[Closed] Why should we save the NHS?

Ask a non-brainwashed American, if you can find one.

bbc seem to have a party line to toe on their reporting of it;

[img] [/img]

[edit] although interestingly doesn't mention if they're committed to keeping it free at the point of delivery...

@Drac, nice post, wonderful speech.

As it stands the NHS needs changing. It can be argued that the Tories are saving the NHS as without change it's going to wither away. Perhaps a system like France where the better off (ie most of the middle class) buy private health insurance to ease the burden on the state sector and also importantly its is not free at the point of use, this raises important funds but more importantly it cuts down time-wasters especially at the GP care level.

I do find a certain irony that we spend £1000,s on bike and expect the NHS to pay for our broken collar bones, wrists etc when we try a jump and get it wrong. We can afford insurance, we should pay for it.

BTW - Ed's planning to save the NHS with £2.5bn - which is about an increase 2% of it's annual budget (circa £120bn). If its as dire as Labour claim an amount such as this is going to make no difference.

I do find a certain irony that we spend £1000,s on bike and expect the NHS to pay for our broken collar bones, wrists etc when we try a jump and get it wrong. We can afford insurance, we should pay for it.

Healthcare should be free at point of care not based on insurance.

It can be argued that the Tories are saving the NHS as without change it's going to wither away.

It really can't.

@Drac, we will have to agree to differ. As I said in left wing France health care is not free at the point of use and it is based upon insurance. Many here think their system is better, me included based on my experience there with my knee injury and living there for 12 months.

My lot treat all patients equally, of course - but it's a huge privilege to help look after the men and women of his generation. They've done their bit, we should do ours.

As for the NHS - it's certainly not perfect, by any stretch. But the incumbent bunch are actually wrecking the things it [i]can[/i] do well. Stuff at the sharp-end gets done because we [by which I mean: hospitals, specialties, teams, individuals] [i]co-operate[/i] with each other - the rhetoric of "choice & competition" tends to amount to FA in acute care. IMO, the current (& un-mandated) re-org (which they said wouldn't happen) amounts to an act of ideological vandalism, aided in no small part by a disingenuous media campaign (e.g. the utterly mis-leading [i]Daily Failograph[/i] coverage of the CHKS "award" for Hinchingbrooke). Despite DoH's protestations to the contrary, it's obvious that services are being privatised (with the "NHS" as a kind of kitemark), the net result being that routine (i.e. easy) and elective activity is being cherry-picked by the private sector (Circle, Virgin, Care_UK etc), leaving NHS acute care to do the heavy lifting. It's partly why emergency depts are now rammed to capacity.

NuLab have plenty to answer for, too - not least PFI.

without change it's going to wither away

One could equally argue that the "change" currently being foisted upon the NHS is designed to speed up its demise - thus far, the reforms are proving to be an expensive disaster. I'm certainly not opposed to change, but not when it's as bludy stupid and muddleheaded as the 2012 HaSC Act, which has actually managed to [i]increase[/i] bureaucratic faff at the expense of frontline services. And in some respects, the [better-invested] continental social-insurance systems merely swap one set of problems for another.

As I said in left wing France health care is not free at the point of use and it is based upon insurance

We'll never agree then if you think that is better.

in left wing France health care is not free at the point of use and it is based upon insurance.

And have you seen what the toerags charge for a bottle of painkillers and a sling?

The only people health insurance helps are insuranace firms and private medical providers.

You're entitled to your opinion but fortunately the vast majority of the UK disagrees with you.

@Drac, we will have to agree to differ. As I said in left wing France health care is not free at the point of use and it is based upon insurance. Many here think their system is better, me included based on my experience there with my knee injury and living there for 12 months.

The problem with this is genomics and data security. You can bet your arsehole that in 25 years, every private company on the planet will be able to get hold of your genetic information if they really want and that will effect your insurance premiums.

The other problem is that insurance only works well if it's done right and those that can't afford insurance either due to poverty or due to chronic illness are cared for. It get's to a point, like in the states where they have medicaid etc that the whole system becomes less value for money for those at the bottom and at the top and you start to think what the hell is the point.

http://www.theguardian.com/society/2011/aug/07/nhs-among-most-efficient-health-services

The other problem with your assessment, is that the NHS is actually more efficient than France.

****ing hell jambo could you be any more stupid?

The ideology of free healthcare for all was the backbone of post war Britain, without it, where are we?

