[Closed] YOur suggestions for saving money for the NHS?

Systematic culling of the non-working classes.

It'd keep the top-hats who go hunting occupied weekly too.

Get rid of anesthetic. That way people will only ask for an operation if they really need it.

Get rid of anything that isn't essential...

Fertility treatment
Fat reduction/bands etc
Breast reduction
Gender reassignment
I'm sure there are many more

Cut any expensive treatment that only extends life a year or two

Allow anyone who wants the above to get it at cost if they pay for it.

Encourage people to opt out - stop taxing private medical cover at 40%!! Make medical cover tax deductible instead.

Prohibitive fines for any treatment required as the result of alcoholic intoxication.

Billywhizz, your idea sounds great in principle, but maybe it should work the other way too- maybe the GP should be fined to compensate me when I am kept waiting for forty minutes before every appointment 🙂
Fairs fair and all

Refuse to treat anyone with ailments caused by their excessive eating, drinking and smoking

Fertility treatment not essential? Oh great more fekkin kids being born then

Prohibitive fines for any treatment required as the result of alcoholic intoxication.

Thing is with that, what's next?

Prohibitive fines for people injured falling off mountains whilst riding bicycles? It's an equally stupid pursuit in some people's eyes.

a limit on the hours served weekly by doctors. The amount of staff sickness in the NHS is shocking.

Prohibitive fines for people injured falling off mountains whilst riding bicycles? It's an equally stupid pursuit in some people's eyes.

5th - will the private sector compensate the state sector for taking the staff that the state sector trained at great expense? ATM it pays nothing towards training costs and they are not insignificant

As on the other thread I'd stop:

Transplants except kidney.
cognitive enhancers for dementia
Fertility treatments
Herceptin and similar treatments. £10 000 per month of extra time to die
Statins except in a tiny majority of cases
RTAs charge the full amount to the insurance instead of a token charge as they are supposed to do now ( but rarely do)
All plastic surgery except for trauma repair and repair after surgery.
End all private healthcare. Its expensive and drains NHS resources.

right - that should be a controversial list.

All non essential medical shite moved to private sector (cosmetic surgery etc

retro83 - Member

a limit on the hours served weekly by doctors. The amount of staff sickness in the NHS is shocking.

Its not actually that high - comparable with other industries - around 4% in my trust
Drs are down to 56 hrs soon if not already from the 140 they use to work

[i]Prohibitive fines for people injured falling off mountains whilst riding bicycles?[/i]

It's a slippery slope, for sure. But I notice that A+E is not currently overrun with injured mountain bikers, whereas you can't move for drunks...

EDIT: I should say, I'm being slightly tongue-in-cheek - as the reality of treating ?drunk?head trauma?fitting etc patients in A+E is (obviously) a serious & complex thing. But the amount of NHS resources tied up in treating alcohol related stuff is truly [i]mind-boggling[/i]. It'd be nice to break the link.

[i]a limit on the hours served weekly by doctors[/i]

Although not at the expense of training or medical cover - as has been the result of the new working hours directive/MMC reforms. [i]Ergo[/i], more doctors, please.

about 4 million quid a year is spent by the NHS to support homeopathy

darrell - and strangely shown to be cost effective! its cheap per treatment and it reduces referrals for real treatment! weird but true.

4 million is 0,004% of the budget.

This may help (from NHS website)...

'Some 60% of the NHS budget is used to pay staff. A further 20% pays for drugs and other supplies, with the remaining 20% split between buildings, equipment and training costs on the one hand and medical equipment, catering and cleaning on the other.'

I spy pay freezes, to pay for consultants, who identify inefficient work practices, and identify areas for redundancy, only for the NHS management to realise that the consultants cost a lot more than the redundancies saved, 'sh1t, who can we fire now'.

5th - will the private sector compensate the state sector for taking the staff that the state sector trained at great expense? ATM it pays nothing towards training costs and they are not insignificant

ANY pedestrian or driver, or DIYer, or any other person admitted with a head injury, that wasn't wearing a helmet- no treatment ( that should save, at least, 400 billion by my calculation) 😉

[i]only for the NHS management to realise that the consultants cost a lot more than the redundancies saved[/i]

[url= http://www.timesonline.co.uk/tol/news/uk/article669590.ece ]Indeed.[/url]

"darrell - and strangely shown to be cost effective! its cheap per treatment and it reduces referrals for real treatment! weird but true.

