• Our booking engine at tickets.railforums.co.uk (powered by TrainSplit) helps support the running of the forum with every ticket purchase! Find out more and ask any questions/give us feedback in this thread!

Isn't the NHS wonderful

Status
Not open for further replies.

Bromley boy

Established Member
Joined
18 Jun 2015
Messages
4,611
I wish I was a confident as you. I am not prepared to take the risk. No one will ever persuade me the Tories can be trusted with anything but especially the NHS. As I said IF they are so generous with funding why is the system falling apart?

I appreciate you’re passionate about this subject.

Do you think “New Labour” did a good job with the NHS? Do you think Labour’s current incarnation would?
 
Sponsor Post - registered members do not see these adverts; click here to register, or click here to log in
R

RailUK Forums

DarloRich

Veteran Member
Joined
12 Oct 2010
Messages
29,182
Location
Fenny Stratford
@DynamicSpirit Change is fine. If you have cash. Perhaps you do. We as a family don't and I doubt we would get insurance. You might be ok with your wonderful new not quite NHS. We won't be.

That is why I am extremely sceptical of any proposed changes to the NHS. I simply do not believe they will offer a better service to people like us.

I appreciate you’re passionate about this subject.

Do you think “New Labour” did a good job with the NHS? Do you think Labour’s current incarnation would?

Yes. They did.

Ps don't talk to me about Corbyn. The man couldn't find his own backside to sit on the toilet.
 

DynamicSpirit

Established Member
Joined
12 Apr 2012
Messages
8,024
Location
SE London
@DynamicSpirit Change is fine. If you have cash. Perhaps you do. We as a family don't and I doubt we would get insurance. You might be ok with your wonderful new not quite NHS. We won't be.

You seem to be working under the assumption that any change to the NHS would mean poorer people would not be able to get essential treatment. I'm pretty sure that's wrong. It's not what I want, and I'm fairly sure it's not what most people advocating change want either. A quick look across the English channel ought to serve as proof that there are alternative systems that also ensure health coverage for everyone.

The problem is, at the moment, in much of the country, already lots of people go without treatment that they may need (or only get their treatment by going private), thanks to huge waiting lists, lack of available appointments, a bureaucratic system that puts somewhat arbitrary limits on treatment, and so on. (One specialist I've seen at an NHS hospital informs me she is 'allowed' two appointments with each patient. After that, no more appointments full stop).


That is why I am extremely sceptical of any proposed changes to the NHS. I simply do not believe they will offer a better service to people like us.

Seems a bit cynical when you don't even know what any proposed changes might be. Besides, can you suggest a workable and sustainable solution to the current NHS crisis which is likely to work in the long term and doesn't involve changing the NHS? If so I'd love to hear it... :)
 

Bromley boy

Established Member
Joined
18 Jun 2015
Messages
4,611
That is why I am extremely sceptical of any proposed changes to the NHS. I simply do not believe they will offer a better service to people like us.

By “people like us” you and I earn roughly the same kind of salary. Middle income earners, not wealthy.

I’ve previously had private health through former employers (which I never had to use). I don’t get it through my current employer but I’m increasingly wondering whether I should buy a policy.

I’m luckily young(ish) and healthy now, so could afford to do so, obviously if I develop chronic problems into old age that might become prohibitively expensive to maintain.

That’s not the road I want to go down. I would like to rely on the NHS as a genuine alternative to insurance but it’s becoming increasingly obvious even to middle income earners that the NHS itself is failing to cope.
 

Bromley boy

Established Member
Joined
18 Jun 2015
Messages
4,611
Yes. They did.

I’d also respectfully disagree with you here.

Do you have evidence that the NHS improved/declined under New Labour any differently to how it has done so under Tory/Coalition governments we have seen since? Both have failed to deliver. Why? Because the system is fundamentally broken.

The (firmly bipartisan) issues it faces are:
(1) being a fundamentally inefficient, monolithic, outdated model;
(2) the rapidly increasing healthcare demands of our ageing and increasingly fat, sedentary, alcoholic population!
 

underbank

Established Member
Joined
26 Jan 2013
Messages
1,486
Location
North West England
Seems a bit cynical when you don't even know what any proposed changes might be. Besides, can you suggest a workable and sustainable solution to the current NHS crisis which is likely to work in the long term and doesn't involve changing the NHS? If so I'd love to hear it... :)

I've first hand experience of the vast improvement resulting from certain aspects being "privatised", i.e. audiology. First time around, several years ago, it took several months to get an NHS hearing aid, including 2 GP appts, separate appts for a hearing test, consultant appt, initial fitting and final fitting and along the way, the inevitable cancelled appointments, running late, etc - the usual NHS bureacratic inefficiency in action. Hearing aid never worked properly even after several more appts so I gave up wearing it.

