NHS in crisis

[LateThanNever]

Would your aspiration of funding by the payment of a higher rate of income tax to "properly fund" the service bring in enough monies to fund the ever-increasing drugs bill borne annually by the NHS, let alone other staffing costs.

Many people are already taken out of the payment of income tax, so they as the poorest wage earners would not contribute anything to this scheme, so would you then put a special tax surcharge on them? If so, would both optical and dental services then also be free of charge to one and all, or would you set income bands of combined income tax and national insurance to cover such an eventuality?

What do you propose should happen to those who already subscribe to private medical services?

You have just cited a very good example in the part of your posting that I have emboldened of why those to which you refer to in the banking industry should forsake Britain as quickly as possible and relocate to the financial hub centres of Europe, to escape such strictures.

The wunch of bankers are absolutely expert at losing money abroad and then expecting, us, the home country to pay. We should start local banking on the German model and let the big banks go bust, when they cannot survive without government money.

Meanwhile please don't forget Britain has a sovereign currency and has, so far, created the best part of a quarter of a trillion £s out of thin air for the banks. AKA Quantitative Easing. If this inane and irresponsible government had any moral fibre it could create Quantitative Easing for the NHS or for social care or roads or railways. We don't tax and spend, we spend and tax. The currency becomes valuable because the government produces it (together with licensing private banks to produce it when they create loans) and legitimises its currency by accepting taxes only in £ sterling.

Fundamentally it matters not how the funding is raised (the lower the overhead the better of course), what does matter is how much funding there is.

In 2015 the USA spent $9,451 per head. Germany $5,267. France $4,407. The UK only spent $4,003. We're closing the gap -- 66% to 75% of German's spend per head in the 5 years of coalition budget, but still more to close.

The NHS is far better funded now than it was in 2010, although how much of that is taken off by PPP profits is another matter. Fundamentally health care is increasing in cost due to more expensive treatments being available, and more elderly people requiring those treatments.

The costs of PFI are crazy and now Quantitative Easing has shown us we don't need PFI (which effectively feeds the richest from government coffers) we should stop it. The NHS administration costs are increased immesasurably by subcontracting - these contracts all need specifying and administering - a complete waste of resources. Then those that quote for the contracts all want to make lots of profit - which in effect the government pays for. Madness!

I'm left of centre, but I'm getting very bored with the hysterical "YOU CAN'T TOUCH OUR NHS" whenever any change is suggested. We need to stop worshiping the NHS and start funding the NHS/ prioritising the NHS/ limiting the NHS.

The NHS has been in a state of permanent change for a long time and made substantially worse by Cameron's pledge not to reorganise it but doing just that. And this just makes for a labour force that is under unecessary extra pressure in an already demanding job.

 

[Xenophon PCDGS]

If this inane and irresponsible government had any moral fibre it could create Quantitative Easing for the NHS or for social care or roads or railways.

I thought that the Government already had a form of the described Quantitative Easing that was providing finance for the DfT in their current crusade on the GTR franchise..

 

[Arglwydd Golau]

When the NHS was semi-privatised by appointing numerous Managers to run "their" hospitals like a business it was the start of the slippery slope.
I have a sister who was a charge-nurse at Whipps Cross who tells tales of staggering amounts of waste. A friend who's a district nurse specialising in respiratory problems says the same. One of the biggest waste is drugs which are issued and never used. Kate's patients demand a new supply every month and when she points out that they still have stuff left over from the previous months she's told that, "I'm entitled to fresh drugs" with the result that perfectly good drugs are thrown away. Now into that equation fill up A&E every Friday and Saturday with drunks. Drunks who used to be rounded up by the police and thrown into a cell to sober up before being either charged with being D&D/D&I before simply sent on their way the next morning. So nowadays whilst 87 year old Doris is waiting for an ambulance said ambulance is transporting 19 year old Sharon and Chardonnay who have passed out in the gutter. Naturally, on the way to A&E they've vomited in the ambulance so now it has to be taken out of service for cleaning.
Then of course there's the ever-popular junkies who've overdosed on whatever they're inhaling/injecting/sniffing.
The population is getting older and this places more demands on the NHS. How many people of 100 years + do you think are alive? 100, 1,000, 10,000?
In 2014 national statistics revealed that there were 14,450 people of 100 or more of which 780 were 105 or more. The numbers of 80 year olds could fill a large town.
If people were charged a flat fee - say £10 - to attend A&E the revenue generated would be immense. But it won't happen and the NHS will continue to run at crisis levels no matter how much money successive governments give it.