4 million is 0,004% of the budget. "

but as an educated person i am appalled that the NHS spends this money on "snakeoil". i would much rather the money was wasted on something else

[i]that wasn't wearing a helmet[/i]

This thread is gonna run... 😀

Noteeth,It was a spur of the moment bad joke! I'm SORRY!

Don't worry - I can't see anybody getting too worked up... 🙂

darrell - and strangely shown to be cost effective! its cheap per treatment and it reduces referrals for real treatment! weird but true.

Not going to dispute this but I do hope that the medication used is just tap water, not bought off some company that alleges there is something special about thier medicines.

If we could move to full tap water medicine you could cut almost 20% from the bill.

I'd forgotten about alternative therapy. Stop wasting tax payers money on it and tax it at 500%.

Try listening to the people who do the job and getting their ideas on what works and what is a waste of money rather than paying vast amounts of money to people who have never done the job, and in some cases can't spell job, to come up with a succession of impractical ideas for money saving and reform.

Of course if the ideas they came up with DID work then we wouldn't need them to advise the NHS anymore - or am I missing something here.

Banning smoking

5th- "Fat reduction/bands etc"

Most auditing suggests these are cheaper than dealing with the long term consequences of obesity.

Just one example but lots of things that look at first glance like unneccesary treatments or throwing money away, actually aren't.

I'm working my 8th night out of the last 10 nights, so whatever you all decide, please do it quietly and don't;

Fall down stairs,
Crash your car,
Have an operation,
Get an infection,
or otherwise get poorly in anyway.

Thanks.

"I didn't suggest opting out of NI payments. So you'd pay full whack for the NHS like you do now, but if you choose to pay for private cover you wouldn't get charged 40% for doing so."

I agree. I dont resent my tax contribution to support people who rely on the NHS. But I'm appalled that my work-arranged medical insurance is taxed this way. It stops people from joining it. The company and I have that insurance to keep me working and making my contribution to the business, the economy, and I dont drain the social security or NHS!

They do need to find a way to claim some financial compensation from wasted drunks and drug users that ram AandE every weekend. You cannot compare this with sport injuries. And a fine might be a disincentive to drunkenness knowing they may have to budget another £100-£500 on a big night out.

Banning smoking

Keeping visitors out of acute hospitals would significantly reduce infection, and therefore effect a cost-saving.

Turn the thermostats down in all hospitals by 5 degrees - no one will notice.

I'm with TJ on the fertility treatments, plastic surgery and banning all private health care.

Reduce the length of NHS gowns by 2 inches. Think of the miles of fabric saved and should be a bit of a laugh (which according to the Readers' Digest is the best medicine of all).

£50.00 fine for anyone who complains about the length of time they've had to wait in A & E.

No private concessions (shops, vending machines, coffee bars, extortionate television rental schemes etc). Nationalise the lot and put any profit back in the NHS.

in return for paying a slightly reduced rate of income tax commensurate to the drop in expenditure per capita (bear with me....), grumpy taxpayers can be treated exclusively in "The 1960's Hospital" which will undoubltedly be cheaper, cleaner and smaller, but also feature nurses with paper hats, no choice whatsoever, even worse food, even more godlike and unlistening consultants and an alarmingly narrow range of drugs and surgical procedures.

Volunteers? 😀

More seriously, it is actually alarmingly hard to get sacked from the NHS if you are just fairly bad at your job or a bit work-shy. Unless you do anything positively [i]wrong[/i], poor performance which would have you out on your ear in no time in private enterprise can take years and untold man-hours of meetings and correspondence at senior level to actually get you dismissed. I'd love someone in my HR department to look over our trust's last 5 years poor performance cases and try and calculate in money what they could have saved if they could have fired people a bit quicker (or at all!!).

And as sponging machine says, visitors are an enormously unpoliceable, errr, "variable" in the fuzzy arena of infection control.

Allow people a dignified death!

Get rid of ambulance response time targets, that way we wont send an ambulance, a car and a supervisor (as the only qualified paramedic) to teenagers having panic attacks and we can focus on patient care instead!