A few years ago, my wife needed a hearing aid, but was offered a choice of Specsaver or NHS - after my experience, she chose Specsaver. All done in one single appt, hearing test, fitting, etc. Worked perfectly, never needed to go back at all except for batteries.

Then this last Summer, my hearing had got worse, so I tried to use my old hearing aids again after a period of probably 3 years left in their box. Still useless, so I thought I'd try my luck to see if I could get a direct appt with NHS audiology for them to be reset again. What a revelation, no problem getting an appointment, literally 2 days later. Went in, on time, explained problems, offered a new hearing test, again, just a week later. Just had the hearing test and given a new pair of hearing aids straight after the hearing test in the same appt. Work perfectly!

So, it seems that despite the nasty tories and their cuts, NHS audiology has improved massively over the past few years - far better than under the Labour govt. I mentioned the speed and improvement in service and the guy who did the hearing test and gave me the new aids said it was down to Specsaver competition in that they needed to match the service otherwise everyone would go to Specsaver instead! That's an example of how free market competition (privatisation for Tory haters) can actually improve service under the NHS - it gives them the impetus to improve and offer a better service - eliminating the attitude of too many NHS staff who think (and some even say) "you're not paying so you can't expect a top quality service - be grateful for what you get 'cos it's free"!!
 

ralphchadkirk

Established Member
Joined
20 Oct 2008
Messages
5,753
Location
Essex
Hello. I don't often post here for many reasons, but I thought I would on this one.

I’d invite anyone - and that includes me - who’s had their life saved by the medical profession in Britain to consider whether they’d be dead in Germany. (Clue: you probably wouldn’t be!)
This isn't true. It compares two, incomparable models of emergency medicine: the Anglo-American model and the Franco-German. Whilst working in this field I've been lucky enough to meet a number of people who work in the German EMS model and I know which one I prefer. In Germany, there is not a specific pre-hospital emergency medicine discipline which means you get markedly different treatment for the same condition depending on which city or region you are in, unlike the UK (with exceptions, and generally where the NHS is advancing the standard of care rather than maintaining or reducing it).
I don't think it's unreasonable to criticise the NHS. Mental health care for example is one area where the service is absolutely dire.
Absolutely true. Mental Health care is an embarrassment.
2) On ward, especially A&E, create a simple cheap job board, doctor/nurse writes down time/bed/patent-name/status/action. It is the responsibility of the ward manager to monitor the board, to ensure that no patients are left in agony or worse for an hour or even longer. If anything like this was in use, you wouldn't get the sorts of A&E horror stories of patients being neglected, or if we did the ward manager could get a rocket. How much would a white board, pen, and cloth cost? This is the sort of basic thing a good restaurant can do, but totally evades many hospitals.
This already happens. But we can't recruit people to work in emergency medicine because it is so unpopular, partly as a result of individuals being blamed (sometimes criminally) for system failings.
3) Take a systems approach, it is not expensive. For example, first-response paramedic visits to assess patient and stabilise. Paramedic decides patient should be taken to hospital and calls ambulance. Ambulance takes over an hour to arrive (yes, I timed it). Hey, guess what, while first-response paramedic is sitting with us waiting for ambulance to collect patient, that is an hour that the paramedic is sitting down, out of use, not going to the next emergency! There was no obvious disaster in the city that day, I hate to think what would have happened if there had been one. Ditto hospitals, several people on the ward had been waiting days for a scan, more than a week in some cases. Those are beds being taken out of use for other incoming patients by a scanning bottleneck, so get another scanner!
So having actually done this job I feel I'm probably an expert in answering it (though when I did it an hour was pretty good - sometimes three or four). Pre 2017 in most places in the country the Government scored ambulance services using the 'A8' target. This effectively was "can we get resource, any resource, to a patient within 8 minutes?". This led to a culture of using fast response cars for all sorts of calls because it meant we hit the target. Post 2017 we have moved to a system called the "Ambulance Response Programme" where cars were de-emphasised apart from the category 1 calls. This meant ambulance services actually had to ensure clinically relevant outcomes rather than an arbitrary 8 minutes (which has reduced for 7 for category 1 calls, and enforced the attendance of a transporting resource to hit the target). On a personal note, I entire agree here. I was a solo responder fast response paramedic for a long time, and I remember the calls I was sent to where I could only sit and wait for an ambulance to come.
5) I have no solution for situations where the NHS decides that treatable people should die. Once an institution gets that Orwellian you do wonder if it is salvageable.
In short, if there is one thing to take away here, this is bull****.