Jambalaya, it would seem a lot French residents disagree with you;

[img] [/img]

from an excellent article here;

[url= http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/18/wonkbook-change-is-painful-but-the-health-care-status-quo-is-a-complete-disaster/ ]http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/18/wonkbook-change-is-painful-but-the-health-care-status-quo-is-a-complete-disaster/[/url]

We do pay insurance, in the form of tax. It is based on affordability rather than risk, this is why NHS is ranked no1 in the world on fairness.

Insurance base systems have much bigger transactions costs and more fraud. So, as a population, it costs more for any given amount of care all else being equal ie medic salaries etc

I think the Fench system is a combination of state and insurance provision, as I understand it you must either have state or insurance cover depending on your work status, and the insurance covers co-payments. Ithink. Wiki suggests french healtcare us sustantiallt government funded

ht[url= http://en.m.wikipedia.org/wiki/Health_care_in_France ]tp://en.m.wikipedia.org/wiki/Health_care_in_France
[/url]

BTW - Ed's planning to save the NHS with £2.5bn - which is about an increase 2% of it's annual budget (circa £120bn). If its as dire as Labour claim an amount such as this is going to make no difference.

I agree it needs more maybe the £9bn from Tobacco. It's still better than the Tories plans.

We do pay insurance, in the form of tax. It is based on affordability rather than risk, this is why NHS is ranked no1 in the world on fairness.

A contribution that for a service you've used long before you start paying for it.

As for the NHS - it's certainly not perfect, by any stretch. But the incumbent bunch are actually wrecking the things it can do well. Stuff at the sharp-end gets done because we [by which I mean: hospitals, specialties, teams, individuals] co-operate with each other - the rhetoric of "choice & competition" tends to mean FA in acute care. IMO, the current (& un-mandated) re-org (which they said wouldn't happen) amounts to an act of ideological vandalism

It should be remembered that parties of every colour have a long and proud history of radically reorganising the NHS on approximately a five-year cycle.

http://nhstimeline.nuffieldtrust.org.uk/ is a great way of seeing just what has happened in recent decades, and you can judge for yourself where the rot set in, and how.

Many of the ideas you criticise - choice and competition, supported by poorly-judged league tables - were introduced by the previous incumbents, along with the expensive drift from one commissioning body and newfangled approach to another.

The warnings about NHS austerity were flying about well before the tories got in in 2010.

So you'll have to excuse me as I fail to get excited about yet another party conference where lots of earnest politicians stand up and claim to be the only ones in the position to 'save the NHS'.

I have no doubt that if Labour gets in next year, the eternal political football will start being booted around again.

Drac,

Where do you stand on dementia.

Where do you stand on dementia.

In what sense?

Many of the ideas you criticise...

Yes, totally - and the ConDem reforms enlarge upon them... NuLav introduced ISTCs, for example. Sometimes these provided useful extra capacity... but mostly it amounted to healthcare corps being paid over the odds for a lower volume of less-complex work.

The tragedy of the NHS being used as a political football is that successive Govs have wrecked its ability to provide a cost-effective service (e.g. at historically-lower than continental cost). At the same time, glib talk of improving patient (i.e. consumer) power via market (or pseudo-market) reform is actually achieving the exact opposite!

I don't have the answers, but I'm very clear on one thing: [i]Daily Fail[/i] "journalists" should be made to work on the wards. 😈

I think we could provide a far better health service for much less if we start with a fundamental paradigm shift - moving towards preventative approaches as opposed to the modern decadent mindframe which too often expects a nanny state to fix things - you can't eat crap all your life take no exercise and remain spiritually redundant and make it through life without issues - But whilst the NHS is joined at the hip with Big Pharmaceutical industries a more mindful approach doesn't seem feasible.. Yes state provision of healthcare is a model all societies should aspire to - But not at the expense of negating individual responsibility.. Case in point I was once referred for physio due to a recurring knee pain - I was eligible for 10 sessions - but all the exercises they 'taught' me I could and did learn of my own back - So obviously those physio sessions were a waste of money ..

In the sense of it not being NHS covered

Moving towards preventative approaches as opposed to the modern decadent mindframe

It's been moving towards preventive for many years now.

The Tories are destined to destroy the NHS as it stands, only those with wealth will be able to afford the basic healthcare.

how come a moderator is allowed to make a politically opinionated statement like this?

Is this the view of Singletrack magazine - maybe you should use a different account to make such statements, or a different account to moderate from ?

