Owen Paterson MP was on Any Questions last week – with a decent panel – discussing spending on the NHS. It was like a scripted story with him trotting out – “You can’t just keep spending on the NHS, we’ve tried that,and our outcomes are poor compared – it’s the way we organise [the money] it???”

I think it was Lucie Green (Physicist) on the same show who said even though politically we have increased funding. It may not be enough. Seems logical to me.

Owen Paterson and his think tank seem to think we’ve got to look to Switzerland, Ireland and South Korea for answers.

http://www.uk2020.org.uk/wp-content/uploads/2016/10/UK2020-Final-eBook-RGB.pdf

I haven’t read the document but I guess it will just prop up a Neo-Con agenda?

Owen Paterson MP was on Any Questions last week – with a decent panel – discussing spending on the NHS. It was like a scripted story with him trotting out – “You can’t just keep spending on the NHS, we’ve tried that,and our outcomes are poor compared – it’s the way we organise [the money] it???”

Well the Tory MP is right – it’s not just about money. If it was, the US, which spends way more of its GDP on healthcare than any other country, would have a healthcare system that was the envy of the world, and it hasn’t.

It’s what you do with the money. For a start don’t hand it over to profit-driven private enterprise.

Crippling PFI deals leave Britain £222bn in debt

“Treasury data analysis unearths the ‘enormous financial disaster’ of Private Finance Initiatives”

Medical consensus changes over time. On Lyme it is doing so. Long term antibiotics have good evidence behind it it you want to see it but you don’t

Okay. Show me the trials and the cochrane meta-analysis. If not, put up and shut up.

kimbers the joint MMR vacine definitely negatively impacted the health of our middle daughter (in our opinion as parents), there have been long term issues she suffers from to this day, she is now 26. My eldest didn’t have it and we paid for the youngest to have the individual jabs. The joint vacine was a cost saving excersize no one asked for amd which tye medical profession amd various governments have been wedded to imo for fear of admitting any mistake. You can post the “nutter” stuff if you like but there are very many parents who feel this way

This is pure gold, defending the lymies and talking shit about mmr – playing into a stereotype there. World class trolling Jamby, as I don’t think you’re being serious.

tom – whats your expertise to be so definite about something you appear to know little about? Myself a nurse trained to honours level in research so I can read research and understand its validity

cochrane is OK but is always very conservative and slow to react to changes in the science.

there is no need to be so aggressive and condescending in a debate

Hahahaha – the stats guys consider cochrane to be the gold standard.

But sure, I’ll listen to a nurse trained to honours level in research – whatever the **** that is. Cochrane may have its issues, but the standard is still better than everything else.

After the false claims were made by a crooked physician and the private healthcare industry seized the opportunity to exploit confused parents by selling them single vaccines, sometimes in a way that left the child unprotected as they didn’t even keep the vaccines cold properly, which the NHS then had to sort out.
You are known for spouting crap Jamba but I didn’t have you down as an anti vaxxer too. Dangerous crap to spout.

Remind you a bit of lymes?

Plenty of peer reviewed articles out there if you want to learn. some of us can separate quackery from medicine. I agree there is an awful lot of quackery around Lyme but the current medical consensus is not unchangeable and there is a lot of new data coming in about lyme. Now this is still a controversial point but there is no doubt good evidence is being accumulated and in the medical estblishment people fight hard to hold onto their views which makes the consensus slow to change. But it does change over time.

Conclusions. Prolonged antibiotic therapy may be useful and justifiable in patients with persistent symptoms of Lyme disease and coinfection with tickborne agents.

http://cid.oxfordjournals.org/content/45/2/149.full

So Tom – what is your expertise then to be so aggressive and condescending? I could point out to you multiple issues where Cochrane has been shown to be wrong in the light of newer data

But sure, I’ll listen to a nurse trained to honours level in research – whatever the **** that is.

thats a nurse who has done their training then done post grad education focussing on research to level 10 / honours level which allows me to have the skills to critically evaluate reseach papers

So Tom – what is your expertise then to be so aggressive and condescending?

