[Closed] Why should we save the NHS?

This is one example of "Privatisation" - very few people step back and think about what was happening before the change which was 15+ years of constant changes / pay offs to the Senior Management Team who by all accounts failed to turn round the trust or deliver good healthcare to the local population:

[url= http://news.bbc.co.uk/democracylive/hi/house_of_lords/newsid_9636000/9636182.stm ]2012 - A financial and clinical basket case[/url]
[url= http://www.bbc.co.uk/news/health-17936745 ]2012 - step change in performance in a matter of months[/url]
[url= http://www.cambridge-news.co.uk/Quality-Hinchingbrooke-Hospitals-care-isbest-country/story-22368467-detail/story.html ]2014 - delivers best care in the country[/url]

If a new team can take the same staff, same buildings, same level of spend and very quickly improve outcomes and patient experience, is this really such a bad thing?

Does it make sense to incentivise a team to do drive a rapid improvement but levy penalties if they fail, rather than continue to use a changing cast of NHS senior managers who effectively get paid off whether they succeed or fail - with one off "early retirement" pension contributions well into the £million+ range...

And what's best for the patient? Sticking to the "public" model that at Hitchingbrooke exposed them to a significant risk of serious untoward incidents / mistakes in routine care or recognising that the most important thing to patients is good care and making a rapid change to turn things round?

If Hitchingbrooke was our local hospital, would we rather that our families and loved ones get treated by a hospital that has caused avoidable injury and suffering for many years, or go to a hospital that costs the same to run but now offers excellent clinical outcomes and first rate patient care? Is the principle of "managed by the state" more important than the impact on real people?

so a "healthcare consultancy" decided they were great?

And what's best for the patient?

What you're doing there is conflating private delivery with good care. There's no rule that says that has to be the case.

There are four options:

Bad public care
Good public care
Bad private care
Good private care

Which is best now?

so a "healthcare consultancy" decided they were great?

Not only that - a "healthcare consultancy" (CHKS - organiser of said awards-dinner) owned by outsourcing firm Capita - themselves partners with Circle in a joint venture to bid for NHS contracts!

The Hinchingbrooke "award" was spun in very, [i]very[/i] misleading fashion - it's nonsense to claim (as the [i]Daily Failograph[/i] repeatedly did) that it's now "the best hospital in the country for patient care". There was also no mention of the terms of the franchise (inc elevated levels of DoH support), no mention of acuity/casemix (i.e. Circle not having to deal with complex stuff - whereas, say, Addenbrookes has to) and no mention of how Circle's cosy "employee co-op" image glosses over its somewhat opaque financial structure.

In fact, the media BS was such that one might almost suspect an orchestrated campaign.

Edit: right, I really do need to get out on my bike. 🙂

@aa I am glad it worked for you. When I tried to see my doctor it was a 3 day wait and then no certainty as to when I could get to see a specialist. My experience with NHS provided physio was that the process was a nightmare and they did all they could to stop the treatments. The other thing I love about the French system is you have to have a French Carte Vitale ("NHS ID" card) or you have to pay in full upfront. Such a system would cut out a lot of abuse of the UK system.

noteeth - Member

And yes, NuLav set much of this in motion - aided by a veritable army of Blairite advisors,

Like they said- tories.

French system is you have to have a French Carte Vitale ("NHS ID" card) or you have to pay in full upfront. Such a system would cut out a lot of abuse of the UK system.

What abuse is that then that you need identify yourself to get care discounted?

anagallis_arvensis - Member

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 **** thing!

That's good, but I could run off probably 10 stories from my friends and immediate family about having to wait months for simple procedures, being constantly and repeatedly fobbed off by GPs, inedible food and poor cleaning in hospitals, relatively minor issues becoming serious even life threatening due to repeated failures in care, never mind being able to get an appointment for the doctor or finding an NHS dentist.
I reckon most people could do so too if they have a proper think about it.

I don't think we need major reform though, for the most part it is very very good; more just a careful look at why the same old failures crop up again and again.

I could ream off 100s of stories of people who have received exceptional care in the NHS, sadly you're right and know of a few who haven't. This won't any difference if you pay at source the care itself may not be any better.

I don't think we need major reform though, just a careful look at why the same old failures crop up again and again.

Very much this.

None of the above is a good reason for getting rid of the NHS. They are reasons for improving it.