There are always examples of waste, (I can list loads from my time in the NHS) and I am no more a fan of the - often violent and abusive - drunks in A&E on a Saturday night than you are. Often, though, more costly in terms of time are those who go to their GP and A&E for simple ailments that do not need the input of Health Specialists at all. Why does this happen these days?..even more and more, and requiring expensive advertising to attempt to limit it. It has been suggested that one of the reasons is to do with the break up of the extended family, when little Penelope has a runny nose it's off to the doctor as Mum doesn't live round the corner anymore.

 

[WelshBluebird]

When the NHS was semi-privatised by appointing numerous Managers to run "their" hospitals like a business it was the start of the slippery slope.
I have a sister who was a charge-nurse at Whipps Cross who tells tales of staggering amounts of waste. A friend who's a district nurse specialising in respiratory problems says the same. One of the biggest waste is drugs which are issued and never used. Kate's patients demand a new supply every month and when she points out that they still have stuff left over from the previous months she's told that, "I'm entitled to fresh drugs" with the result that perfectly good drugs are thrown away. Now into that equation fill up A&E every Friday and Saturday with drunks. Drunks who used to be rounded up by the police and thrown into a cell to sober up before being either charged with being D&D/D&I before simply sent on their way the next morning. So nowadays whilst 87 year old Doris is waiting for an ambulance said ambulance is transporting 19 year old Sharon and Chardonnay who have passed out in the gutter. Naturally, on the way to A&E they've vomited in the ambulance so now it has to be taken out of service for cleaning.
Then of course there's the ever-popular junkies who've overdosed on whatever they're inhaling/injecting/sniffing.
The population is getting older and this places more demands on the NHS. How many people of 100 years + do you think are alive? 100, 1,000, 10,000?
In 2014 national statistics revealed that there were 14,450 people of 100 or more of which 780 were 105 or more. The numbers of 80 year olds could fill a large town.
If people were charged a flat fee - say £10 - to attend A&E the revenue generated would be immense. But it won't happen and the NHS will continue to run at crisis levels no matter how much money successive governments give it.

Ok I'll bite.

1 - So who is going to pay for the admin that will be required if you are going to be essentially charging people an entrance fee?

2 - As for charging a fee at all, a few years ago I was violently assaulted and required A&E treatment (thankfully the police were VERY good and he was in custody before I even left A&E), are you really suggesting that people in that situation should have to pay £10 upon arrival at hospital? That is without evening mentioning the issue of that it would deter people who legitimately need the A&E services from attending (£10 may not sound like much to you, but for some people it is the difference between eating that week or not).
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There are always examples of waste, (I can list loads from my time in the NHS) and I am no more a fan of the - often violent and abusive - drunks in A&E on a Saturday night than you are. Often, though, more costly in terms of time are those who go to their GP and A&E for simple ailments that do not need the input of Health Specialists at all. Why does this happen these days?..even more and more, and requiring expensive advertising to attempt to limit it. It has been suggested that one of the reasons is to do with the break up of the extended family, when little Penelope has a runny nose it's off to the doctor as Mum doesn't live round the corner anymore.

The thing is the GP issue and the A&E issue affect each other. It can be very difficult to get a GP appointment now, so people turn up to A&E instead. Maybe not the correct course of action but people feel they have no other option (especially with the NHS direct phone line being utterly useless in my experience).

 

[Tetchytyke]

There aren't many who say "you can't touch our NHS". Nearly everyone I know who works in the NHS- nurses, junior doctors, psychologists- are happy to embrace any change that improves their patients and improves their ability to get the work done. The problem isn't too little change within the NHS, the problem is too much change. The NHS was working fine under Labour, but the Conservatives stated aim whilst in opposition was to "liberalize" the NHS. So they ripped everything to shreds, cut funding, and then stand there saying they don't understand why it's going to pot.

The Primary Care Trust system largely worked. But there wasn't any money for McKinsey and PWC. So it was torn up and now we have the Commissioners who know nothing about organising and procuring a service. But just coincidentally McKinsey and PWC are here, for a large fee, to help them.

 

[bramling]

The best way to increase funding the NHS I think is via a wealth tax, not an income tax. Typically those with incomes don't use much in the way of NHS services, it's those who don't have incomes (long term sick and elderly) that cost the most.

Right, so those who have taken the trouble to save get hammered, whilst those who haven't bothered to save get it all paid for?

No thanks.

 

[tbtc]

You could extend this to other items that contribute to health, such as the free provision of toilet rolls, which perform a most useful contribution to the general health of the population at large.