If you mean how do we cover the cost of an aging population. I think there is stuff to be done in terms of intergrating health and social care.

But ultimately the costs are going to be big and similar amount whether it is funded by tax, families or both. For me it's a question about what sort of society we want.

Personally, I think the tax route is most efficient and certainly most fair, but there has to be some recognition of wealth wrapped up in assets (houses basically) if we go fully funded care via tax route.

In the sense of it not being NHS covered

I take it you're talking about the social care of dementia patients on a daily basis not the treatment of it. Tough one that but the NHS doesn't really take social care of many conditions on a daily basis though does it, so why should dementia be any different. Social Services is responsible for daily care.

how come a moderator is allowed to make a politically opinionated statement like this?

Ermm! Because it's not against the rules.

how come a moderator is allowed to make a politically opinionated statement like this?

Yes, I mean won't somebody think of the impressionable children.

Drac is a senior Paramedic - as long as he defers to the nursing staff, he can say whatever he likes. 😀

Social Services is responsible for daily care.

Ironic how the buzzword is always "integration" - and yet services are becoming increasingly fragmented.

how come a moderator is allowed to make a politically opinionated statement like this?

Is this the view of Singletrack magazine - maybe you should use a different account to make such statements, or a different account to moderate from ?

Get over yourself darling.

Drac is a senior Paramedic - as long he defers to the nursing staff, he can say whatever he likes.

Hahaha! I wish. As a Paramedic I have to be very careful what I say on public forums. Oh and less of the Senior.

"Tough one that but the NHS doesn't really take social care of many conditions on a daily basis though does it" - I actually don't know, can you give me some examples.

Also maybe I should have asked - should people have to pay(somewhat complicated rules/means tested etc) for social care but get 'medical'(word possibly used incorrectly) care *free* at point of usage

Fantastic clip from Drac,I had the same model and age as Harry Smith, he was my dad.He went through similar things and always believed in the NHS.

The NHS was fought hard to get and maintain, with free treatments for all,even some that should be privately funded.

But what we need is a root and branch examination of every aspect ofthe NHS, to reduce costs and management staffing,if youre ill you need a nurse dr or therapist, not an acountant counting how many bandages you have used, also with more sharing of responsibilities, more cross training in skilled jobs and less job demarkation in lots of departments, same as has happened in lots of indusries uk and world wide,instead we have empire building, and splitting off of units and departments to make easily sold ready made and fully equiped and staffed companies, same as happened to British Rail.

Please support your NHS, say thank you to the staff, attend rallies,make sure your mp knows you want a fully funded and free NHS.

The most telling sign that the Tories are privatising the health service is the competition rules.

That's right, state providers have to compete with each other.
Massive improvements provided by collaboration between services are now not permitted.
Departments whose skills are in treating patients rather then marketing are forced to waste time tending for contracts.

Competition always driving efficiency is ideological bullsh!t.

The only concern of the current government is that not enough of their mates are getting rich out of UK health provision!

I actually don't know, can you give me some examples.

MS, Stroke Patients, Heart Disease, Paraplegics the list goes on.

Also maybe I should have asked - should people have to pay(somewhat complicated rules/means tested etc) for social care

You can get an awful lot of social support but you're right it is means tested, not sure about that one though if it's right or not. However you can get a great deal of Social support no matter what you circumstances.

Perhaps an element of insurance and insurance assessment would be a good idea - if someone makes the conscious decision to live an unhealthy lifestyle and 'eat all the pies' and not exercise, why should everyone else pay for the risks they are taking ?

Administration would be a nightmare though, so maybe the only answer is taxing sugary foods, etc?

less of the Senior

OK, "Drac is a Paramedic of respectable age & experience." 😳

The political football thing is only get worse - especially if the public aren't convinced by service re-configurations (even if undertaken for sound reasons - e.g. consolidation of acute care, "all-in-one-place" etc). We already have MPs voting for one thing in the Commons, and then opposing such changes in their own constituencies. 🙄

Competition always driving efficiency is ideological bullsh!t.

As epitomised by CMD waving around a [url= http://www.allysonpollock.com/?p=98 ]pretty dodgy LSE paper[/url] as justification for the re-org clusterfug (IIRC, the paper mis-handled data on acute MI). In short, it will never be like going to the supermarket.

Unfortunately, Monitor is now full of seconded suits whose job it is to enforce the ideological BS... regardless of reality!

OK, "Drac is a Paramedic of respectable age & experience."