Also, greater allowance for staff to work in different areas... i.e train everyone to HCA level so when one area is quiet staff can move around or help out, drives me mad when A&E is run ragged and staff are sitting about to SFA upstairs on wards!

Anyone injured through a DIY related accident should only be provided with the materials to patch themselves up.

[i]but as an educated person i am appalled that the NHS spends this money on "snakeoil". i would much rather the money was wasted on something else [/i]

Counter intuitive though it may seem, spending more on 'snakeoil' may cut overall costs 😯
I think (haven't looked for stats but have anecdotal evidence from GPs) that many people visit their doctor simply for reassurance and a bit of attention, if more "counselors" (for want of a better word) were employed medical admissions/prescriptions may be reduced.

On a less controversial note, perhaps increasing health education/promotion may be more cost effective than medical intervention as a result of avoidable health problems ?

Oh, and make people financially liable for irrelevant use of emergency services.....

Abolish "protected salaries"

Remove the target system that means doctors don't offer advance appointments and get paid more.

24/7 utilisation of every major asset where possible. MRI scanners and the like.

Increased employment. Seriously. There are people walking around that look like the living dead. I don't care what they do, so long as they're doing something, and sober for at least 8 hours a day.

Some research on the price elasticity of booze and a minimum price / unit if it will actually cut consumption.

Proper home economics taught in schools.

Massive sentences for drug dealing.

Improved road design. 300 people a year croak it after driving into trees at the side of the road.

I suspect the big savings are to be made in cutting demand...

shoot smokers?

"Massive sentences for drug dealing."
Untill smoking is banned I find this morally wrong. It's the user's fault if they die not the dealer.
Why do we have to cut one of the western world's cheapest healthcare systems anyway?

Promote smoking!

Cut back on treatment for smoking related illnesses though. Let 'em die and we may have found a solution to the pension crisis too.

4 million is 0,004% of the budget.

Well reduce it to 0.00000000000000000000000000000000000000000000000000004%
and it will start to work. it' clearly to concentrated.Reduce the money and it will take on magical properties.

Having just spent 2 days in hospital (I now have type 1 Diabetes - woohoo!!) i would suggest that it may help if patients are charged for meals. Just a token charge of 50p per meal must go a long way to raising a fair bit of revenue. The NHS doesn't pay for my meals at home so why should it pay for them when i'm ill? And at a maximum of £1.50 per day each i can't see anybody having a reasonable excuse not to be able to afford it, after all, do many people exist on less than £1.50 per day for food?

Well if 60% of it really goes on salaries, I feel a blanket 10% pay cut might save 6% overall - which is a lot.
As this seems a little harsh on the lower paid employees it should probably be applied on a sliding scale such that the highest paid individuals get the highest percentage cut.
Saves cash with no reduction in service.*

*with the probable added benefit of the flying pig display every night, 'cos politicians will not have the guts.

igm,

To be fair, cut everyones wages in the whole country by 10% and put all that money into the service. 😀

As a few have said there are treatments that do little and can be cut, but there will be a high personal cost for some. Who would want to tell someone that his treatment is expensive and statistically only gives a short term life increase - I do believe that there's someone on the forum in this position at the moment.

Personally I think his chance to a few more years with the missus is worth a lot more others having extra disposible income to buy xtr rather than xt and a new HDTV.

Close the fast food restaurants in hospitals as they're really only contributing to increased obesity.

Increased promotion of healthy lifestyles, stopping the use of obesity as an excuse.

Untill smoking is banned I find this morally wrong. It's the user's fault if they die not the dealer.

It's a bit of an oversimplification to equate the drugs trade with the tabacco one. I certainly don't class the local newsagent who sells cancer sticks as being on the same moral plane as a dealer who may sell drugs using very dodgy tactics to very vulnerable people.

But setting aside moral arguments, the simple fact is that junkies are expensive. They have to steal an inordinate amount of stuff to get enough money for drugs, they're largely inactive in the official economy, and we have to pay for their treatment. And I am for treatment. It seems rather daft that at the moment the government is so afraid of it that it often employs an ALMO like Turning Point.

Be a good idea to make migrants Who have not paid into the system
to put at least £ 15,000 pounds before they get any treatment
and after 5 years they will recieve free treatment.

a dealer who may sell drugs using very dodgy tactics to very vulnerable people.