Good point.

Some things that we happily accept paying for, we don't even think of as "health". Paying for some health costs seems acceptable to most people.

Personally, I think healthcare is a right and not a privilege. It should be available to everyone, whether they're financially comfortable or they're struggling to feed themselves and heat their home. I do agree that some things need to be paid for such as medication (I pay £8.40 every four weeks for mine), glasses etc; but medical treatment at a hospital is expensive and I doubt many people could afford to pay for the treatment they need without sacrificing other daily essentials, if at all. I certainly couldn't, especially as I'm currently the only one in my house who works and brings in a regular salary.

I'd gladly pay a bit more income tax towards funding the NHS, but I'm totally against outright charging for using its services.

Sounds nice, but what level of healthcare do you define as "a right"?

Home births?

Gender surgery?

IVF?

Cosmetic surgery?

How long do you have to have been living in the UK (or being economically active in the UK) to qualify for medical treatment?

Do you keep patching people up into their '90s, so that they've had more hip replacements than the number of hips they were born with?

Does the NHS have to be the party that foots the bill for apparently increasing levels of mental health problems/ addictions/ abuse?

How many nights do you keep people in hospital if they are fit but their house isn't suitable to go back to (and they haven't sufficient money to pay for a care home)?

Do you draw a line when it comes to personal responsibility in terms of smoking/ alcoholism/ obesity (or just meekly treat people regardless)?

How much do you accept the NHS being a dumping ground for the woes of a broken society?

Easy to say "the NHS should be free", but what kind of NHS do you have in mind?

Firstly, the Government needs to redistribute taxpayers' money. And it needs to sort things out...people act like a Robin Hood tax would solve all our problems, but it is true that there's money out there that a mansion tax would help very well with. Then there's bankers' bonuses. And, at this critical point in time, why are the Govt choosing to fund new grammar schools instead?

That may raise revenue, but unless you tackle the level of free healthcare that the NHS currently provides, you'll find any increase quickly swallowed up.

People on here are too focussed on the "revenue" side and not the "costs" side. Does anyone want to have a difficult conversation about an ageing population (where people may spend as long in receipt of a pension as they did in employment)? Do we allow (or even encourage) assisted suicide like other countries? Or just keep people alive regardless of quality of life?

Very true! Those who paid their mortgages and heeded the politicians' advice to save for their old age get almost everything taken off them to pay for their care homes (and through their private fees subsidise the inadequate fees paid by LAs for their "clients") whilst those who've spent their working lives spending to the hilt get paid for.

The distinction between "deserving" and "undeserving" as applied by the Victorians may not be quite the one we woul want, but some sort of such distinction has a good deal to commend it.
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I think there are an awful lot who have "saved a few quid from their working life" who now get penalised despite being nowhere near a threshold for having "untold wealth, often inherited, squirreled away in tax havens"

I don't know how we square the circle re Social Care.

Most people accept that "Hospitals" should be free but that "Nursing Homes" cost money.

Making Nursing Homes free penalises the financially prudent who have saved in anticipation of that cost in later life.

I have a sister who was a charge-nurse at Whipps Cross who tells tales of staggering amounts of waste. A friend who's a district nurse specialising in respiratory problems says the same. One of the biggest waste is drugs which are issued and never used. Kate's patients demand a new supply every month and when she points out that they still have stuff left over from the previous months she's told that, "I'm entitled to fresh drugs" with the result that perfectly good drugs are thrown away

I hate this kind of operation - but it seems impossible to stop - departments have budgets and if they don't spend that budget in full then they might see their budget cut for next year, so there's no incentive to focus on costs.

It happens elsewhere, sure, but given the scale of the NHS it's costing a lot of money.

 

[backontrack]

There aren't many who say "you can't touch our NHS". Nearly everyone I know who works in the NHS- nurses, junior doctors, psychologists- are happy to embrace any change that improves their patients and improves their ability to get the work done. The problem isn't too little change within the NHS, the problem is too much change. The NHS was working fine under Labour, but the Conservatives stated aim whilst in opposition was to "liberalize" the NHS. So they ripped everything to shreds, cut funding, and then stand there saying they don't understand why it's going to pot.

Indeed. I think that the whole 'hands off our NHS' thing thrives because we can't trust our Government not to mess it up, either deliberately or no.

 

[miami]

The money spent on health care in the UK per head is less than that in Germany, France and the US. Costs aren't the primary issue.