I really wouldn’t worry too much TJ, it’s nothing to do with you, Lyme disease, or his expertise. Tom has excelled at being unpleasant on this thread, he’s probably got some personal issues to deal with. Here’s an example from earlier in the thread.

Tom_W1987 – Member

Ok. Fat, lower tax band, lower NI contributing Northern Brexiteers that shit out too many kids.

Posted 1 week ago #

Lyme disease hadn’t even been mentioned when Tom decided to rant about Northern Brexiteers that shit out too many kids.

Raphael B. Stricker
International Lyme and Associated Diseases Society, Bethesda, Maryland

Lolz

Some paradigm shifting research right there, better ignore the rest of the reputable evidence in favour of this authors conclusoon.

So tom – are you going to tell us what expertise you have that allows you to be so definite about this? Or are you going to continue being so unpleasant without anything to back up your assertions?

Well, Im studying a related masters in September. But I don’t use appeal to authority to prove my point.

Burden of proof is on the lyme literate not the skeptics. As Hitchens once said, what can be asserted without evidence can be dismissed without evidence. Although in this case the skeptics have more studies on their side.

It’s what you do with the money. For a start don’t hand it over to profit-driven private enterprise.

Well, contradictions abound as the ‘Commonwealth fund assessment of healthcare systems’ sort of contradicts the UK2020’s study in many ways.

It seems measuring things in different ways is the problem here.

No – you use strawmen and ridicule instead. So in the future you are going to study in the area? I guess then you are recent graduate?
Glad to see you finally accepting that the evidence points both ways with the medical consensus at the moment being against long term antibiotics but that there is evidence the other way – and you are right in that its up to those who promote this view to prove it – and that is what a lot of research is aiming at doing. You are way behind the curve on this and as is often the case with people with such dogmatic attitudes you don’t realise the holes in your knowledge.

Me – I have an open mi9nd and will listen to all sources, discard the obvious nonsense and snake oiland then critcally evaluate whats left.

this approach has informed me and I know that Lyme can lead to lifelong effects where the causes are unknown. that the testing for lyme is pretty unreliable and that the lyme bugs are dead sneaky and hide and that the medical consensus does not answer all the questions and that those answers are not certain at all yet.

As you grow you will realise that medicine is not an exact science and tht medical consensus changes all the time in the light of new data

Not exactly a recent grad. 😀

But whatever helps you sleep at night. History is littered with scientific rebels and naysayers who went up against the mainstream and who were wrong – chances are it will be the same with long term antibiotics treatment for lyme.

Large parts of current problem related to social care which is nothing to do with NHS budget.[/I]

I’ve often thought that since ‘bed-blocking’ is usually linked to a lack of social care budget, and it is also mentioned that hospital stay costs more than been in a Care Home etc that if it was all under a single budget then management would ENSURE that the patient was in the cheapest place to cover their health needs.

FWIW when I worked in the NHS I saw results of bed audits that reckoned (medically) +30% of patients were bed ‘blocking’.

what is it 10000+ NHS beds lost since 2010?

now the decimation of local council budgets means that social care is seeing a greater decrease

This winters crisis was always going to happen, just lucky that its been such a mild one!

out of idle curiosity, would you describe Corbyn as ‘far left’…?

He is starting to get there yes, not communist but on his way. Anti-capitalist / Communist distincion is quite slight. McDonnell is a proudly Marxist, he said so himself. That’s far left IMO.

TJ I am no where near rar-right. You and others just use that to attempt to discredit me and shut down debate. It is what it is.

@kimbers as I posted before major row in France as Socialist Govt has asked hospitals to delay all non-urgent surgery. Beds situation no different there.

The NHS would be in a bigger mess under Labour.

I am no where near far-right.

You may want to trawl through your posts (not something I would wish on anyone)
You are definitely far right in your stance (in this forum at least)

You and others just use that to attempt to discredit me and shut down debate.

comical

b r our local trust funds rehab beds in the community to get people out of acute beds when the council can’t/won’t. It shouldn’t happen but it does reduce the acute trusts costs. So the ring fenced NHS budget is used to support the social care budget. But the tories won’t want to hear that this happens.

