Interesting graph, is it from a realiable source?
The population growth that came after the war are in retirement now so we should be looking at a reduction in the pension spend as they pass away over the next 10/15 years. Also, the current state pension isn’t mean tested either.
Quarter of the total for welfare!?

jekkyl – Member

Quarter of the total for welfare!?

It’s a hateful lie.

That (now infamous) pie-chart includes pensions for teachers, nurses, police, etc, ie. state employees.

Pensions actually make up more than half of the 25% attributed to ‘welfare’. My dad’s not on welfare, he’s a retired teacher.

In other words, the budget for pensions is *****ing huge. That’s the budgetary elephant in the room.

It is completely disingenuous as it suggests that the only solution is to cut the level of service rather than increase funding.

Not quite. Its suggests both which is what medical bodies are also saying.

The level of service is already rationed anyway. That’s how scarce resources are allocated when the state is the monopoly supply and the service is free at the point of delivery.

Re pensions, I lost the link but read yesterday the percentage of the budget that was absorbed last year by pensions. Makes you think….. 😉

Mike, I’ll say it one more time. The rate of cost increase in the NHS is double the rate of growth of the economy (and we have tye best growth in the G7). Cost growth exists in the NHS independent of whether the economy’s growing or not. Health care costs are rising party as new technology/drugs costs more not less and the population is growing and ageing. Your point about a growing economy is exactly what the PM said at PMQ again today, the Tories are the party to devliver that is her point

People are asking why there cannot be a cross party effort to address this and it’s a very good question. The answer is neither party wants to face the real problem.

We need a total rethink

This is from DrP I agree wholeheartedly

The reality is the nhs cannot afford it’s current level of activity.
And there lies the crunch ,, the vast majority of overspend is increase in activity, rather than significant waste. More things are happening.

Three kids cost more than two.

Two cars cost more than one….

We need to sensibly reduce activity.

teamhurtmore – Member

it is completely disingenuous as it suggests that the only solution is to cut the level of service rather than increase funding.

Not quite.[/quote]

Yes it is. Cutting the level of service rather than increasing the funding is one solution but it is not the only solution. This thread has half a dozen pages of suggestions which include what other savings could be achieved to increase NHS funding.

Thank you making my point Ernie. You have corrected yourself, thank you.

This thread has half a dozen pages of suggestions which include what other savings could be achieved to increase NHS funding.

Most (all ?) of them not even Labour Party policy. It’s a fantasy list of suggestions supported by virtually no one.

Even Corbyn himself doesn’t propose abolishing the Trident programme, just the missiles but keeping the new subs.

We need a totao rethink

We need proper intergration between state and private provsion

We need people to pay for more private health insurance

We need higher taxes to oay for increased state spending, we are one of the very few countries without VAT on food and we have a much lower level of VAT on energy bills than does the rest of Europe. We need to address tax avoidance by the gig economy and tech companies

The solutions are out there. They are what everyone else are doing.

and the population is growing and ageing.

partially, the population is getting older, and in the west we’re very good at identifying/stabilising/treating chronic conditions rather than catching them early enough to cure them. But mostly we’re getting chronic lifestyle illness that don’t lend themselves to a trip to a hospital to be “cured”. Often I see people taking pills to “stabilise” one condition that needs a couple of other pills to alleviate the worst of the side-effects of the first…We are, as a population not paying enough attention to our own well being.

IMO, FWIW, we need to have a more much interventionist view on people’s health, we have a system that tries to treat people once they are ill, where we need to have a system that prevents people getting ill in the first place, which is largely a social rather than monetary change. (although the countries with the best health outcomes spend something like 11% of GDP on health care vs the 7-8% we spend.)

I’d scrap the idea of a massive “national” NHS and go to a much more nuanced regional system without the “one size fits all” mentality that pervades the current system to it’s detriment. let a culture of “do what works” grow.

Even Corbyn himself doesn’t propose abolishing the Trident programme, just the missiles but keeping the new subs.

crazy lefties. that’d be like making the decision to have an aircraft carrier without any planes…

Teamhurtmore – Member

Thank you making my point Ernie. You have corrected yourself, thank you.

Posted 30 minutes ago

God you’re pathetic.

Yes increase VAT on food and energy (heating). It’s a regressive tax so a suitable compromise in order to continue our “**** the poor” theme.

Why thank you Ernie, you are too kind.

(SQ, VAT is a tax on consumption not income so by defintion it cannot be regressive. That aside, carry on…)

VAT is a tax on consumption not income so by defintion it cannot be regressive.

you do talk the most utter bobbins sometimes

Ernie – you seem to be coming across very angry, somewhat agitated. I think it’s skewing your replies..