😀

We already have MPs voting for one thing in the Commons, and then opposing such changes in their own constituencies.

It'll never change.

Perhaps an element of insurance and insurance assessment would be a good idea - if someone makes the conscious decision to live an unhealthy lifestyle and 'eat all the pies' and not exercise, why should everyone else pay for the risks they are taking ?

So only the sporty types should get free health care. Why should the pie eaters have to pay tax for you fall of your bike and break you arm?

I'm sure Harry Smith is a good Labour chap but his analysis is utterly wrong. The NHS is a minor player in the improvements seen in health over the last 80 years; new drugs, technology, improved living conditions etc have all played a much bigger role.

We are ending up with a 2 tier system regardless as more and more private companies take out medical insurance for their employees. The NHS won't last as it is for another 20 years regardless of who is in power.

I've worked with kids on welfare in the USA, the NHS is in a different league

The NHS is a minor player in the improvements seen in health over the last 80 years; new drugs, technology, improved living conditions etc have all played a much bigger role.

And you still don't pay for them thanks to well the NHS which is also one of the big researchers for such things.

**** hell jambo could you be any more stupid?

It should be remembered that parties of every colour have a long and proud history of radically reorganising the NHS on approximately a five-year cycle.

After Miliband's speech there where some stats put up which showed that likley increases in NHS costs over the (5 or 10) years Milliband quoted as his horizon would be £30bn yet he thought £2.5bn was somehow going to "save the NHS"

The moderators can say what they like, frankly given the time and effort they put into this place they have more right to do so than the rest of us.

@Drac when I bust my knee the hospital visit cost about £20, each time I saw a special knee surgeon it was about £50, the MRI scan was £200 and I had it immediately at my request not months later after pestering a UK GP, the physio was £25 a session. All of this (ex hospital) was in Paris, ie expensive for France. Even if you double these amounts to reflect UK wages I still think it's good value and had I had health insurance I could have claimed it. BTW under the EU rules I am supposed to have been able to claim from the NHS but they declined my claim.

I am very much in favour of a strong well funded NHS, I think many of us here could afford to pay private/state top-up health insurance, the French do and they pay much higher rates of tax on lower wages. The insurance makes payments to the state hospitals/doctors not to private hospitals.

new drugs, technology, improved living conditions etc have all played a much bigger role.

And where do you think these new drugs, technologies and drive to improve living standards were conceived, tested, refined, trialed and implemented ?

Fine, but the NHS takes a lot of running and overhead and management costs in the NHS are some of the lowest in the, precisely because it is tax funed and payment systems are elatively simple.

Using your example, do you want nurses counting and ordering stock, or nursing. I'm not saying there aren't examples of aministrative inefficiency, but you need to be careful what you wish for. One of the big arguments of the right is that the NHS would be much more efficient if managed by private sector and driven by profit incentives.

I've worked with kids on welfare in the USA, the NHS is in a different league

Administration would be a nightmare though

It's partly why the [time/financial] costs of insurance systems can rocket. That's not to say that robust, "fair" (i.e. non-exclusive, comprehensive cover) systems can't be made to work a la the continent... but I'd say the current lot are more interested in opening the NHS up as some kind of new commercial frontier, with smooth talk of [i]"patients don't care who provides the care, as long as it's excellent"[/i] - er, except that many of those "willing providers" seem to be passing the buck back to the NHS.

Is medical insurance like any other insure?

i.e. its gerat if you never have to use it, or only use it once. But if you're unfortunate enough to have to make a couple of claims your premiums go through roof, even if you can get someone to sell you a policy.

And we are all going to need to make a claim under some sort compulsory health insurance at some time.

I just can see how it fits in with providing long term quality health care. Particulalry into old age.

Please support your NHS, say thank you to the staff, attend rallies,make sure your mp knows you want a fully funded and free NHS.

Careful what you wish for, that would bankrupt the Uk.

There has to be a stop point as to what is funded/not funded.

Even over the last 10 years it is now quite amazing what you get for 'free' on the NHS.

Social Care and Health are very closel linked. The NHS has for some years now been trying to change eating / drinking habits, with very little sucess.

So only the sporty types should get free health care. Why should the pie eaters have to pay tax for you fall of your bike and break you arm?

well that is not what I said, is it?

I never implied having to partake in a sport to stay healthy, just that why should people who make an effort to remain healthy pay for the deliberate risks taken by someone who decides to overeat and become obese?