Jamba – by any stretch of the imagination you are far right. Its just that where you sit it looks centrist. Now I am centrist and you are far away to the right from me same as Ernie is to the left of me ( I have never forgottten his insult – ” some sort of wishy washy pale pink liberal” IIRC. Nothing to do with attempting to discredit at all – just calling a spade a spade

Jamba – by any stretch of the imagination you are far right. Its just that where you sit it looks centrist. [/I]

My wife considers she is slight right of centre, but from my perspective she is somewhere to the right of Genghis Khan 🙂

docrobster – our NHS trust started doing this as well – we are in scotland further along the integration road. Unfortunately the initiative had to close as all that happened was those beds were blocked as well

£78 per 20 mins is the price of private GP consultation as I found out today. I assume it applies to all sort of medical consultation as it just says consultation on their website. Not sure if they are NHS funded but it says private.

I am willing to pay for GP consultation for non-urgent matter but the price at £78 is too much for me to pay. I don’t want to use NHS GP if I can afford to but … £78 per 20 mins … hmmm …

£30 to £40 for consultation is fine for me but more than that I really think I am being held “ransom”. What’s the average income in UK? £28k per year?

Even in the far east with low income or low cost living private GP don’t charge people at that rate. i.e. normal for our currency is around 30 to 50 max for consultation. However, the prescription might be expensive if you buy from them otherwise buy somewhere else. (Yes, some unethical ones will get you to buy prescription from them but they will not last long once words get out if they are not good)

I have just made an appointment to see my NHS GP and the only available time is in a month time. In the meantime I have been asked to call everyday at 8am for available appointment if I want to see GP earlier.

Not sure about you lot but I am willing to pay but not at ransom rate …

For dentist (private) I pay £80 for each visit check up every 6 months i.e. general checkup (15-20 mins max) plus cleaning. I pay extra at private rate if things need to be done. I don’t use insurance.

@chew French state pays GP €26 an appointment, they can charge more and patient / their insurer pays the rest. State always pays something. Here £78 / €100 would get you a top consultant.

£78 / 20 mins would be roughly £300,000 pa total revenue, building and staff to pay for too. £78 is £234 an hour, an average solictor is much more than that.

Much more!!!

£78 will not get you a top consultant in the UK and I very much doubt it would get you one in France – its certainly not the full cost by any means

jambalaya – Member

@chew French state pays GP €26 an appointment, they can charge more and patient / their insurer pays the rest. State always pays something. Here £78 / €100 would get you a top consultant.

£78 / 20 mins would be roughly £300,000 pa total revenue, building and staff to pay for too. £78 is £234 an hour, an average solictor is much more than that.

Our solicitors at my hometown can charge crazy price that is way much more than GP that I am sure of, but they don’t get hourly client to charge that. I don’t know what they earn if they average out their charges by comparison to GP. I guess it might simply be an amount that they can get away with I guess …

Actually my calculation at £78/20mins = £488,592/year.

£78 / 20 mins
1hr = £234
1 day = 8 hr => 8 x 234 = £1,872 per day
52 weekend roughly 104 off day. Therefore, roughly about 261 working days.

Therefore, £1,872/day x 261 working day = £488,592 income per year.

No wonder we say doctors become millionaires rather quickly in our country …

I want to pay and I assume at one point in future there will need to be some sort of payment for GP consultation. I don’t earn a lot but I am willing to pay because it means I can help free up NHS service or fund for much more urgent matter.