Selfish people who didn't spend money (and thus didn't employ people) throughout their lives should still keep their money. It should only be taken after death, therefore they don't lose out (can't take it with you)

 

[DynamicSpirit]

There appears to be an element of luck involved or possibly a sixteen stone bloke, is regarded as being less of a good idea to annoy than a small woman.

As while my treatment by the NHS has been OK, my wife had several very bad experiences with various parts of the NHS, culminating with us being accused by an ambulance crew of wasting their time, by calling them out when there was nothing wrong with my wife except hysteria. She was at the time so weak and short of breath that she could not stand, and collapsed and died less than two hours later.

My deepest sympathies, that must've been an awful experience for you I can't even imagine how I'd be feeling if something like that happened to me or to someone I was close to. I'm guessing from your other posts that this was a long time ago? But whether it was or not, I hope you're OK. (Not that my hoping is likely to be much help )

 

[Phil.]

Ok I'll bite.

1 - So who is going to pay for the admin that will be required if you are going to be essentially charging people an entrance fee?

2 - As for charging a fee at all, a few years ago I was violently assaulted and required A&E treatment (thankfully the police were VERY good and he was in custody before I even left A&E), are you really suggesting that people in that situation should have to pay £10 upon arrival at hospital? That is without evening mentioning the issue of that it would deter people who legitimately need the A&E services from attending (£10 may not sound like much to you, but for some people it is the difference between eating that week or not).
--- old post above --- --- new post below ---


The thing is the GP issue and the A&E issue affect each other. It can be very difficult to get a GP appointment now, so people turn up to A&E instead. Maybe not the correct course of action but people feel they have no other option (especially with the NHS direct phone line being utterly useless in my experience).

I don't know why you find the need to "bite". If something is free it'll get abused. I should have known someone will come up with a "what if" scenario. The bottom line is people who deserve treatment get it free. The people who abuse the system - I've mentioned drunks and druggies - should pay. End of.

 

[WelshBluebird]

I don't know why you find the need to "bite". If something is free it'll get abused. I should have known someone will come up with a "what if" scenario. The bottom line is people who deserve treatment get it free. The people who abuse the system - I've mentioned drunks and druggies - should pay. End of.

The problem is there are so many "what if" cases that they HAVE to be discussed else your whole suggestion falls apart.

For example there are many medical conditions that cause the person to appear drunk to the untrained eye (read admin / reception staff who would presumably be the ones "taking payment").

And of course, in trying to segregate people into the "deserving" and the "undeserving", you ignore the reality that alcohol and drug addictions are serious illnesses that we need to be treating as any other illness.

And any positive impact such a scheme would have, would no doubt be negated by the negative impact of putting people off getting the treatment they need. You see it in the US all the time and you see it a fair amount in this country when it comes to dental treatment.

 

[Senex]

Right, so those who have taken the trouble to save get hammered, whilst those who haven't bothered to save get it all paid for?

No thanks.

Absolutely!

 

[deltic]

When the NHS was semi-privatised by appointing numerous Managers to run "their" hospitals like a business it was the start of the slippery slope.
I have a sister who was a charge-nurse at Whipps Cross who tells tales of staggering amounts of waste. A friend who's a district nurse specialising in respiratory problems says the same. One of the biggest waste is drugs which are issued and never used. Kate's patients demand a new supply every month and when she points out that they still have stuff left over from the previous months she's told that, "I'm entitled to fresh drugs" with the result that perfectly good drugs are thrown away. Now into that equation fill up A&E every Friday and Saturday with drunks. Drunks who used to be rounded up by the police and thrown into a cell to sober up before being either charged with being D&D/D&I before simply sent on their way the next morning. So nowadays whilst 87 year old Doris is waiting for an ambulance said ambulance is transporting 19 year old Sharon and Chardonnay who have passed out in the gutter. Naturally, on the way to A&E they've vomited in the ambulance so now it has to be taken out of service for cleaning.
Then of course there's the ever-popular junkies who've overdosed on whatever they're inhaling/injecting/sniffing.
The population is getting older and this places more demands on the NHS. How many people of 100 years + do you think are alive? 100, 1,000, 10,000?
In 2014 national statistics revealed that there were 14,450 people of 100 or more of which 780 were 105 or more. The numbers of 80 year olds could fill a large town.
If people were charged a flat fee - say £10 - to attend A&E the revenue generated would be immense. But it won't happen and the NHS will continue to run at crisis levels no matter how much money successive governments give it.

Alcohol abuse is a tiny problem to the NHS and charging £10 for both A&E and GP appointments would raise less than 5% of the NHS's budget

Some interesting facts from NHS England annual report.

