TJ, the OECD figures are total spend, public in dark blue, private in light blue.
Can’t find any figures for health spend per capita, and not really sure what the various sets of figures represent ‘on the ground’ anyway 😕

What Hilldodger said. See my first post and his, second post is purely gov spending where we are near the top.

Why do you think that spending more is a good thing?
Why do you think that hospitals are a good thing?

A significant redirection of money from acute care (eg. hospitals) to prevention and early intervention, (eg. GP’s and Physio’s) could save hundreds of billions – try doing it, and the unions would be calling for blood and out on strike overnight!

Its about what you spend it on, not what you spend.

Why do you think that spending more is a good thing?
Why do you think that hospitals are a good thing?

A significant redirection of money from acute care (eg. hospitals) to prevention and early intervention, (eg. GP’s and Physio’s) could save hundreds of billions – try doing it, and the unions would be calling for blood and out on strike overnight!

Its about what you spend it on, not what you spend.

Despite your history of right wing nuttery, this is actually right.

Unfortunately it would take about 20 years to really see any benefit from it, and would be unpopular for most of that time. Spending £2000 a day on Intensive Care for alcoholics is a waste, when that money should have been spent 20 years ago on pre school care and education for the mother of that child.

Z-11 Prevention and early intervention like Andrew Lansleys latest wheeze

worthless, regurgitated, patronising rubbish

Yip. That’ll revolutionise healthcare eh?

France gdp per capita USD 29,000, therefore spending on health per capita 3,470 and government spending 2,700.

UK gdp per capita USD 32,000 therefore spending on health per capita 3,140 (a 10% difference) and government spending 2,625 (a 3% difference).

Germany has a similar gdp per capita so relative spends will be similar to those shown earlier.

No Binners – how about Increasing the Number of GP’s by 19%, and decreasing their average list size from 2,247 to 1,918.

Oh, no, we choose to forget that thats exactly what happened between 1980 and 1991 under the evil she witch Thatcher. But, like Crikey said, you’d make yourself really unpopular taking bold decisions like that wouldn’t you…

You are right Z-11, investing in Primary care is the most sensible use of any healthcare spending, full stop.

But… and this is perhaps a bit trickier; it works best with some attempt at social engineering built in. Give poor parents help, with benefits, with subsidised jobs, with extra cash and input, and you begin to break the cycle of being born into poverty and the subsequent ill health associated with that.

Essentially it’s about investment in people, but it takes a generation or maybe two to have any effect, which is 4-5-6-7-8 different governments who all have to appeal to the populace.

Nobody has so far actually explained how these failing nursing staff and more importantly the management are still employed, or even employable.

Basic needs of patients, like water and food doesnt require much education, its a human need,yet so many fail to understand the concept.

Crikey – maybe, just maybe, part of the social engineering problem lies with people knowing that they don’t have to take responsibility for their own actions and long term health, means that people take less care of themselves than if there wasn’t a “free” NHS which will

There’s a significant difference between the state (ie. us) paying for healthcare from a disease or chronic condition that the patient cannot control, and paying to repair a pissed up idiot who puts their fist through a window, should he have to foot the bill for his own actions? its not an unreasonable suggestion!

but where does that stop – obesity, gout, diabetes, all have an element of personal responsibility and lifestyle choice, and where does an injury in the process of mountainbiking down a rocky hillside come in that equation/balance? its a bloody good question… and I don’t have the answer.

I agree with a lot of that Z-11, we have created or fostered a situation where people don’t have to take responsibility, but I think the solutions take longer than the natural life of a government, so we never get to see what works or what doesn’t.

Gotta sleep now, 12 hours of public service tonight…

mcboo – Member

The unnacceptable part of this is that it is happening after a period where the NHS was sprayed with cash.

Oh dear… Modern medicine is expensive. New drugs and procedures are expensive. My treatment for my hip cost several times more than an oldfashioned hip replacement. It also helped to increase waiting times, most probably, since I got several times more physio than a hip replacement patient would get. Just for an example.

And the absolute most expensive thing a health system can do is keep people alive, which we’ve got much better at- people live longer, terminal conditions take longer to kill people, and people survive things which would previously have killed them. All at great expense at the moment of treatment, and ongoing expense to look after the person who previously would have been a cash-efficient corpse.