However, the current private GP price is somewhat at the premium end …

~Then you have to subtract the costs and also the support services and you dont get 40 chargeable hours for 40 hours work – you would be lucky to get 25

Cost of running any kind of health premises is vast, it’s not just buildings furniture electricity and employees but the business of sntthing medical involving equipment, sterilisation, clinical waste and so on and so forth. With no margin of profit at all, simply the infrastructure around an hour’s work from a doctor that is paid exactly the same as a solicitor adds or rather multiplies the cost. In fact chewkw I am surprised you get 20-30 mins of a dentist (or rather the whole team etc behind them too ) for just £80: there must be a few people in the same day paying £45 for a 5 minute checkup subsidising you!

tjagain – Member
~Then you have to subtract the costs and also the support services and you dont get 40 chargeable hours for 40 hours work – you would be lucky to get 25

If you have 4 Private GPs at the practice that will be £1,954,368 per year income combine for the practice. The cost is divided amongst the GPs so how much will that be? Assuming the cost is one third (1/3 or 30% cost = £651,456/year) they are still making £1,302,912 amongst the four of them which is equivalent to £325,728 per GP per year.

Assuming the cost of £651,456/year is for receptionist staff nurses etc … at £24,000 salary per person … you are employing 27 staff nurses etc everyday. The question is do you need 27 staff everyday at GP centre?

….I know that my annual salary is actually a small percentage of the operating costs of my employer to provide a service for the people I see. I am just the person they see in clinic but plenty more people and costs behind me allowing me to do all this. I.e. If we charged at cost to my patients (we don’t charge at all of course) then i can well imagine it being 5x my hourly salary without any danger of making a profit.
Even Relate with cheap premises, minimal overheads and support staff, charity status and relatively low wages compared to NHS family and couples therapists need to charge an average of £50-60 an hour just to break even.

julianwilson – Member
….I know that my annual salary is actually a small percentage of the operating costs of my employer to provide a service for the people I see.

I am not against charging etc but if you look my my calculation above what other cost do you think will need to be incurred?

The NHS centre that I am see my GP has 2 receptionist, 4 nurses, 1 manager I think … which is less than 10 at anytime.

The private GPs must be made more affordable for people if NHS want to reduce the funding burden. However, dictating a price for private GPs is not the solution but there need to something done there … I want to use private GPs but I want to be able to pay too. Not ransom.

tjagain – Member
– you would be lucky to get 25

Yes, I should have deducted one hour break for the GP above so 35hr week if you wish.

But why is that 25 hour per week for a GP?
Any breakdown?

Even at 25 hr we are talking about £304,200 per year income per GP at private rate. 4 of them combine will be 1,216,800. 30% cost = £405,600 (equivalent to hiring 16.9 staff or nurses at £24,000/person/year). Which means take home pay per private GP per year is £202,800.

I am not against charging etc but if you look my my calculation above what other cost do you think will need to be incurred?

Building costs, electric, heating, medical supplies, non medical supplies, pensions for staff, waste disposal it’s around £250 a tonne for medical plus many more items. You’re also calculating that Dr’s charge for every hour they are at work.

Drac – Moderator

I am not against charging etc but if you look my my calculation above what other cost do you think will need to be incurred?

Building costs, electric, heating, medical supplies, non medical supplies, pensions for staff, waste disposal it’s around £250 a tonne for medical plus many more items. You’re also calculating that Dr’s charge for every hour they are at work. [/quote]

Drac look at the 30% allocation for overhead cost etc. Do they incur 30% cost every year?

For a small 4 private GP do you need to 17 staff/nurses/employees everyday? We are talking about 4 employees to support a GP everyday.

Yes, you can include all pension, building over heads etc from the 30% cost. All included as I am just using the most costly “cost” in that calculation.

Chewkw – you haven’t even considered Many costs that I’d expect a bureaucrat like yourself to be aware of; NI, VAT, rates, etc etc

All these numbers make my brain hurt!
Average NHS expenditure is £136 per patient per year for 5-6 consultations and house calls etc for the frail elderly terminally ill. And people wonder it’s hard to get hold of a gp.

For a small 4 private GP do you need to 17 staff/nurses/employees everyday? We are talking about 4 employees to support a GP everyday.

Depends what other clinics they run. This GP is in your head so I’ve no idea.

Yes, you can include all pension, building over heads etc from the 30% cost. All included as I am just using the most costly “cost” in that calculation.

You can’t pick random costs.