If I were to pay insurance and be assessed on risks, then the risks I am taking by using my bike would be taken into account.

[i]We'll never agree then if you think that is better. [/i]

Oh dear. It's Drac's way, or no way. Not that Drac is biased or anything.

Bottomless pit into which our money disappears under the threat of emotional black mail, should anyone speak out about the mind boggling mountains of cash the NHS consumes.
Yet nay a word from the experienced on how the NHS could do better with the money it already receives.
And are we paying for NHS employees to sit at a computer and stir things up on a cycling forum ?
Shouldn't such types be doing something more career related while on shift ?

The job is the job, do it and stop the belly aching. Or find alternative employment.

[i]If I were to pay insurance and be assessed on risks[/i]

Including genetic ones?

Personally i think that the NHS is one of the best things we have in Britain. Without it you can only imagine the suffering that a lot of people would go though.

Having spent some time in a hospital recently and visiting its changed a great deal from when i was a lad from what i could see from the outside. I have no idea how things work there but from what i saw and experienced at both the NHS level and privately shocked me. A lot of the people just didn't care anymore. It was just a job to go to and get a wage. They had little consideration of patient care at all. Infact in Sheffield my mother (an ex ward sister) actually ended up doing some of their jobs for them as the nurses were not capable of doing them properly. In Barnsley we had to stop one nurse from giving a double dose as she hadnt read the notes! it was poor imo for what was once a world class service.

Anyhow i think that this has crept in because the nurses themselves are not valued as a profession. Why should they bother if no one is looking after them. The amount of uncertainty cant be good for morale? these guys need a massive shakeup at top management level, get it run like a proper business instill trust back in the job for both the patients and the nurses and tax us more if it needs it but just don't bloody privatise it else it wont be long before we cant afford the proper care and then what do we do?

my 2penneth.

wwaswas - Member
If I were to pay insurance and be assessed on risks

Including genetic ones?

Turneyguy. The reason you have to pay for those who do not exercise, drink etc is because the electorate keep returning Governments who support tax funded NHS. Other electorates in other countries make different decisions. Democracy - after a fashion anyway...

Including genetic ones?

there are some risks that I can control and some that I cant.

So morally you can easily say no to genetic risk assessment, whereas it would be fair to make risk assessments based on lifestyle choices.

And you still don't pay for them thanks to well the NHS which is also one of the big researchers for such things.

You do pay for them through taxes.

And where do you think these new drugs, technologies and drive to improve living standards were conceived, tested, refined, trialed and implemented ?

The reason the were trialed for the UK market in the NHS, is there isn't really anywhere else. You think that the Fence, Germans, Yanks etc don't bring new drugs and tech into their hospitals?

Shouldn't such types be doing something more career related while on shift ?

Yes, I mean right now I could be eating a big box of quality street at the nurses station, whilst taking a selfie. Actually, seeing as it's my day off - I should be on my bike.

The job is the job, do it and stop the belly aching.

I've been a nursing auxiliary, on and off, for the best part of twenty years - I'm not belly-aching about [or scared of] "the work". The issue is a sh1te set of reforms - reforms which are actually [i]wasting[/i] money the NHS "already receives". What's doubly stupid is that this effectively counters existing efficiency measures (e.g. the infamous Nicholson challenge) - not to mention having to re-hire staff due to poorly considered redundancies, etc.

this has crept in

Poor care follows burn-out follows poor morale, as sure as night follows day. That's not to excuse neglect, of course - but if you read the Francis Report, the wards concerned were in free-fall. Paradoxically, the actions of some of the nursing staff attempting to hold the line were nothing short of exemplary.

Although there are issues re the "correct" numbers of staff (e.g. there's different levels of acuity/dependency), the single biggest improvement would be better nurse:patient ratios on general wards.

Bottomless pit into which our money disappears under the threat of emotional black mail, should anyone speak out about the mind boggling mountains of cash the NHS consumes.
Yet nay a word from the experienced on how the NHS could do better with the money it already receives.
And are we paying for NHS employees to sit at a computer and stir things up on a cycling forum ?
Shouldn't such types be doing something more career related while on shift ?

The problem with BS right wing speak like this is that it never listens to the evidence. The evidence being that the NHS is the 2nd most cost efficient service in the world.

he reason the were trialed for the UK market in the NHS, is there isn't really anywhere else. You think that the Fence, Germans, Yanks etc don't bring new drugs and tech into their hospitals?

The NHS does research that biotech companies are not willing to do as they don't see en economic incentive, eg rare disorders.