As per above – treatment costs going up and up. Putting a 700 quid plate on a wrist not two forty pound wires uses up money. Not that hard to put 10-20k of metalwork in a spine now.

Add that up across all specialities and all treatments and costs are going crazy.

Equally 18 week target means yes everyone is treated quickly but far more are being treated too – even more costs, especially when lots of surgery being done in private sector/outside hours to meet targets.

Could go on….!

crikey – Member

I agree with a lot of that Z-11

That’s probably because Zulu-Eleven hasn’t, as is absolutely typical of right-wing neo-conservatives, said what he truly believes.

Zulu-Eleven takes his political direction from his mentor Dan Hannan and his beloved bible “The Plan”, which he often promotes on here.

Dan Hannan has very clear views concerning the NHS, he considers it to a “failed experiment” which makes people “iller” and would much prefer the American healthcare model. Which despite the ongoing huge political debates and furore in the US concerning its failure to deliver effective cover to all its citizens is, he claims, better.

Of course unsurprising Dan Hannan is somewhat “shy” of telling the British electorate how strongly he opposes the NHS’s existence, knowing full well how much it is cherished by the British people.

He is however more candid and forthright in expressing his true feelings concerning the NHS when speaking to an American audience, specially when being interviewed by his political soul mates Fox News.

I have in many occasions posted this video of Dan Hannan rubbishing the NHS and singing the praises of American healthcare provision, but it’s always worth remembering what Zulu-Eleven’s political mentor and guru has to say on the NHS, specially when Zulu-Eleven joins in the healthcare debate.

I have yet to hear Zulu-Eleven ever criticise or distance himself from any opinion expressed by Dan Hannan, so we can safely assume this also represents Zulu-Eleven’s views on the matter, despite his understandable reluctance to honestly express them.

It should be added that David Cameron publicly criticised his friend, and former Tory Party leader speechwriter, Dan Hannan, for giving that interview – well Hannan wasn’t suppose to say those things publicly was he ? just like the BNP who don’t like to publicly admit they’re racist, in fact they will strenuously deny it.

[video]http://www.youtube.com/watch?v=FiSPRkq28iU[/video]

For over 60 years the NHS has provided high quality open-ended healthcare to millions based on clinical need, not how healthy your bank balance is. It was one of those fundamental reforms which changed people’s lives in a real, tangible, and profound way.

There are however those who see healthcare and the £billions involved as a significant profit opportunity, and would like to take us back to the time of reversed priorities – profit before people.

They will exploit genuine failures such as the shameful examples of elderly care found to be wanting in an attempt to achieve those ends. They will make wild and farcical claims such as in the title of thread that “The NHS isnt working”. The NHS is working. And it’s working a lot better than any system which puts profit before people.

Ernie – are you still unable to progress the discussion beyond childish ad hominem dismissal ?

How about some ideas about how health care could be improved in the UK instead of point scoring?

Go and ‘king read what I’ve written above, and tell me one thing you disagree with!

I challenge you to tell me what I’ve said on this page thats wrong!

Zulu-Eleven – Member
Ernie – are you still unable to progress the discussion beyond childish ad hominem dismissal?

That’s the trouble with political dogmatists – strong on ideology, weak on ideas 🙄

Sorry ernie, but your post shows the problem in a nutshell.

It’s easy to fall back on rhetoric and stereotype, its easy to look through your political glasses and interpret everything in shades of left and right, and that is the reason the NHS is kicked around by politicians.

No one comes to us and asks, they all come and tell us.

Go and ‘king read what I’ve written above, and tell me one thing you disagree with!

I’m not interested in what you’re saying…….I’m interested in what you’re not saying.

You have never denounced your political guru for claiming that the NHS is a “failed experiment” which makes people “iller” and that the American healthcare model is by far superior.

Which of course is hardly surprising ….. right-wing neo-conservatives fully support Dan Hannan’s views on the NHS. You just don’t like to talk about it.

If you change your right-wing neo-conservative views I might well stop challenging you Zulu-Eleven, but I won’t just because you choose to be highly selective in what you are honest about.

And you might well like to dismiss my opposition to your cranky right-wing views as “childish”, well you would wouldn’t ? but I’m afraid that won’t make an iota of difference.

You could just choose to ignore me, as I generally choose to ignore your baiting – I fully recognise the futility of trying to have a grown-up sensible discussion with you.