That's pretty much my perspective on Tobacco companies.

Withdraw NHS treatment from anyone unless their National Insurance Stamp was up to date?

(theres a nice old fashioned phrase you don't hear any more) 😀

Some fine ideas in here. I think we may be on to something

Reduce the length of NHS gowns by 2 inches. Think of the miles of fabric saved and should be a bit of a laugh (which according to the Readers' Digest is the best medicine of all).

Anyone injured through a DIY related accident should only be provided with the materials to patch themselves up

Both of these should be adopted immediatly

grantway - Member

Be a good idea to make migrants Who have not paid into the system
to put at least £ 15,000 pounds before they get any treatment
and after 5 years they will recieve free treatment

a dealer who may sell drugs using very dodgy tactics to very vulnerable people.

That's pretty much my perspective on Tobacco companies.

I know of someone who's a drug dealer. Amongst other things, he convinces his female customers to become prostitutes, with him as their pimp. I really can't see the equivalence. When I say very dodgy tactics, I mean preying on the vulnerabilities of abused teenagers and the like. Not giving out free jackets that say "Drugs are ace" and sticking their names on Ferraris.

Be a good idea to make migrants Who have not paid into the system
to put at least £ 15,000 pounds before they get any treatment
and after 5 years they will recieve free treatment.

Several EU laws make that impossible for much of our immigrant population. For what it's worth, illegal immigrants often work under someone elses' NI number, so they do end up "paying into the system".

Augustus - surely if we're going to skimp on hemlines, it should be by reintroducing proper nurses uniforms?

[img] [/img]

More seriously, one of the ways that the NHS could save money long term isfor goverment to restrict or discourage car use*.
The timebomb that we are beginning to see in this country of obesity, heart disease, diabetes and others is not unrelated to the low exercise, convenience lifestyle that is only made possible by mass car use.
* It'll never happen though.

More seriously, one of the ways that the NHS could save money long term isfor goverment to restrict or discourage car use.

Kind of agree. I don't think we need to restrict car use. Just encourage other ways of getting around. Cities tend to have some bike stands, but small towns don't. The other thing that's needed is to remove the fear / threat of crime. I can see a lot of people driving short distances due to that.

Zulu - I don't think me crickey, and dangerous beans will really suit that uniform

tron - every £ spent on treating junkies saves £7 in criminal justice ( I have seen quoted)to say nothing of what preventing illness in them saves.

Another area where what looks like a sensible saving would actually cost the country more in the long run.

I would just give all junkies as much smack as they want - it would be cheaper for the country and would legitimise a cash crop in afghanistan

5th you only have 2 years to live so we're not operating on you unless you pay £2 million up front in cash in 30 minutes.

BillyWhizz - Member

My suggestion - A big fine for people who make Dr's appointments and don't turn up. According to my local surgery, it averages 170 appointents a week.

The only exceptions would be people who have a Dr's note excusing them . . . .

Can I fine the surgery for messing up my appts too? only fair right?

Hospitals to do half day closing on a wednesday?

Car use is a good point. further subsidy of cycle to work and an increase in cyclist favourable traffic law would be great.

Not so Barclat Augustus
We dont get reinburst or do other countrys give us free treatment
as when we are in other countrys this country requests you to take
what they call a medical passport so when you need treatment abroad
they have some means to claim from other than that they may refuse treatment.

My wife works for the NHS and had many years working in the private sector
But not in medical but in finance.
What she says is unbelievable firstly at the moment the NHS are breaking and splitting the departments to try and save money but take a look at this.
In the offices each department has the below.
The Directors get in the region of £ 100,000 a year
and then you have a sub Director on around £ 60,000 per person
Then you have the secerteries IE PA £ 80,000. per person
then the office staff approx 4 person plus at around £ 24,000 per person
Also you may have a few contractors brought in for short projects
on around £ 800.00p plus a week.
Also if a Director is brought in from another part of the country the
NHS on top of there salary will pay for accomadation IE Hotel,Houseor
appartment which will average between one week to several months.