[img] [/img]

[i]there are some risks that I can control and some that I cant. [/i]

They could test you and your choice of partner when having children and assess the risk of any inherited conditions or predispositions and then charge extra for insurance of both partners to cover possible extra costs associated with their children. Who you choose to have children with is a lifestyle choice?

Drac when I bust my knee the hospital visit cost about £20, each time I saw a special knee surgeon it was about £50, the MRI scan was £200 and I had it immediately at my request not months later after pestering a UK GP, the physio was £25 a session. All of this (ex hospital) was in Paris, ie expensive for France. Even if you double these amounts to reflect UK wages I still think it's good value and had I had health insurance I could have claimed it. BTW under the EU rules I am supposed to have been able to claim from the NHS but they declined my claim.

Colleague is off at the moment having a busted knee repaired, he didn't wait months and it's cost him 100% less.

And are we paying for NHS employees to sit at a computer and stir things up on a cycling forum ?
Shouldn't such types be doing something more career related while on shift ?

I'm not at work until tonight so might want to try harder with your trolling.

Yet nay a word from the experienced on how the NHS could do better with the money it already receives.

Scarp pointless target, scrap PFI, scrap procurement there's plenty that can be done but that's not the discussion here is it. Of course you didn't look at that you just waded in looking to start an argument.

Have to admit I'm always bemused by statements such as "The Tories are privatising the NHS" as many people who say things like that mostly seem to work on the principle that saying it enough times actually makes it so.

If we take a step back and look at what's really going on, there are several forces at play

1.The move from secondary to primary care (enabled partly by technology and advances in medicines that mean fewer things are treated in hospital, and of those that are, less time spent in hospital for recovery)
2.A rapidly ageing AND rising population who are putting a lot more pressure on Primary Care
3.The urgent need for a step change in Leadership, Culture and Patient Outcomes in the NHS so that the experience isn’t a complete lottery depending where you are in the country and things like the Mid Staffs don’t get covered up / no-one being held accountable
4.The move to more GPs working part time / retiring early following their massive increase in pay 10 years ago and end of night-time responsibilities
5.The urgent need to improve the patient experience by joining up Health & Social Care.

Both of the first two forces really require a change in prioritisation of funding from Secondary Care to Primary Care. Pretty much every analysis done over the last 15 years shows that fewer beds are needed in Secondary Care than we currently have, and that clinical outcomes typically approve fastest when specialties treat a higher volume of patients i.e. you get better results when the Hospital Consultant treating you spends most of his / her time treating patients with that condition rather than doing it a few times a year.

Most of the NHS Secondary Care budget after staff is tied up in buildings and estates - so in order to make more money available to Primary Care where the demand is greatest there needs to be a commensurate reduction in the size and number of hospitals to meet the current level of demand. Many of the 150+ hospitals we have now are too old and cost too much to run now that patient volumes have fallen not to mention are pretty depressing places to work for staff.

As we've seen many times recently, very few politicians are willing to be honest about the shift that's required so they generally support efforts by the public and staff to resist the necessary changes with the consequence that the NHS is stuck in limbo with GPs effectively under siege and hospital utilisation continuing to fall, wards mothballed and patients with treatable illnesses getting very hit and miss care.

As for the public / private point, Primary Care has always mostly been private even if Labour and the Trade Unions would have you believe otherwise. Where "Privatisation" has actually taken place it's actually pretty limited in scale if you set aside the wave of very poor PFI deals completed under the last government. From memory around 5% of the total NHS budget is now allocated for external provision but importantly, the providers aren’t all “private” – they include the likes of MacMillan and other charities for cancer care and Bupa for some diagnostics / imaging.

The level of private activity hasn't changed much year to year under the current government so despite the amount of noise that vested interests make, the facts don’t really support the argument that the Tories are trying to destroy the NHS, not least as they have protected it from spending cuts, something that Alistair Darling refused to commit to in his forward look just before the last election.