🙂

its easy to look through your political glasses and interpret everything in shades of left and right, and that is the reason the NHS is kicked around by politicians.

Healthcare provisions is highly political …. here in the UK …. in the US……anywhere.

Next you’ll be suggesting that economics shouldn’t be a political issue.

Durr… Is it really?

The point is that by making every argument into a political one, we never get anywhere, and nothing ever changes and you miss the opportunity to see common ground or good ideas because you are blinded by ideology.

We had the postwar consensus…….the Tories tore it up over 30 years.

I would be more than willing to work with Tories like Macmillan who amongst other things, were committed to universal healthcare provisions. Where are they ?

Well, if you want a grown up discussion – I think you’ll find that Hannan does not say the american model is better, he says that the UK NHS is not the model that the americans should follow, and that the Singapore model is better, this is also clearly laid out in “The Plan” as you’d know if you’d read it before dismissing it.

I think you’ll find above in my discussion with Crikey a fairly reasonable discussion on just how the NHS can make people “iller” – as he said “we have created or fostered a situation where people don’t have to take responsibility” – and all without hysterics or name calling either.

On top of this, you’ve still not actually said which of my points above you disagree with.

If you wanted my personal views on improving healthcare for the same amount of money – I’d first suggest that instead of massively increasing GP’s wages with the contract settlements of the Labour years, this money should have instead been pumped into employing more GP’s and support staff. but we are where we are, I’d tell GP’s that there would be a five year pay freeze for those who benefited under the reforms, and all increases would go into more of them. I’d also consider rewarding GP’s for reducing the amount of antibiotics prescribed.

I’d then get rid of gastric band operations and fertility treatment on the NHS. A proper review of the efficacy of widespread statin prescription (which I think may well lead to more targeted use in at risk groups rather than across the board) bill people for drunken injuries and I’d start hitting people with fixed penalty notices for misuse of ambulance services.

problems? lets talk about solutions.

We had the postwar consensus…….the Tories tore it up over 30 years.
I would be more than willing to work with Tories like Macmillan who amongst other things, were committed to universal healthcare provisions. Where are they ?

It’s called the Labour Party. Socialism is dead.

So funding – as I said to TJ – has increased, and waiting lists and customer satisfaction have improved etc etc etc. And the way pensions have been handled is a huge demotivator.

But that is to miss the core issue here which is why some hospitals/wards seem bad, and others with similar funding seem good. Anyone listening to some of the patients stories on the radio today would hear things that mirror things patients have told me. Often the care is excellent. But sometimes patients do seem to be getting in the way of ward staff members chatting and having tea. And often there are unacceptable bureaucratic snafus with appointments and investigations…

There do seem to be teams and units which are good at learning, and some where the patients seem to be perveiced as a nuisance.

Socialism is dead.

And then you woke up.

why some hospitals/wards seem bad, and others with similar funding seem good

A decent standard of care requires proper leadership.

Blindingly obvious, I know – but it can make all the difference between a ward running like clockwork and sliding into chaos. I would have followed my old Senior Sister to Hell and back – we liked, respected and (sometimes) feared her. It’s nothing to do with Daily Mail matron-fetish BS, just recognition of those individuals who can rally staff when the chips are seriously down. Poor care follows on from poor morale, just as surely as night follows day.

See also: long-in-the-tooth but seen-it-all band 5 RNs.

On BBC’s Question Time last night one of the panel stated that it was almost impossible to have an informed debate about the NHS – entrenched views, dogma, mis-information on all sides. I think this thread illustrates his point exactly.

We are forced to accept the mantra that the NHS is the best health service in the world. To question any part of this becomes heresy which is an absurd barrier to progress. As is the fact that any debate struggles to move beyond the narrow argument for and against the US vs NHS models. This is far too simplistic.

Perhaps the best test is to ask oneself, if money was not object what healthcare choice would you make?

IMHO, there is no doubt that in the case of serious illness and emergency I would choose the NHS. In these areas the NHS can justifiably lay claim to being the best in the world.

However, in the case of routine/ non-time sensitive treatment, I would choose the private sector every time. Why because the quality of the experience would be much better in too many ways to list here.

I genuinely feel sorry for anyone trying to make sense of a profession in the NHS. Talented people with honourable motivations to help others. For that, we underpay them, patronise them and subject them to constant and harmful change. No wonder many are so demotivated.

V8ninety ….