The best reason for keeping it? We pretend we are a civilized culture,

I'd like to understand how many (particularly of the NHS detractors) have experienced other country's healthcare...
it's a bit of a wake up call to hear that medicine a) costs x (still more than an NHS prescription) and might work but b) is extortionate but [i]will[/i] work

Yes the patient care is great but then nurses aren't overloaded with admin and get paid a proper wage commensurate with their education and training (rather than getting overlooked because it's viewed as a 'vocation' and they refuse to strike)

AFAIK we are not proposing the US system, my comparisons have been to France.

Which is also worse than the UK's system.

With the way private costs are going, private healthcare is going to collapse in the west when people realize it's cheaper to have a holiday and get on a plane to India to get the same treatment.

That or your insurance companies are going to start flying you half way across the world to die.

That's good, but I could run off probably 10 stories from my friends and immediate family about having to wait months for simple procedures, being constantly and repeatedly fobbed off by GPs, inedible food and poor cleaning in hospitals, relatively minor issues becoming serious even life threatening due to repeated failures in care, never mind being able to get an appointment for the doctor or finding an NHS dentist.

retro, my point wasnt that it was all great and that the nhs doesnt need help just that it was free and I was helped. If I was in France it would have cost a fortune.
A month or so I took my dad to hospital for surgery on a brain tumour. He's pretty ****ing ill and we had to wait from 7 am till 1.30 in a waiting room until some ****ing bed manager arrived to tell us she couldnt ****ing manage beds and we had to leave, dont call us we'll call you. Had to wait another 2 weeks till his op took place so I hear where your coming from. I dont think the nhs would improve if people had to pay. We have the money just not the will to spend it in that way.

[i]I could ream off 100s of stories of people who have received exceptional care in the NHS[/i]
Again, biased opinion, born of a conflict of interest. The Care wasn't "exceptional" it's what should be considered the norm, for the cost to the nation.
When / how did someone think that when service is good, the customer is lucky and when it's poor, it's due to a shortfall in funding.
This is why threads like this one serve no useful purpose, they are, just a thinly veiled political argument. We might as well revive the milliband thread, started earlier this week and just duke-it-out, left Vs right.
🙄

Alternatively, to selectively quote another [i]contributor[/i] to this forum.
[i]Cougar - Moderator
[s]the two main reason you will have had it done are either
A> a medical reason
B> belief that it is a sensible thing to do to prevent medical problems
You missed religious / tradition reasons, which I'll bet my own foreskin is the main reason the vast, vast majority of people have had it done ([/s][b]whiny white middle-class cockbag STW skewed demographic aside[/b]).
[/i]

The NHS might be able to remove that chip on your shoulder Solo.

When / how did someone think that when service is good, the customer is lucky and when it's poor, it's due to a shortfall in funding.

No, sometime it's down to crap staff amongst other reasons.

We might as well revive the milliband thread, started earlier this week and just duke-it-out, left Vs right

I love the NHS and so does everyone but the very right wing IME. Its not really a political issue, everyone loves it, unless you adhere to a hatred of the state / insistance that private is better at everything.

One of the few things we can all be trully proud of

To all of you who work such long hours, for shit pay with few thanks from the bottom of my heart; thanks you for all you do for the people of this country

I salute every last one of you

to those who think the pursuit of profit will improve this have a word with yourself and then read this - its both better and cheaper at least one of those should make you happy.

IMAGE.GUARDIAN.CO.UK "http://image.guardian.co.uk/sys-files/Guardian/documents/2011/08/07/JRSMpaperPritWall.pdf"

IN clinical terms the NHS is one of the most cost effective systems there is and the US the least

If you're employed you pay Class 1 National Insurance contributions. The rates are: if you earn more than £153 a week and up to £805 a week, you pay 12% of the amount you earn between £153 and £805. if you earn more than £805 a week, you also pay 2% of all your earnings over £805.

This is why threads like this one serve no useful purpose, they are, just a thinly veiled political argument.

"Thinly veiled" ? The first line of the first post which kicked this thread off was : [i]The Tories are destined to destroy the NHS as it stands.[/i]

It's hard to imagine a more obvious and blatant political statement.

And the embedded video in the OP was of a political speech made at a political party conference.

I can't see anything that's thinly veiled.

Alternatively, to selectively quote another contributor to this forum.

Wow, seriously?

[url= http://www.google.co.uk ]This site[/url] might help.

The NHS is a great institution, but it's not free at the point of delivery - dental, eye care, prescriptions, the common stuff that most people use - are often paid for privately. Which is fine if there is adequate provision for those who can't pay, and it protects funds for other non-routine problems.