22m A&E attendances a year - ie 1/3 of population turn up at A&E each year
0.3m alcohol related admissions (ie equivalent to about 1% of A&E attandances )
340m GP appointments - ie we each see a GP 7 times a year
70% of NHS budgets goes on long term health problems
10% of NHS budget goes on diabetes
Prescription and dental charges account for about 1% of NHS revenues

Our use of the NHS needs to change - minor ailments should be redirected to pharmacists, GP services should be split between providing long term routine monitoring of those with long term health problems - possibly via community nurses; diagnosing new conditions via present GP appointments; and providing minor accident assistance.

A & E should turn away non emergency cases referring them back to GP minor accident services.

We also need to change our diets radically to reduce amount of self imposed illness via use of more "sin" taxes (eg sugar and fat taxes) which would also help raise more revenue for health. For example, a 2p per gram sugar tax would raise about £10bn and would significantly improve our health.

 

[Phil.]

The problem is there are so many "what if" cases that they HAVE to be discussed else your whole suggestion falls apart.

For example there are many medical conditions that cause the person to appear drunk to the untrained eye (read admin / reception staff who would presumably be the ones "taking payment").

And of course, in trying to segregate people into the "deserving" and the "undeserving", you ignore the reality that alcohol and drug addictions are serious illnesses that we need to be treating as any other illness.

And any positive impact such a scheme would have, would no doubt be negated by the negative impact of putting people off getting the treatment they need. You see it in the US all the time and you see it a fair amount in this country when it comes to dental treatment.

Alcohol and drug abuse is not an illness. it's a self-inflicted state. I don't care what right-on PC medical staff say. One doesn't "catch" alcoholism and drug addiction in the same way as one catches measles or influenza. It's self-inflicted.
Admin/receptionist staff don't assess people in A&E, doctors and triage nurses do that.
Here's the thing. Why are there advertisements for no win no fee lawyers in every A&E department? Why is the NHS inviting people to sue them?
Why is the NHS funding breast enlargement operations?
Why is the NHS funding sex change operations?
This is not what the NHS was set up for when first thought of by Lloyd-George's government.

 

[deltic]

Alcohol and drug abuse is not an illness. it's a self-inflicted state. I don't care what right-on PC medical staff say. One doesn't "catch" alcoholism and drug addiction in the same way as one catches measles or influenza. It's self-inflicted.
Admin/receptionist staff don't assess people in A&E, doctors and triage nurses do that.
Here's the thing. Why are there advertisements for no win no fee lawyers in every A&E department? Why is the NHS inviting people to sue them?
Why is the NHS funding breast enlargement operations?
Why is the NHS funding sex change operations?
This is not what the NHS was set up for when first thought of by Lloyd-George's government.

A significant proportion of illnesses/conditions treated by the NHS can be regarded as self inflicted (eg many cancers) - but some are as result of underlying (mental) health issues - eg many abuse victims turn to alcohol and drugs.

Not having seen the adverts you are referring to, this is only a guess but I assume they are aimed at people who have had an accident which is not their fault and not actually aimed at people who have had a problem with the NHS.

NHS are funding operations because a highly qualified medical practitioner believes it is in the best interest of the patient.

 

[furnessvale]

You have just cited a very good example in the part of your posting that I have emboldened of why those to which you refer to in the banking industry should forsake Britain as quickly as possible and relocate to the financial hub centres of Europe, to escape such strictures.

Whether one agrees or disagrees with bankers bonuses, given our imminent brexit, relocation to Europe will be the last thing on the minds of bankers trying to protect bonuses, given that it is the EU trying to curb bonuses, and the UK protecting them.

I am however prepared to say that bankers may (erroneously) believe they have other reasons for relocating.
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You could extend this to other items that contribute to health, such as the free provision of toilet rolls, which perform a most useful contribution to the general health of the population at large.

What is this toilet roll of which you speak? It took the (premature) death of my father before I saw anything other than squares of newspaper in the privvy!

 

[WelshBluebird]

Alcohol and drug abuse is not an illness. it's a self-inflicted state. I don't care what right-on PC medical staff say. One doesn't "catch" alcoholism and drug addiction in the same way as one catches measles or influenza. It's self-inflicted.
Admin/receptionist staff don't assess people in A&E, doctors and triage nurses do that.
Here's the thing. Why are there advertisements for no win no fee lawyers in every A&E department? Why is the NHS inviting people to sue them?
Why is the NHS funding breast enlargement operations?
Why is the NHS funding sex change operations?
This is not what the NHS was set up for when first thought of by Lloyd-George's government.