Im not sure what you do but you talk drivel about “social” admissions. Have you ever spent any time in primary care?

I remember working for a really good care of the elderly consultant as an sho who told me there is no such thing as a social admission. You know what she was and still is right.

I’d tell GP’s that there would be a five year pay freeze for those who benefited under the reforms,

Most GPs would bite your hands off on that one old chum, after year on year pay cuts for the last 3 years at least. Strange how that never made it to the front page of the daily express…

Spot on. Looking at 3% down last year, a further 5% this year and 5% next year. And thats before adjustment for inflation. Plus our pensions (which are not final salary) screwed with. Increased workload and being blamed for everything. I know a lot of GPs retiring a year or two earlier than they had planned. There is a workforce crisis coming soon. And you Z11 know eff all.

teamhurtmore – Member

We are forced to accept the mantra that the NHS is the best health service in the world. To question any part of this becomes heresy

What nonsense…

We are forced to accept the mantra that the NHS is the best health service in the world. To question any part of this becomes heresy which is an absurd barrier to progress.

Have you got some evidence to back up this claim ? Who’s been saying that the British NHS is the best in the world ? Who’s been denying that it ever experiences failures ?

Sounds like empty rhetoric to me – the very “entrenched views, dogma, mis-information” which you complain about.

Far from being forced to accept the mantra that the NHS is perfect, we are constantly reminded of its limitations – long waiting list, limited resources, staff shortages, care failures, dilapidated buildings, etc. And who would argue with that ?

What isn’t in doubt is that a healthcare system in which people receive according to their need, and contribute according to their ability, is vastly superior to any other alternative.

.

Zulu-Eleven – Member

I think you’ll find that Hannan does not say the american model is better, he says that the UK NHS is not the model that the americans should follow

Why do you think that ? I’ve seen the video and found that Dan Hannan very clearly says that the American model is better, and warns them not to make the “mistake” we made. Can’t you be honest just for once ffs ?

And Dan Hannan is no ‘inconsequential’ Tory. He is a personal friend of David Cameron, a Daily Telegraph leader writer, a speechwriter to a former Shadow Foreign Secretary, and a speechwriter to William Hague when he was Tory Party leader. He represents very much today’s mainstream Tory, and he has some clout.

If Tories like Hannan believe that the NHS is a mistake in principle, then it goes without question that they would want to rectify the mistake and dismantle it – why wouldn’t they want to put right a mistake ?

It’s clear that the NHS is not safe in the hands of today’s Tories. It would be perilous to ignore that threat. Only it’s not being ignored – there is widespread public and professional opposition to their plans.

The neo-conservatives will fight back by making wild nonsensical claims that “the NHS isn’t working”, like mcboo did when he started this thread.

i doubt that many actually see the NHS as perfect, the problem is that the proposed solution seems to owe much to the US model and the belief that rightly or wrongly the only thing that will matter is what you can afford to pay. What is needed is to stop trying to change the NHS every five years, introducing new plans and new ideas, give things time to settle.

And something that seems not to be understood by some is that some things are a service and not a competition between providers. My SO had to go into hospital a week ago, emergency situation, there is no choice of which hospital you go to. There is no market. To suggest otherwise is pointless. As for non emergency treatment, how can it work? people want care near to where they live, where there is support available, if i need cancer treatment i would use the local hospital, why would i look at a hospital in London? again no market? i want a blood test, i go where is convient, which means where i live or work. See the pattern here?

And i suspect that most in the UK are not actually interested in the rantings of neo-con free marketers. They want there to be regulation, to be a health service that is there when they need it.

Oh and the british complain about everything. So there will always be something to moan about.

comparisons with singapore and the uk are silly

for a start singapore is a lot younger average age than the uk (and most western countries)-its old age that drains resources in healthcare
youre also looking at a country with a far healthier lifestyle, significantly lower car ownership, alcohol use, no maccyDs on every corner etc etc

preventative healthcare is a good idea
sadly this government couldnt care less about it

all they are interested in is lining the pockets of their private healthcare/insurance backers, like those that funded hannahan to trot around the USA peddling lies about the nhs

and so far this government has shown no interest in preventative healthcare;
goves brainwave of slashing sports funding in schools
scrapping the food label traffic lights system under pressure from industry (something consumers and doctors were very keen on)
reducing alcohol and fast food consumption by letting the relevant industries influence policy
http://www.independent.co.uk/opinion/leading-articles/leading-article-we-should-not-let-the-drinks-industry-set-policy-on-alcohol-2329611.html

only an idiot would think that this governments reforms are about making the NHS better, they are about making money for their chums

Here is a link to the health Bill now I gave it a quick read but I struggle to find all this privatisation stuff – could someone point me to the clauses?

my wife works with the NHS. I work in private healthcare. Growing up.my mother had a severe chronic condition. through all of this I have seen the very best, and the very worst of the NHS.