You challenge the statement “The reality is the nhs cannot afford it’s current level of activity” as if that’s incorrect?

That statement is made ‘now’ as a snapshot of ‘now’. Hence, it IS correct!

Can you afford 4 ferraris? If you can, great, but if not, the statement “ernie lynch cannot afford 4 ferraris” is true.
Yes, you might win the Lotto tomorrow, hence is no longer true. But today, it’s true.

And (unfortunately) there was no jest in my statement suggestions on how to manage the current NHS crisis.
In a was (a very ‘mail headline way’) you are correct – taking the cataract threshold example (which IS just a quick example i typed over breakfast or something) then yes – by increasing thresholds you reduce the number of operations required hence reduce the cost of said operation. Some people may need an operation at a later date, some people may die of other causes, some people may never deteriorate to NHS operation thresholds.

Of course, there is also an additional spend required by NOT doing operations i.e you increase knee op threshold, you save money on knee ops by doing less, but you spend more on teh analgesia budget and physio budget.
If the saving > the new spend, then it’s a goer.

Anyway, I know your agenda, you won’t be skewed, you’re not as ‘aware’ as you like to think you are, so all is forgiven…

DrP

jambalaya, earlier on the thread I did agree with you that increased taxation is required. But I also said I would only find that agreeable if there was a more equitable distribution of wealth in the country. Increasing taxation on spending is going to affect the poorest most.

Big row in the French Parliament today about health spending, Socialist government getting a battering but fighting back. Politics is politics.

Sorry if truth/accuracy is uncomfortable nick

(I will contact the Alevel examining boards to alter their marking schemes as this is a regular question, on your behalf)

Dr, don’t worry, Ernie likes to make things up about what you said in order to argue with you/himself. Nothing new there. Your comments on services are echoed across the profession.

DrP – Member

Ernie – you seem to be coming across very angry, somewhat agitated.

Your diagnostic skills are poor doctor.

@slow maybe maybe not. We do need a proper discussion. IMO wealth inequality is primarily driven by globalisation as there is unending supply of ultra cheap labour. This is going to hit the middle income earners too as the supply of uktra cheap skilled labour inc in services is growing very rapidly. A big chunk of the very wealthy in London now and in the future are Chinese. Think about that.

For example. As far as I am concerned lack of funding for education meant I had to pay a higher price in direct costs than I would have had to pay in taxes to get the quality I was looking for.

Cut the 25% who go to A&E who aren’t genuine emergencies and could have accessed health care from their doctor or via phone (NHS figures)

Would cure the problem overnight

Your diagnostic skills are poor doctor.

Hence why you can’t beat face to face appointments.
It’s not like anyone is suggesting email/text/skype consultation should be the norm, are they… 🙄

DrP

In terms of individual income and wealth, a regressive tax imposes a greater burden (relative to resources) on the poor than on the rich: there is an inverse relationship between the tax rate and the taxpayer’s ability to pay, as measured by assets, consumption, or income.

Who has more disposable income, rich or poor?

Based upon the your first answer, who pays more on food or heating as a proportion of income?

Therefore, could VAT be considered regressive?

If you could answer these questions directly it would be much appreciated.

om_W1987 – Member

You do know that they wouldn’t have done the study right, if someone had already proven that these drugs work for ‘chronic lyme’. Don’t you?

So you’re now agreed that you can’t make a blanket statement regarding the efficacy on longterm antibiotic treatment based on just two drugs, and that you’re distinction between quacks and ‘real science’ also accommodates a considerable lack of knowledge in both parties? Excellent.
A lot of those comments are from butt-hurt Lymie quacks. In fact, they seem so upset – I might just choose this as a PhD topic to troll the **** out of as many of them as possible
Why not? You’re ambition seems to be acting like a Phd level troll on here. Or you could do something medically useful. Either way, they raise pertinent and informed questions about the quality of that study and unlike you many have a Phd. Internet troll vs Doctor?

You’d think that they’d start with the drugs that are used to tackle acute lymes though? Wouldn’t you, drugs that have been proven to work in neurological lymes disease eg doxycycline.
you would, wouldn’t you? And yet, they are already shown to have improperly used IV ceftriaxone by using it for less than the lifespan of the borellia and it ignores current research regarding persistent or chronic Borellia infection that actually discuss in vitro and in vivo antibiotic efficacy in-depth. That would have been a better place to start, wouldn’t it? Or from your lofty position of achievement do these scientists not meet your standards?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3132871/#__ffn_sectitle
a mean improvement in all test groups after the 14 weeks.
Oh you mean like in the placebo group as well?

