That's done it. Stand by for a flood of hilarious images grabbed from Life of Brian. Oh, my sides!!

I don't see why I should be paying for other peoples poor choices or bad genetics, seeing as Britain has collectively decided to punish me and my wife financially because I married a foreigner.

Let us have a look at Pharmaceutical companies and what they are charging for 'life saving' drugs......
things to consider -
1. How effective are they at curing people?? or is it that they just reduce symptoms?
2. How much do they actually cost to develop and produce?

I am not saying this is the best or only fix, but it needs major consideration.

Drug companies those outstanding humanitarians.

http://www.telegraph.co.uk/business/2016/12/16/drug-maker-overcharged-nhs-hiking-price-hydrocortisone-tablets/

The Competition and Markets Authority issued a statement of objections after it found Actavis UK put up the price of generic 10mg hydrocortisone tablets from 70p a pack in April 2008 to £88 per pack by March 2016.

VAT on all food except fresh fruit and veg (environmental and heath bonuses too)
Close corporate tax loopholes
Healthcare to age 70, beyond that it's private or if you have a serous illness you have the choice of euthanasia. Healthcare needs to be about quality of life not keeping people alive regardless. Better than the all most everyone has good health for 70 years than go back to people dying of preventable ailments when younger.
As far a poor choices are concerned, maybe there is a middle ground - 3 strikes and your out - [i]Mrs Smith you've not lost any weight despite you being warned and provided with a training so all healthcare charageable until you lose the weight[/i].

Mr CD you've fallen off your bike too many times, you will have to pay to fix you're broken collarbone.

Healthcare to age 70, beyond that it's private or if you have a serous illness you have the choice of euthanasia.

Another person to completely miss the point of the NHS.

So you can only get healthcare past 70 if you are rich, otherwise you may as well just kill yourself. Nice.

Count yourself luck to be genetically blessed...
So far...

I knew someone who consistently argued the case Tom is arguing, till Parkinson's Disease manifested itself (not sure its something you catch). Remarkably he suddenly realised that poor health can be as much down to luck as poor choices

Indeed I have heard (feel free to debunk) that one tobacco company was on the brink of sharing the fact that people who smoke die younger AND CHEAPER than those who don't as a lobbying tactic for governments though, a few years back.

So get smoking, proles.

So you can only get healthcare past 70 if you are rich, otherwise you may as well just kill yourself. Nice.

good god 6 pages! what have I started.

OP it's one of the better discussions on the topic, there have been a few. It's constructive.

Let us have a look at Pharmaceutical companies and what they are charging for 'life saving' drugs......
things to consider -
1. How effective are they at curing people?? or is it that they just reduce symptoms?
2. How much do they actually cost to develop and produce?

I am not saying this is the best or only fix, but it needs major consideration.

My may or may not realise this but Trump is very pro pharma and its not as if we buy them in $ so its not like there has been a price hike anyway 😯

https://www.ft.com/content/3e981008-a6cd-11e6-8b69-02899e8bd9d1

OK then, so where do you draw the line? As medical advances continue can you all the extra people surviving in to old age is not sustainable, what if we could keep people alive for ever. I'd rather everyone one had a great life for X (perhaps 70 is too young?) amount of years then let nature decide. If it helps we can man private treatment over that age too so all people regardless of wealth will die naturally after X. This isn't just an NHS thing, it's excepting that endless medical advances are not sustainable. We can't live forever.

That all depends on how many years at the end of your life are poor quality/plagues with illness.

For example;
Person A lives until 84. They become ill with a variety of problems from age 80
Person B lives until 64. They became ill with a variety of problems from age 60.

Both ill for 4 years before dying but you would only keep the 60 year old alive?

That all depends on how many years at the end of your life are poor quality/plagues with illness.

For example;
Person A lives until 84. They become ill with a variety of problems from age 80
Person B lives until 64. They became ill with a variety of problems from age 60.

Both ill for 4 years before dying but you would only keep the 60 year old alive?