The NHS is a fantasti thing and when it works, its the best healthcare system in the world.

When it goes wrong its horrendous. a couple of years ago my mother had a scan which showed lesions on her brain. a 5 minute consultation with the consultant and he told her she had MS. this turned her world upside down and they did not consider any more tests necessary.

only at my insistence did she go private and a battery of tests confirmed she did not have MS.

this is one of many failings ive encountered with the NHS. Diagnosis always seems to be a major problem.

however, if youre seriously ill and they know whats wrong, the NHS is second to none

Here is a link to the health Bill now I gave it a quick read but I struggle to find all this privatisation stuff – could someone point me to the clauses?

The problem is not so much as what this bill is calling for, but where this bill will take us and what the next bill will do.

mefty – Member

Here is a link to the health Bill now I gave it a quick read but I struggle to find all this privatisation stuff – could someone point me to the clauses?

I am astonished by the level of pretence and dishonesty shown by some. Whilst for the obvious reason that the NHS, and the principles behind it, enjoys pretty much incomparable support amongst the British people, they can’t openly declare their intention to transform it into privatised profit making concern, do they not realise that anyone who bothers to give the issue any consideration can see straight through them ? ………and hence the massive public and professional opposition to their plans.

Of course the neo-cons aren’t going to openly declare their intentions to carry out widespread privatisation of the health service – why would they when it would have no public support ? But the multibillion pound industry has far too much potential for huge profits for them to resist it, and there isn’t a whole lot left in Britain to privatise.

So yes, words such as “privatisation” won’t enter their vocabulary when they are discussing the NHS, preferring instead to suggest that it’s all just about improving patient care, such as Z-11’s contributions.

Because everyone knows that the right-wing of the Tory Party, people like Dan Hannan, have always had a deep commitment to the NHS ! And which Labour has never had ! In fact so committed as these these bleeding heart right-wingers to non-profit motivated free healthcare for all, that they are prepared to take the political fallout resulting from the massive opposition from all the professional healthcare organisations ! ….. God bless them.

The official policy of the British Medical Association – which has given the Bill more than just a “quick read” mefty, is that the Bill should be withdrawn. And that the government is misleading the public by repeatedly stating that there will be no privatisation of the NHS.

The Council of the BMA has issued a statement on the Bill which amongst other things states :

That this meeting of Council:

1. recognises the medical profession’s lack of support for the Health and Social Care Bill;

2. recognises the lack of support from the majority of GPs for involvement in GP or clinical commissioning as proposed in the Health and Social Care Bill;

3. rejects the idea that the Government’s proposed changes to the Bill will significantly reduce the risk of further marketisation and privatisation of the NHS;

4. agrees that the Government is misleading the public by repeatedly stating that there will be ‘no privatisation of the NHS’;

5. calls for the BMA to start a public campaign to call for the withdrawal of the Health and Social Care Bill.

BMA Statement on Health and Social Care Bill

It should be noted that 60 years ago the BMA, because of its understandable links with the Conservative Party, was strongly opposed to the creation of the NHS, but it went ahead anyway because of overwhelming public support. Today the BMA is passionately in support of the NHS and the reason is very clear : because despite the lies spouted by Dan Hannan to his American audience the NHS has not been a ’60 year mistake’, it has been a stunning success – something which the BMA fully recognises.

I await being told that the BMA is just playing the tired old left v right game and using healthcare as a political football by exposing the government’s hidden privatisation agenda.

It should be noted that 60 years ago the BMA, because of its understandable links with the Conservative Party, was strongly opposed to the creation of the NHS, but it went ahead anyway because of overwhelming public support.

Google “stuffed their mouths with gold” you will find the real reason the doctors went along with Atlee.

As an aside what is this obsession with Daniel Hannan? And why do you keep banging on about Neo-Conservatives? Do you even know what it means?