The reply from deltic pretty much covers everything I could say, with a few additions:

The problem with saying "self-inflicted" issues should be charged for at A&E is how far do you go? Should people playing a sport be charged if they need attention for an injury, what about if someone trips up in the street, or what about say cancers of throat cancer, which may or may need be caused by smoking, etc.

In terms of doctors etc assessing people, so you think we need to add to their workload by getting them to decide if this person should pay or not?

And as for your comments about sex reassignment surgery and the like, I take if you are not at all familiar with the very real mental health issues surrounding that then (which often will lead to a much larger "cost" if left to develop, specifically around suicide and self mutilation).

 

[Yew]

A surprisingly large number of tories have shares in private US healthcare companies. Hence they're slowly trying to head towards privatisation by pointless austerity.

There is plenty more money available, if we take efforts to close down tax loopholes properly (perhaps by having dedicated staff, rather than contractors from the very companies which devise avoidance schemes), stop giving the richest in our society massive tax cuts, and drop the pointless and expensive 'fit to work' scheme.

An attempt should be made to put in a proper computer SYSTEM. Instead of every GP surgery having various photocopied documents from the last 30 years. Note that a computer system is not simply buying a load of computers, but a bespoke system as a result of an investigation into methods and working practices. It will be rather pricey, but will certainly pay off in the long run.

Furthermore we need to stop unanimously putting doctors in charge of projects, they have no meaningful experience of project management, and it's severely impacting the ability to make positive change.
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Meanwhile please don't forget Britain has a sovereign currency and has, so far, created the best part of a quarter of a trillion £s out of thin air for the banks. AKA Quantitative Easing. If this inane and irresponsible government had any moral fibre it could create Quantitative Easing for the NHS or for social care or roads or railways. We don't tax and spend, we spend and tax. The currency becomes valuable because the government produces it (together with licensing private banks to produce it when they create loans) and legitimises its currency by accepting taxes only in £ sterling.

Unfortunately, European laws strictly forbid 'direct' quantitative easing (where the money is spent directly on government bonds, giving the government money to spend on useful projects) and only allow 'indirect' quantitative easing, where the money is spent buying government bonds from pension companies, who then invest in whatever they see fit to make the most money for their fund (and not necessarily , the national economy.

Not that this lot would use it for anything useful, even if we could. The shrill and baseless cries of the Da*ly M*il about 'turning us into Zimbabwe' would be unbearable, despite the fact that small amounts of quantitative easing, when invested in projects that return more money to the government over time (rather than used to pay the public wage bill) is a fairly standard and safe government practice.

 

[deltic]

A surprisingly large number of tories have shares in private US healthcare companies. Hence they're slowly trying to head towards privatisation by pointless austerity.

There is plenty more money available, if we take efforts to close down tax loopholes properly (perhaps by having dedicated staff, rather than contractors from the very companies which devise avoidance schemes), stop giving the richest in our society massive tax cuts, and drop the pointless and expensive 'fit to work' scheme.

An attempt should be made to put in a proper computer SYSTEM. Instead of every GP surgery having various photocopied documents from the last 30 years. Note that a computer system is not simply buying a load of computers, but a bespoke system as a result of an investigation into methods and working practices. It will be rather pricey, but will certainly pay off in the long run.

Furthermore we need to stop unanimously putting doctors in charge of projects, they have no meaningful experience of project management, and it's severely impacting the ability to make positive change.

If you are a member of a pension scheme then the chances are you have shares in a US healthcare company. This idea that members of political parties are taking decisions based on possible financial gains in 20 years times are rather extreme.

Hasnt the NHS has been trying to computerise medical records for years with a number of major private sector companies loosing a fortune over it as well as the NHS?

Main benefits of computerising records comes from mining the data which many are not to keen on.

 

[Phil.]

The reply from deltic pretty much covers everything I could say, with a few additions:

The problem with saying "self-inflicted" issues should be charged for at A&E is how far do you go? Should people playing a sport be charged if they need attention for an injury, what about if someone trips up in the street, or what about say cancers of throat cancer, which may or may need be caused by smoking, etc.

In terms of doctors etc assessing people, so you think we need to add to their workload by getting them to decide if this person should pay or not?

And as for your comments about sex reassignment surgery and the like, I take if you are not at all familiar with the very real mental health issues surrounding that then (which often will lead to a much larger "cost" if left to develop, specifically around suicide and self mutilation).