You mean the placebo group that was also given a two week course of ceftriaxone? It’s not really a placebo group anymore is it? They should perhaps have considered that when designing the study… Did you even read the paper beyond the abstract or are you just trying to save face and regurgitating whatever suits your purpose?
I’m sorry, but I really don’t think coinfections would statistically alter this study at all – there should be a representitive sample of coinfections in both the placebo group and the treatment groups – these coinfections do not intereact with antibiotics do they – you state that they intereact with the immune system.[.
Yes, and if the study relies on measuring the production of antibodies in response to the treatment but the patient is immunosuppressed they won’t get an accurate finding, will they? Again, did you actually read it

1) You shouldn’t recommend a treatment until there is evidence to prove that it works. So even if the studies havent been done, Lymies shouldn’t be demanding access to these antibiotics.

2) Many of the “doctorz” raising questions in the comments section are actually raising non questions in an attempt to discredit the paper in the eyes of those that dont know any better.

3) This study relied on quality of life indicators, not immune markers.

4) A placebo group that were never treated would not have passed an ethics committee for fairly obvious reasons, its still a perfectly fine contol for the studies intended question.

5) Do you even science, bro?

6) I can’t be **** to check the validity of the accusation that they didn’t treat one arm of the study properly, at the moment, as Im typing from a phone. But like all the other “crticisms” I think it will end up being refutted quite easily.

DrP – Member

It’s not like anyone is suggesting email/text/skype consultation should be the norm, are they..

Sounds like a brilliant idea. How much would it save the NHS?

Sorry if truth/accuracy is uncomfortable nick

The most common definition of whether a particular tax is regressive is that it affects the poor more than rich, which by any measure, expert of text book, VAT very clearly does. I’m content that this is the most common definition of “Is VAT a regressive tax”

If that doesn’t fit your view, it’s your look out, not mine

I get what DrP is saying, in a very brutal way its the most pragmatic course of action. The question we have to ask ourselves is whether we want our health provision granted in such a manner.

Cut the ‘Around 1 in 10 hospital outpatient appointments are missed every year in England’ again NHS figures

10% improvement here

It’s not just DrP saying it…

DrP

Edit – This is quite an informative procedure document.

Yes increase VAT on food and energy (heating). It’s a regressive tax so a suitable compromise in order to continue our “**** the poor” theme.

Exactly. VAT should be removed from items not added. The poor are the most affected by VAT relative to their income. It should only exist on luxury items, i.e. not on most food and not on energy.

Edit – This is quite an informative procedure document.

hmmm, I’d be wary of using anything from Shropshire/Teford CCGs…

use one of the others then!
The point being, the process and idea isn’t new.

DrP

yep, they’re all under pressure, and all looking to shed costs.

DrP – Member

The point being, the process and idea isn’t new.

Why do you need to make that point?

Who said that reducing whole services, starting with those with the least impact, or delaying knee replacement and cataract ops was a new idea?

It’s pretty damn obvious that cutting back on NHS provisions is an idea that’s been around for a long time.

I thought we were discussing whether it was the only solution, or whether it was necessary, or whether it was desirable.

Ultimately it’s about political decisions and priorities.

It’s pretty damn obvious that cutting back on NHS provisions is an idea that’s been around for a long

yep, everyone understands that, why d’you feel the need to make the point?

Nick, common does not mean correct as this case proves. You may be comfortable too, but you are still incorrect. Plus FWIW, the impact that you are alluding too is not constant anyway – the IFS analysis shows for example that VAT differs over lifetimes with the opposite effect to the one commonly described.

VAT has grown in popularity globally for a very simple reason – it is considered to be the least disruptive form of taxation. But again, getting into technicalities now.

Cut the 25% who go to A&E who aren’t genuine emergencies and could have accessed health care from their doctor or via phone (NHS figures)

If only it was that low.

(anyone here got kids?? – you know when you’re trying to have an adult conversation with a friend, and your kid keeps grabbing at you and asking about skylanders and such, and kind of getting involved in the conversation, but really they just hear what you say, repeat it back to you in a childish voice, just to get attention – anyone relate to that??!!)

Anyway.. Ernie, you’re right. I’m sorry.
Take care – I’m out of this thread now as it’s just gotten silly.
Enjoy your skylanders.

DrP

If the government wants to reduce people going to A&E with nonemergency cases, probably having GP surgeries closing at record levels (with another 10% apparently under threat) and 12% of GP posts currently unfilled is something you could look at. Or the 36% reduction in district nurses. Or fixing issues in social and mental health care. Or they could just say it’s all irresponsible individual’s faults.

(of course there are irresponsible individuals misusing A&E)

Sounds like a brilliant idea. How much would it save the NHS?

Great, we could offshore it.