If we also look at what type of private activity has taken place the facts are pretty interesting:

- Independent Sector Treatment Centres – were set up under the Labour Government to create a “challenge” to NHS Trusts and force greater competition and reduce waiting lists. They were very successful in that regard.
- Alternative Providers for Primary Care Services – were set up by the last Labour Government and overseen by Tony Blair’s healthcare advisor and staunch “Blairite” Simon Stevens. He’s recently started as the new NHS CEO so hardly a sign that the current government are taking a different approach to Labour.
- Tendering for things like Pathology Services also started under the last Government.
- Takeovers of failing Trusts by "private" management teams (like the arrangement at Hitchingbrooke) was enabled by regulations laid down under the last parliament.
- Transfer of GP night time responsibilities to companies was completed under the last Government and contributed to many of the current problems with continuity of care

It’s always interesting to hear Andy Burnham re-writing history when he’s interviewed as the timing of many of the “privatisation” activities go firmly back to his door when he was Secretary of State for Health, not that he would ever admit this. Interestingly in his speech this week he made a case for Hospitals to drive the integration with social care but many would say that this will only make the current problem worse as what’s really required is smaller Secondary Care, and more investment in seamless Primary Care / Social Care.

Finally, to the original point, if the Tories were really trying to privatise the NHS they would probably have done a lot more than just maintain a similar scale of private sector activity to the last Labour Government – if they were as evil as people claim wouldn’t they have by now copied the approach taken by Labour when NuLab effectively dismantled NHS Dental care and moved it to a service that most people now expect to pay for?

Bottomless pit into which our money disappears under the threat of emotional black mail, should anyone speak out about the mind boggling mountains of cash the NHS consumes.

It has been argued that as societies develop they spend a bigger proportion of GDP on health systems (of whatever sort). On a per unit basis, the NHS is actually cheaper than the US system.

Personally I don't have a problem with this, as our standard of living increases, we demand better and better health care.

Solo, are you the milk conspiracy therory guy?

Just saying.

[url= http://www.nytimes.com/2014/09/21/us/drive-by-doctoring-surprise-medical-bills.html?_r=0 ]NY Times: After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know[/url]

You do pay for them through taxes.

Yes I know that.

This is the OECD's breakdown of health costs as a percentage of GDP and further split by private/public. UK seems to be a relatively low spender, tbh.

[img] [/img]

They could test you and your choice of partner when having children and assess the risk of any inherited conditions or predispositions and then charge extra for insurance of both partners to cover possible extra costs associated with their children. Who you choose to have children with is a lifestyle choice?

By extension, it is.

What makes people attractive at a basic level - it is either because they look like good providers for your offspring, or they look like a source of good genes for your offspring, both increasing the chances of your offspring surviving.

your're right wwaswas - the spend on healthcare isn't as high as some other countries but several bits of data are missing so it's not as clear cut as the graph suggests:

1. We now spend 50.5% of GDP on the public sector compared to c45% in 1997.
2. We spend more on the NHS than everything else in the public sector put together i.e. we're spending more and the NHS is taking a bigger share of the increased spend but the trend clearly isn't sustainable
3. The spend on the NHS is net of parallel spend on social care - which in some of the examples above are included
4. The total healthcare costs for other countries e.g. USA, Netherlands, Germany include the cost of retirement benefits. The NHS annual budget does not include this and will rise to c30% of the total budget over the next 15 years - making the NHS much more expensive than most other health systems and about the same cost as the USA.

The evidence being that the NHS is the 2nd most cost efficient service in the world.

I'm not sure where you read that but looking from the inside out, I very much doubt that!

This is the OECD's breakdown of health costs as a percentage of GDP and further split by private/public. UK seems to be a relatively low spender, tbh.

I genuinely don't understand how anyone could look at that graph and conclude that our health provision should be more like the US model.

Unless of course they had some dogmatic ideological attachment to privatisation...

[i]We spend more on the NHS than everything else in the public sector[/i]

nope.

NHS 105bn, Work and Pensions 160Bn. Not the most recent data but it won't have changed by 50%.

[url= http://www.theguardian.com/news/datablog/interactive/2011/oct/26/public-spending-uk-government-department ]http://www.theguardian.com/news/datablog/interactive/2011/oct/26/public-spending-uk-government-department[/url]

The NHS does research that biotech companies are not willing to do as they don't see en economic incentive.

That is missing the point, the point is that improved drugs e.g. antibiotics and imaging techniques like X-rays, ultrasound and MRI, have all had big impacts on healthcare and had very little to do with the NHS. If the NHS was as wonderful as claimed you'd expect to see an increase in things like life expectancy in the UK over similar countries over time but you don't.

irony is that large US corporations rely on the state to subsidize their employees health care;

[img] [/img]

I wish they'd let him do that with notes instead of the bloody awful and insincere auto-cue. No one should ever use them unless they are very very good at it and no one is aware they are using it. And it also felt like they'd got a speech writer to improve his words, again it takes away from the message.