You asked if receptionists should be assessing whether people should pay or not. What part of "Receptionists don't assess patients, Doctors and Triage nurses do" are you not understanding? Person is delivered to A&E nissed as a pewt. Patient is assessed, put in a bed for the night to sober up. Kerching, £10.00 please- yes we accept cards.
Person arrives in A&E with a broken wrist and cuts to the face that require stitching having been whacked off their bike (me eight years ago). Patient plastered up, sewn up and sent on the way rejoicing. No charge.
Sex changes? Why is it getting increasingly common nowadays for people to decide that they want to be the opposite? People used to go to continental clinics - and pay - for that sort of thing.
I won't go all Daily Mail/Express-esque about health tourists, it happens despite people being in denial.
France has an excellent healthcare system being a combination of state NHS type stuff and pay for it type stuff. It works but suggest that here and it's cries of, "This is the first stage of privatising the health service".

 

[507021]

Sounds nice, but what level of healthcare do you define as "a right"?

Home births?

Gender surgery?

IVF?

Cosmetic surgery?

Home births can sometimes be unavoidable, and as far as I'm concerned, I think it would be immoral to charge a fee for helping someone give birth. How is that right?

I also feel that gender surgery should remain free on the NHS (I know of someone who intends to go down this route and I fully support them, even if we're not on the best of terms anymore), however IVF is only free on the NHS for one attempt after you have paid for a certain number of attempts anyway. Cosmetic surgery depends in my view - if it is for personal gain then it should be paid for without question. In the cases where it isn't for personal gain then I feel it should be free.

How long do you have to have been living in the UK (or being economically active in the UK) to qualify for medical treatment?

As far as I'm concerned anyone who has worked and paid their taxes in this country regardless of where they are from should be entitled to free medical care.

Do you keep patching people up into their '90s, so that they've had more hip replacements than the number of hips they were born with?

I feel that people should be treated no matter how old they are. I feel that's extremely unfair to suggest we keep treating people in their 90s or older as if it's a hardship. They have just as much right to medical treatment as you or I do and have paid their taxes to pay for the NHS.

Does the NHS have to be the party that foots the bill for apparently increasing levels of mental health problems/ addictions/ abuse?

As someone with mental health problems and currently using the NHS mental health service, I'm not going to answer that comment.

How many nights do you keep people in hospital if they are fit but their house isn't suitable to go back to (and they haven't sufficient money to pay for a care home)?

I can agree with you on this. My 80-year-old father was in hospital twice last year, and one of those times he was waiting 13 or 14 hours for a bed on the ward he needed to be moved to for more specific treatment. What I also object to is drunk people being taken in to hospital because they've had far too much to drink and been stupid enough to get into a fight or fallen over. I'm sorry, but they chose to get drunk, so if anyone should be charged for NHS treatment it should be them.

How much do you accept the NHS being a dumping ground for the woes of a broken society?

I do in the sense of what I said above, with drunk people being taken to A&E because of their own self inflicted stupidity, whilst people who are ill through no fault or choice of their own, are sat waiting for an ambulance for hours on end and then a similar or even longer wait in A&E/Resus.

Easy to say "the NHS should be free", but what kind of NHS do you have in mind?

An NHS that treats people who need medical treatment, and not those who take it for granted.

 

[LateThanNever]

Unfortunately, European laws strictly forbid 'direct' quantitative easing (where the money is spent directly on government bonds, giving the government money to spend on useful projects) and only allow 'indirect' quantitative easing, where the money is spent buying government bonds from pension companies, who then invest in whatever they see fit to make the most money for their fund (and not necessarily , the national economy.

As you say - but there are other ways of doing it. Bonds could be offered to buy out PFI for a start. And whatever way it is done it is still government crerated money. But by calling it quantitaive easing you can demonstrate the equivalence, and demonstrate the fact that we've spent almost £.25 trillion on the financial crisis but it is quite impossible for this government to find any extra money for what the Red Cross has called the NHS humanitarian crisis. The message that money is more important than humanity is pretty clear.

Not that this lot would use it for anything useful, even if we could. The shrill and baseless cries of the Da*ly M*il about 'turning us into Zimbabwe' would be unbearable, despite the fact that small amounts of quantitative easing, when invested in projects that return more money to the government over time (rather than used to pay the public wage bill) is a fairly standard and safe government practice.

Agreed. And I am of the opinion that the current government, along with their tax haven press baron friends, are indeed trying to turn us into Zimbabwe. It is just they sell it as firm government, executive control and the royal prerogative, instead of a straightforward absolute dictatorship.