The genuine problem that needs to be addressed is how will the NHS - and despite being fairly right wing, I don't want to see it abandoned - continued to fund a growing range of (often expensive) treatments for an ever growing number of (previously untreatable) conditions with an increasingly large and eventually frail elderly population.

I don't know what the answer is. I do know I want the NHS to concentrate on providing frontline services and not fat cat salaries to chief executives, but I don't know how something the size and complexity of the NHS can be run without the mechanics of the bureaucracy swallowing quite a bit of the budget.

I don't know if tax rates and collection levels can keep going up and pay for all the extra costs and treatments. I'm not totally averse to the idea of some sort of insurance scheme for those of us engaging in dangerous activities. (Is there still an element of NHS costs recoverable under car insurance for accident treatment?) But again, there needs to be provision for those who haven't or can't pay.

The alternative is some sort of rationing, or a decision as to at what point a persons condition and/or treatment would make it better for them to be "put to sleep". We do it for pets, why would we not do it for ourselves? Logically, it seems fine, but realistically no one would want to agree to that for a parent, partner or child.

Is it a circle that can never be squared?

We don't seem to be able to have a debate about the NHS without everyone jumping on their own particular party political bandwagon and shouting at each other. Which isn't very helpful.

As I understand it, we have an ageing population and an increasingly obese population - one of these is just an unavoidable fact of demography and the other is more complex but could have been avoided.

Either way - this increase in poor health means the NHS in its current form of funded by the taxpayer and free at point of delivery, surely needs more funding. At a time when we're mired in debt and there's little scope to increase taxes.

Therefore reform is 100% necessary - there's a serious an unavoidable problem which needs dealing with.

Private healthcare is also in a poor financial state which shows you it's more than just an NHS problem - Bupa have had major problems with falling profits as the cost of treatment is running so far ahead of what their customers can afford to pay.

I've no idea how I think it's best done to be frank, but a few years ago when I found myself repeatedly in hospital from falling off my bike (3 operations in total) I noted that the rest of the country were paying for it, despite it being the result of my own actions. I'm not sure that's fair really, not when the service is under so much pressure.

Don't know how you do it but step one is make the NHS cross party - I..e not run by governing party alone - many things are done to win votes and little else,

Step two - we need to decide as a society what it should cover, eveything for everyone for free is not sustainable. Some hard choices need to be made.

The NHS does many great things, it also gets some wrong. That is real life and sadly always will be.

For a different perspective watch the TED talk - doctors make mistakes

if it is underfunded why is reform 100% necessary ?
There seems no obvious link there tbh.

It just needs ore money

There are several problems with the insurance for dangerous activity idea.
(1) What is actually dangerous - who is to say that mountain bikers are a net risk to the NHS. I exercise because I have a genetic propensity to high blood pressure.

(2) What do you do with those who don't have insurance - make them pay cash and don't treat them if they will not. Clearly not we are not going to see rugby players stacked up in A&E because they can't pay. They would just be treated - so why get insurance. It is done for road traffic accidents because vehicles have compulsory third party insurance - but they will still treat uninsured drivers...

(3) It would raise peanuts - just look at the total cost of acute trauma compared to total NHS pot - then take out all the RTAs and stuff that wouldn't be covered

(4 Now this is important - IT WOULD STILL COST THE SAME - actually it would cost more, as it is would be a nightmare to collect. It would just be some degree of cost shifting from taxpayer to individual.

If there is an insurance system risky activity is not the way to go, it would need to be much wider to have any impact - BUT IT WOULD STILL COST THE SAME - and unless anyone believes it is ok for people who cannot afford to pay to not receive treatment then it would still cost wealthier people more as it would be tax funded for those that could not afford and insurance funded for those that could. In what way is that more efficient than tax funding.

If there is a call for not treating poor people because they can't afford insurance ... well it is a choice - but fortunately it isn't one that the electorate seen to be likely to make soon

NHS - 70%
Private health care - 30%.

How's that?

😀

But why? What incentives would the 30% insurance drive that would reduce the overall costs of healthcare. If none then I don't see the point

continued to fund a growing range of (often expensive) treatments for an ever growing number of (previously untreatable) conditions with an increasingly large and eventually frail elderly population.

Hmm. With advances in preventative medicine costs might not rise as much as you think. Previously mentioned in this thread is the fact that people sometimes get better quicker if you send them home. So not only is less care needed, but it's also cheaper.

A lot of technology is about to be brought to bear on the problem of treating people better - better outcomes, better quality of life, better services but also more cost-effective.