I want to live in a country that looks after everyone when they are sick or hurt or they are old, and if that means spending my money on **** ups as well as the "deserving" then I'll give it equally willingly to both. Life can go horribly wrong for any of us at any time, non of us know if it'll happen to us, but if it does for me or any of you then I want to know that something will be there to help us through it.

As for who will make a better job of making sure that exists I'm not sure I know.

Takeovers of failing Trusts by "private" management teams (like the arrangement at Hitchingbrooke) was enabled by regulations laid down under the last parliament.

Given both the franchise terms & DoH's [arguably special] treatment of Hinchingbrooke, it's hard to view it as anything but a kind of stalking horse for Circle and their backers... not that it's necessarily working out for 'em, despite the media PR rubbish.

As for the general point - if it looks, walks, talks like a duck, etc etc. Services are being commissioned from the private sector with an NHS "in-partnership" kitemark, left, right & centre. It's a big jump from ye olde GP practice to, say, Virgin providing community nursing (though could anything match Serco's frankly spectacular effort at providing OOH cover in Cornwall?) And, again, the reality is that the big corps will seek to win contracts by bidding artificially low & then cutting back - Care_UK being a prime example. None of this - despite the political rhetoric - is putting the patient at the heart of decision-making, or (even more laughably) "putting doctors in the driving seat", as I seem to remember [endlessly] hearing.

And yes, NuLav set much of this in motion - aided by a veritable army of Blairite advisors, many of whom are still hanging around. But that doesn't change what's happening... besides, there's not much difference between Red and Blue teams (or their acquiescence to lobbyists).

They were very successful in that regard.

As long as your definition of successful doesn't include "dealing with anything tricky and/or post-op complications"...

I genuinely don't understand how anyone could look at that graph and conclude that our health provision should be more like the US model.

Unless of course they had some dogmatic ideological attachment to privatisation...

NHS 105bn, Work and Pensions 160Bn

The NHS figures are for England alone, once you factor in the devolved regions it is just shy of 130bn.

Its the Tories opponents who are trying to label NHS reforms as privitisation,

No one in their right mind would want a system more like the American one. Sky high costs to the user, a tendency to over medicate and huge costs to the government as well due to the admin costs in administering medicare. It's a ****ed system.

The NHS, while not perfect, is really very good. Anything that could threaten the free at point of use principle on which it was built should be given a very wide birth.

Given the usual pattern for privatised services, I think we're right to view the increasing use of private companies providing the services that they're being encouraged to supply with great suspicion. It's the thin edge of the wedge and when the NHS can't compete because it's been de-skilled it'll be used as the argument for properly privatising the whole thing.

and when the NHS can't compete because it's been de-skilled it'll be used as the argument for properly privatising the whole thing.

[Regulatory body] Monitor is packed with management consultants and big group accountants - it's not hard to imagine that kind of conversation... in that respect, I hope the CQC doesn't end up becoming a blunt tool.

[url= http://myemail.constantcontact.com/Delighted-to-help-him.html?soid=1102665899193&aid=z4cWsb5bPWo ]"The Machiavellians will say it is part of a sinister plot to soften the NHS up... sell it to the private sector. I would have refuted that. Now, I'm not so sure."[/url]

[i]The NHS figures are for England alone, once you factor in the devolved regions it is just shy of 130bn. [/i]

so still less than work and pensions?

@Drac when I bust my knee the hospital visit cost about £20, each time I saw a special knee surgeon it was about £50, the MRI scan was £200 and I had it immediately at my request not months later after pestering a UK GP, the physio was £25 a session. All of this (ex hospital) was in Paris, ie expensive for France. Even if you double these amounts to reflect UK wages I still think it's good value and had I had health insurance I could have claimed it. BTW under the EU rules I am supposed to have been able to claim from the NHS but they declined my claim.

you see this is why Jambo

I fell off my bike, was seen at a hospital, no charge, saw a consultants, no charge was sent to physio, no charge, physio didnt work saw consultant again on the friday, had surgery on the tuesday, no charge, had more physio, no charge, went to see consultant again told when doing op they found a snapped acl, no charge, had surgery to repair acl, no charge, now seeing physio again still no charge. How much would all this have cost if I was in France and didnt have insurance?

and my bike didnt cost a grand, the ****ing thing!

although I do concede my 6 operations on my legs in the last 8 years are likely to be the major cause of the NHS being broke... sorry