Some fascinating posts. 😯

Now we are getting somewhere. Instead of looking at life expectancy, look at disability free life expectancy.
The thing that if you are born poor you are guaranteed to have less of. Regardless of your "choices"

I'll say it again.
Fairer society
Social determinants of health.

Listen to experts not politicians

I doubt any of this will happen.

With reference to the spmd graph - 45% of all spend on US healthcare goes on administration of billing, terrible system.

Th simple answer to what to fund is data is needed on quality outcomes versus cost of treatment. That data exists in a reliable format for very little - that should be the goal as allows genuine treat,ent comparisons.

**** the poor.

Am I right?

I think Tom calls them Northners but yes.

Yes but the 80 year old has had 20 more years to liver and make the most of a healthy life. Or are you proposing that people have a limit of one or two major medical treatments in a life time however long that may be?

I haven't proposed anything. You are the one proposing that only rich people can have some quality of life with an illness or that people should be killed!

I am happy with how it works now, access for all. Just needs more money because there are more people in an increasingly aging population.
Money is easy to get (increase tax to over 40% earners), just that nobody wants to do it.

Yes you can make the service more efficient, yes you can cut other things but ultimately that won't be enough so it needs more money.

Majority would be happy to pay more tax if it was all going direct to NHS. Or that's what they say until it hit's their wages...

Times investigation into drug prices:

http://imgur.com/a/U42vD

[url= http://www.bbc.co.uk/news/uk-politics-38547760 ]crisis[/url] what [url= http://www.bbc.co.uk/news/health-38570960 ]crisis[/url]

Indeed Cinnamon. Indeed..

Let us have a look at Pharmaceutical companies and what they are charging for 'life saving' drugs......

OK understood. Then stop buying them because it's decided they are making too much profit ? How long do you think a Government could keep that up for ? Patients dying in UK whilst being treated in Ireland or Spain with "expensive" medicines.

**** the poor. Am I right?

Seems to be the default answer regardless of whether it improves anything.

Oh dear the battlelines are drawn again too old **** off, too fat on your bike son, smoke yeah mate jog on, too rich do one. Yeah seems a recurring theme. We just need to get the list of exclusions right, preferably with more categories to please all the loonies 😀

Bring back hanging. What we need is a good war 😆

good god 6 pages! what have I started.

Has anyone mentioned immigrants yet, or does that come in later at about page 10?

Been done.

This is a very good question.
Really the answer comes in a few stages:
1- cut waste. Simple. Don't prescribe when you shouldn't, don't double-pay providers of services. Don't request needs you don't use.
2-stop services without evidence our clinical benefit. This may be unnecessary or 'little evidence'clinical treatments. Or services such as IVF.
3-change thresholds for proven treatments; you need to be in MORE pain for a knee replacement, your cataract needs to be really bad for an operation etc
4-reduce whole services -starting with those with the least impact.

There you go.
Sorted.

DrP

edit- it would be interesting for posters of the ideas above to consider what category they'd fit their suggestions into.
Not saying they are right or wrong, but makes you think...
Certainly over investigating and treating frail elderly would fall into category 2.

Interestingly,i heard of a ccg that wouldn't operate unless the patients gave up smoking. That's a double win!

4-reduce whole services -starting with those with the least impact.

Can you give more details? EG, start with those with the least impact and stop where?

Not sure if Dr P missed a smiley or not.

1 - cut waste;

If the NHS was Walmart there is no way it would pay what it does for software licences, or IT consultancy rates. Collectively the NHS is massive and should really have the clout to dictate what it will pay. Instead (as I understand it) each trust negotiates it's own purchases so lose the ability to collectively threaten to take [i]all[/i] the business elsewhere if a vendors prices are not keen enough.

I know that prior to 2010 the NHS in England & Wales did have a half-decent agreement with one large software vendor. Then a new government talked about making cuts to save money and got rid of whatever department a previous government had established to manage these kinds of things.