I feel there should be some sort of penalty system for NHS staff who muck up. My father in law needs a heart operation.
They lost him in the system and if he was operated on in June could have had keyhole surgery. Now he needs open heart at considerable more risk to his health ,not to mention the extra burden and cost he will be to the hospital.
The person who couldn't be bothered to make sure he got his operation should be reprimanded and a black mark put on his record. There's a good chance his inactions could cause a death.
From my experience too many people in hospital don't give a shit.
When I spent a few days sitting with my dying Dad the nurses spent most of their time chatting at that station thing rather than emptying my dad's fluid bags or making sure his bed was pumped up. Surely it's someone's job to administer bollockings.

The genuine problem that needs to be addressed is how will the NHS - and despite being fairly right wing, I don't want to see it abandoned - continued to fund a growing range of (often expensive) treatments for an ever growing number of (previously untreatable) conditions with an increasingly large and eventually frail elderly population.

Increased taxation, economic growth, immigration, investment in treatments that keep people at work and a longer working life. And maybe an agreement could be reached to means test certain types of treatments for the elderly if they are deemed not to be cost effective or whatever.

There are several problems with the insurance for dangerous activity idea.
(1) What is actually dangerous - who is to say that mountain bikers are a net risk to the NHS. I exercise because I have a genetic propensity to high blood pressure.

This +1

Save the concept of free at the point of delivery - hopefully
Save the current method of delivery - you are kidding

Zk went thru a similar experience last year. Makes me cry now.

@ zippykona - agreed. I have found out that there is a lack of accountability and, furthermore, my complaints have been dismissed. We could sadly see another Shipman.

Cinnamon are you suggesting that you received care from some one who was trying to kill you? If so go to the Police.

Zippy sorry I know this sounds harsh, but I bet you could bot have afforded to pay for any of your Dads treatment.

How about we give the NHS independence in a similar model to the Bank of England? Remove the short term-ism of political control and let health care professionals shape the future of heath and social care?
Just a thought(awaits flaming).

[quote=FunkyDunc said]Cinnamon are you suggesting that you received care from some one who was trying to kill you?

She quite clearly didn't suggest that.

We are accountable I've seen staff sacked, struck off the register and others disciplined short of dismissal.

@ FunkyDunc - no, I did not say that.

How about we give the NHS independence in a similar model to the Bank of England? Remove the short term-ism of political control and let health care professionals shape the future of heath and social care?

the problem is , as with education, we[ the electorate] expect the govt to be accountable for this and deliver stuff.
Whilst they are accountable for it they will manage it.

the other problem is we want an even access to services and not an NHS postcode lottery. Localism would exacerbate this and those unable to get a service would be very very vocal in complaining about this.

I am not against trusting experts to deliver but it is unlikely to happen IMHO

This could only work if we did not blame politicians when it went wrong or if it did not do something

I think you're right there - Independence would last until the first casualty department was relocated

if it is underfunded why is reform 100% necessary ?
There seems no obvious link there tbh.

It just needs ore money

Are you willing to pay more tax? Is anyone willing to pay more tax? With a cost of living squeeze and massively overpriced houses (higher mortgage repayments) can anyone actually afford to pay more tax?

Is it fair that I pay more tax to fund the NHS because so many people are eating too much, when I look after myself?

My point is that finding more funding may or may not be possible and may or may not be acceptable to the electorate whatever our own personal political stances on the matter..

My point is that finding more funding may or may not be possible and may or may not be acceptable to the electorate whatever our own personal political stances on the matter..

Perhaps we could have a referendum.

"Should we pay more tax in order to properly fund the NHS - yes/no"

But politicians don't seem to like devolving power to the people 🙁

I would be willing to pay more tax to fund the nhs, but you raise a good point. Build some ****ing houses drive down prices and we could pay more tax and be better off...it will never happen though.

"Should we pay more tax in order to properly fund the NHS - yes/no"

This is a serious question: At what point is the NHS properly funded?

Didn't the Labour years tell us that simply throwing money at the NHS in bucketfuls didn't solve the problems? Stafford etc. happened when Funding was at an all time high after years of growth:

[img] [/img]

somewhatslightlydazed - Member
"Should we pay more tax in order to properly fund the NHS - yes/no"

Yes.

Yes.

How much of the bucketful of money ends up in the massive scam of PFI?

Ninfan, nice graph. Doesnt show anything about improvements to the NHS, I thinks its fairly well accepted the nhs improved during 2000-2010 isnt it. Thats my impression anyway.