 

[deltic]

Unfortunately, European laws strictly forbid 'direct' quantitative easing (where the money is spent directly on government bonds, giving the government money to spend on useful projects) and only allow 'indirect' quantitative easing, where the money is spent buying government bonds from pension companies, who then invest in whatever they see fit to make the most money for their fund (and not necessarily , the national economy.

Not that this lot would use it for anything useful, even if we could. The shrill and baseless cries of the Da*ly M*il about 'turning us into Zimbabwe' would be unbearable, despite the fact that small amounts of quantitative easing, when invested in projects that return more money to the government over time (rather than used to pay the public wage bill) is a fairly standard and safe government practice.

My understanding is that the definition of quantitative easing is the purchase of existing Government Bonds but I wont claim any expertise on this. There are not as far as I know any European Laws on QE - the European Central Bank has certain rules it follows but these as far as I am aware relate only to own activities in the Eurozone.

There is nothing to prevent the UK Govt "printing its own money" to spend as it wants but evidence from around the world suggests this rarely ends well.

Happy to be corrected if I am wrong.

 

[LateThanNever]

My understanding is that the definition of quantitative easing is the purchase of existing Government Bonds but I wont claim any expertise on this. There are not as far as I know any European Laws on QE - the European Central Bank has certain rules it follows but these as far as I am aware relate only to own activities in the Eurozone.

There is nothing to prevent the UK Govt "printing its own money" to spend as it wants but evidence from around the world suggests this rarely ends well.

Happy to be corrected if I am wrong.

Remarkably the Treaty of Lisbon (and also,incidentally, US law - but not Canada's) prevents Central Banks from directly financing their own governments' treasuries. The treasury - absurdly - has to issue bonds to the market, through private banks, who earn a commission of course, which the Central Bank then purchases. The government owns the Bank of England so it has issued a bond to itself and that's why the Chancellor's (though not the Office of Budget Responsibity's) national debt figures are wrong. It's Alice in Wonderland and the whole scheme was doubtless the result of lobbying by the private banks. Which keeps the private banks happy, but the result is that it gives this devious government (along with Eurozone members) an excuse for austerity, which is a straight con.

 

[DarloRich]

The sentiments and views expressed by several posters in this thread disgust me and support all of the I'm all right jackism beloved of the Conservatives.

We as a country should defend the institution and services offered by the NHS. Instead we are asked to throw it away and return to some 19th century idea of the deserving poor or third way medical care based on some mythical Downtonesque noblesse oblige.

We all rely on the NHS. Even you with your fancy health insurance and your wad of cash will be carried off the street by an NHS ambulance and rushed to the NHS hospital when you keel over and that emergency life saving surgical procedure will be done at the local NHS hospital. We all need it and should all defend it. It is despicable madness and those suggesting an insurance or payment system for health care should be ashamed. Sorry if that means you have to pay something extra out of your savings or your tax but we have had the benefit of these services and are responsible for passing that benefit on to the next generation to help them improve their lives as your lives were improved by decent social care and support.

 

[vrbarreto]

Well the hospital my Mrs works at was definitely in crisis last night. She had to go in at 10.30pm to do an emergency operation and she said that there were about 90 patients in A&E. Many of them were 2 or 3 to a cubicle (one on the bed, 2 on chairs) as there was no where else to put them..
Also in term of IVF, it depends where you live.. Most NHS trusts fund one cycle but Cambridge for example will fund 3.

Also having a conversation yesterday it is unbelievable how many locums are available in the hospital where she works.. They are struggling to fill full term vacancies and it is forcing them to get locum staff..

Don't start me on the stupid training numbers scheme either.. Prevents very good doctors from progressing up the ladder and encourages favouritism and a limit in the number of doctors qualifying.

 

[ainsworth74]

Instead we are asked to throw it away and return to some 19th century idea of the deserving poor or third way medical care based on some mythical Downtonesque noblesse oblige.

I take it that is how you view the provision of healthcare in places like Germany, France, Sweden and Australia?

 

[Senex]

I take it that is how you view the provision of healthcare in places like Germany, France, Sweden and Australia?

And ask those people if they'd really want to change their healthcare provision for the British NHS.

 

[DarloRich]

I take it that is how you view the provision of healthcare in places like Germany, France, Sweden and Australia?

And ask those people if they'd really want to change their healthcare provision for the British NHS.

At present the NHS is a universal, free at the point of use service that provides support for all of us regardless of means or social standing. Why is that seen as a bad thing? Why the rush to change to a system that will exclude people from health care provision?