So a saving of some centralised salaries meant that some NHS Trusts faced massive software licence fees (well in £ millions) when the old centrally negotiated agreements that previously covered them expired.

Speaking of software one of the key reasons the massive-super-expensive-project got so super-expensive was that the vendors were trying to please each hospitals requirements. They were not dealing with a single customer so no surprises it completely failed - I went to a fascinating seminar on that.

I've been told it's not too dissimilar with how drugs are purchased and some are now a lot more expensive than in the past. I don't know if true but certainly sounds plausible.

Haven't read all the posts so shoot me if some else has said this but, sell the houses of parliament off instead of rebuilding it (approx 5billion cost to rebuild) Find an empty office block (doesn't really matter where, Its a connected world!) and move all muppets, sorry M.Ps and their staff out there and spend money saved, plus what we'd get for selling Westminster on NHS.
Its a start.

Get rid of the nukes, easy.

ps. haven't read the thread.

It seems that you haven't read the original post either 🙂

Get rid of Trident, would that be enough?

Ooops!!

Could anyone please give a rational justification for keeping Trident, i know brexiteers seem to think we are still some sort of imperial power, but really if it is just about job creation then at least be honest about it, rather than talk about unforseen threats.

PS. infact wholesale cuts to the military, why do we need such a large military anyway, i would like to see a defence force!

Erm, numerically our military is pretty small. There's not much left to cut if the government still wants to support international operations, and even then we have stepped back a lot in recent years whilst the focus has been on Afghan and Iraq.

The NHS and pension budgets also dwarf the defence budget. So yes it could help but given the way things work you soon be looking for something else and would have zero capability to do anything other than what the police and coastguard could manage.

Hi Tom,

again, we weren't talking about climate change: you made the assertion that there is no proof that courses of antibiotics longer than current NHS pot-luck guidelines have any effect on Lyme, and that their supposed over-use by these patients diminishes the overall effectiveness of these medicines.

Here is a list of 700 peer reviewed medical papers that all support the claim that tick-borne diseases can persist and survive short term antibiotic use, all state the need for further research and large-scale sample groups:

ILADS.ORG "http://www.ilads.org/ilads_news/wp-content/uploads/2015/09/EvidenceofPersistence-V2.pdf"

Please show me just one paper that states Lyme is comprehensively cured by a sub-30 day course of antibiotics, and can prove that longer term use is unnecessary. If you can't do that, perhaps better to wind your neck in when talking about a subject you appear to know very little about. Just goes to show, all you need is one shit in the wrong woodpile and the whole house starts to stink.

Bwhahahahahahah.

None, I repeat none of those papers support the CLINICAL effectiveness of long term antibiotic therapy in humans. These studies have been done.

eg 1200 patients, well designed study, published in the New England Journal of Medicine?

http://www.nejm.org/doi/full/10.1056/NEJMoa1505425#t=article

Hmmmmm. Who do I believe, biased lobbying group or a study in the NEJM? A bunch of papers indirectly supporting a treatment and a good clinical trial?

Well that is a myth, the fith largest spend in the world just behind Russia, having offensive capability has only made situations worse, Iraq, Afghanistan, libya are all operations that have caused a shit storm, destabilising the region has not helped.

IMHO we do not need to get involved in these foriegn adventures, if you are cutting public services you can not sustain a military that has historicaly been the backbone of an old imperial empire, something has to give.

@fergel our military has been cut savagely over the past 30 years.

The Trident argument is a red herring imo. The Tories have promised to deliver an extra £10bn pa that's double the Trident cost, yes "every bit helps" but Trident money isn't going to transform the NHS/Health provision.

The Tories have promised to deliver an extra £10bn pa that's

According to my recent tax statement, the amount we spend on "defence" is around 26% of the amount we currently spend on health. Looks to me that we could redirect some of that spending.

Health Care spending (blue) and Defence spending (red). Up until 1987 we spent more on defence than the NHS.

[img] [/img]

@scotroutes Germany will be increasing defence spending by 80% to meet the NATO target.