Also you have to consider the rush to get PFI funded buildings and boy
the charges are stupid.
Firstly you have the contract of maintainance the contractor here does not do the work but gets in outside contractors to do the work.
And basically with these new buildings the NHS maintanance team IE
in your area cannot do any drilling in the property and any works
you have to right a works sheet on how to assemble a cabinet to work in these new buildings.
Idea of cost to put a picture up on the wall will cost the tax payer
on the new rate of £ 65 pounds this was last year charged £ 80 pounds.

On average the NHS matainance skilled guy say an electrician is paid
in London £ 520.00p per week We pay double for these new PFI buildings.
And the NHS for some reason are trying to get rid of there own maintainance teams My wife thinks its down to them shown as fixed charges
and paying Holidays and sickness pay as with the contractor you dont
But MAD as you will always need maintainance.
Also with the above buildings you will find that the Hospital will close wards because after all the costs etc they shut them as they cant offord the running costs from the contractors.

After all the above charges you then may get your appointment.

Clone Harold Shipman?

Coat, door - don't bother seeing me out 😀

rantway - Member

Not so Barclat Augustus
We dont get reinburst or do other countrys give us free treatment
as when we are in other countrys this country requests you to take
what they call a medical passport so when you need treatment abroad
they have some means to claim from other than that they may refuse treatment.

simply wrong.

Money could be saved if when trusts are allowed to develop and get work done ( ie new buildings) the goverment give the trust the money and allow them control over when to pay the contractors so that defects can be picked up and rectified rather than as it is now, that you have to pay them by a certain date to get the money.

I've been a visiting health tourist scumbag* in Australia, New Zealand and France, without paying any cash except prescription charges, cos of the reciprocal agreements that we have with them.

Well if 60% of it really goes on salaries, I feel a blanket 10% pay cut might save 6% overall - which is a lot.
As this seems a little harsh on the lower paid employees it should probably be applied on a sliding scale such that the highest paid individuals get the highest percentage cut.
Saves cash with no reduction in service.*

I'm not convinced that cutting people's pay by 10% has no effect on how well or efficiently people do their jobs, or how many people apply for the jobs as people quit or are replaced. I reckon if you read up on it, you'd probably find that great big pay cuts have a positive impact for the first few months, but the massive deterioration in morale probably reduces the efficiency and ups the turnover of staff enough to outweigh the advantages pretty quickly.

Joe

*I've had bizarre accidents and put myself in A&E whilst working / on holiday in those countries

With regard to NHS pay cuts - doesn't it just set up a bizarre vicious circle? Let's not forget that the NHS is one of the largest employers in the country, reduce pay and you also reduce tax income, so possibly a little self-defeating.

1.Get rid of the utterly riddiculous response times...as stated earlier an over resourcing total waste of finances!
2.Introduce a payment system for all emergency treatment - if the 'emergency' required an ambulance and was necessary then the payment is refunded (this would take a simple decision by the A and E Doctor).This would dramatically reduce a massive proportion of the dross that our highly trained Paramedics have to break their necks to get to in 8 mins.
3.Integrate the out of hours GP service closer to other services - at the momment they are a law unto themselves and seem happy to take their inflated overtime wages but simply burden other health professionals with their wriggling and visiting avoidance.
4.Now this one really is basic!! All medical attendances by ambulance crews should be forwarded onto the patients GP - it may not stop unnescessary A and E attendance but at least this way someone is monitoring the situation.

With regard to NHS pay cuts - doesn't it just set up a bizarre vicious circle? Let's not forget that the NHS is one of the largest employers in the country, reduce pay and you also reduce tax income, so possibly a little self-defeating.

Not really, it was more of a question than a statement though. What I meant was that just cutting staff pay isn't a simple calculation, we have to take into account lost tax revenue. Cutting 10% off the wage bill will demolish morale in the NHS (if that's possible), but won't save 10% in real terms, so is it worth it?

woody2000 - pay cuts impacting on the general economy

There is a multiplier effect associated with government spending - the nurses, doctors & building firms paid out of the NHS budget do not hoard all of their cash from wages. So the cash gets spent in shops etc. and an initial spend of £10k may end up having the effect of generating £20-30k in the economy.

The problem is that the the multiplier is linked to deficit, and there's something of a tipping point where the deficit becomes so large that people anticipate tough times (ie, high tax to pay off the deficit) in the future and increase their savings, removing the impact of the multiplier. I'd argue we are already there, and that's why we can't spend our way out of the problems we have.