Only the dashed line matters on that plot. And it would be interesting to overlay France.

I think we get the health service we pay for. And be sure we pay, just not as much as other countries.

Free at the point of delivery, fine. But I am also happy with modest profits for better service.

But I am also happy with modest profits for better service.

You have that option - private insurance, in the UK?

A_a - my point was more to question what 'properly funded' means? Where do you stop? £200 billion? £300 billion?

Would increased funding to the n'th degree have prevented Stafford, or are there other deeper issues issues within the NHS that need to be tackled to prevent disasters happening? is funding [i]really[/i] the issue or is it a panacea?

NHS transformed from 1990s to now. One example - max waiting time from years to 18months to 18 weeks and max 2 week (or is it less now?) cancer wait. People used to die on waiting lists. And hospital buildings are generally unrecognisable from the Victorian nightingale wards of the past. There are many more examples.

But how much is enough is a valid question. There will always be tension between tax and publuc services and that is where a legitimate political battle is fought, and why the NHS can't be independent of Govt. I want someone who I is ultimately accountable to me spending £100+bn of my taxes.

Would I pay more tax - yes
Would i redesign tax system
Would I link tax revenue to specific public service eg cig tax to health or VED to roads- No

as in most things the answer is no doubt some of each, funding alone wouldnt stop things like stafford but the endless pursuit of "outcomes" at the expense of care could be helped by freeing up nurses time.

simply throwing money at the NHS in bucketfuls didn't solve the problems?

Utter FAIL

Yes I would pay ore tax for a better healthcare system and for many other things as well - better education in your case 😉

EDIT: seeing as you have posted whilst I made my brew

As others note money [ or the sector you are in ]wont stop some people being shit at their jobs....see Tescos "finance department" for example.
I would imagine they are only related at the point at which a service has to little money to operate and after this point it is thelaw of diminishing returns

A debate on how much we pay to fund it is totally different from how we fund it it.

Ok junky - its a simple question

At what point is the NHS properly funded?

What is the point you are trying to make here with this question ?

TO describe that as a simple question is laughable.

At what point is the NHS properly funded?

Simple answer - At the point it is able to deliver the sort of service you expect.

Junky:

The question was posed

"Should we pay more tax in order to properly fund the NHS - yes/no"

So, At what point is the NHS properly funded?

somewhatslightlydazed - Member

Simple answer - At the point it is able to deliver the sort of service you expect.

Right, but we've accepted above that 'the sort of service you expect' does not necessarily have anything to do with money, because its often down to other things, like the pursuit of "outcomes" at the expense of care, or like people being shit at their jobs. cf. Stafford.

We could spend ten times as much as we do now and still be unable to deliver the 'sort of service you expect' !

yes ninfan everyone knows there is no relationship between what you spend and what you get - look at private schools all that money and yet no better outcomes - same goes with private healthcare

An excellent point and well made

Could you at least make sense or a point in your musings as I am reaching my boredom threshold.

Yeah, just as soon as you tell me what you think 'properly funded' means?

accepted above that 'the sort of service you expect' does not necessarily have anything to do with money,

But I don't accept that. I believe it has quite a lot to do with money, amongst other things.

I am reaching my boredom threshold.

Is this a first?

Its not a phrase I used I said i would pay more money for a better service

PS if it was me I would have denied the claim I was not making sense 😉
Exits thread

Right, but we've accepted above that 'the sort of service you expect' does not necessarily have anything to do with money, because its often down to other things, like the pursuit of "outcomes" at the expense of care, or like people being shit at their jobs. cf. Stafford.

Problem is it does necessarily have something to do with funding, other variables are involved of course.

Health is the only thing that matters. Without we are dead.

So how do we prioritise our resources? £2k on a season ticket to wendyball, £xxx on Murdoch TV, £3 for a cup of hot brown refreshment with some sickly syrup in it - no problem.

A small contribution to health care. What? Are you serious? £10 to check the things we see with are ok. That's a scandal, that's 3 cups of coffee or 1/9th of a replica shirt....

You have that option - private insurance, in the UK?

http://en.wikipedia.org/wiki/Healthcare_in_the_Netherlands

As I said, I think we get what we pay for, possibly a little more due to some economies of scale, but we don't pay enough as a nation.

Good [url= https://www.opendemocracy.net/ournhs/john-lister/first-privatised-nhs-hospital-success-or-smoke-and-mirrors ]article on Circle's franchise at Hinchingbrooke[/url].

As he says, smoke and mirrors.