I'm very pleased that you are recovering well.

Yes, the NHS is great when compared to a world without ambulances, doctors and hospitals.

That shouldn't stop us from comparing its strengths and failings with other civilised societies that also have access to these things. For some reason that conversation often ends up comparing the NHS against the U.S. system, or the lack of a system. Germany, the Netherlands, Switzerland, Canada, etc, would be much more interesting and insightful comparisons.
Couldn't agree more! The amazing thing about the NHS is that it is always willing to learn, just reference the huge amount of world-leading research it completes every year.
 

falcon

Member
Joined
8 Mar 2009
Messages
425
@DynamicSpirit Change is fine. If you have cash. Perhaps you do. We as a family don't and I doubt we would get insurance. You might be ok with your wonderful new not quite NHS. We won't be.

That is why I am extremely sceptical of any proposed changes to the NHS. I simply do not believe they will offer a better service to people like us.



Yes. They did.

Ps don't talk to me about Corbyn. The man couldn't find his own backside to sit on the toilet.

The NHS IS an insurance based system the premium is called National Insurance Contributions.

Not only is the NHS an insurance based system, it is a compulsory insurance system for those who work they have to pay the premium. No opt out allowed.

It is system that allows people who do not pay a premium (national insurance contributions) to receive a premier NHS service which includes free dentistry, free prescriptions and the daily fix of methodone dispensed at the local pharmacy. All at the cost of those who have no option but to pay.

When one conciders those facts, not opinions one can see what a con the term

"Free at the point of use is". Free if you don't pay in.

My car is free at the point of use because I just paid the salesman for it before I got in it.

NHS is a complete and utter shambles from start to finish: hospitails effectively closed on Saturday and Sunday, 3 weeks appointment to see a doctor, 4-5 hrs wiating in A&E, No Ambulances available for 2 hrs and the list goes on and on.

Too many people have an emotional attachement to the NHS therin lies the problem.

There are two fears involved with this debate.

1. I am frightend I have to pay.

2. I am frightened that I will have to use the NHS as it is.

Which fear do you think the people who pay national contributions are aligned with, and which fear do you think those who don't pay national contributions are alighned with.1 or 2.

:E
 

DarloRich

Veteran Member
Joined
12 Oct 2010
Messages
29,182
Location
Fenny Stratford
@falcon Goodness me what a silly post!

  • Hospitals are not effectively closed at weekends.
  • I don't have to wait 3 weeks to see my doctor. I can generally get in if not the same day then within a couple of days. The doctors surgery offers a range of appointment types and times and there never seems to be a problem. They are open from 0700 until 1900 every day. They aren't open at weekends but i expect that to change in due course.
  • MY A&E experience is mainly at a weekend after sporting injuries and while there was a wait I wasn't that ill and would rather they treated small children or those with life threatening injuries first.
  • I haven't called an ambulance for a long time but when my dad needed one it arrived ASAP. When it did the paramedics worked like Trojans to keep him alive then carried him down three flights of stairs to take him to hospital.
PS As to the NI point I can respond from both sides having experienced both signing on and paying higher rate tax. Sorry that you have to pay to keep the scum alive. Imagine how much you could save in your scrooge mcduck vault/swimming pool if you didn't have to.

PPS Sorry if that is to emotional for you.

By “people like us” you and I earn roughly the same kind of salary. Middle income earners, not wealthy.

I have a decent job now. I am on my second career and had a period in between when I was on the bones of my rse fighting off bailiffs, CCJ's and the temptation to nick baked beans off Morrisons so I could have some dinner. I have some experience of both sides.

I have been fairly lucky in life. I had a good education, got good qualifications and have a good job. I also know many extended family members who don't have much. They work, if the work, low paid or self employed jobs and live in hard if not abject conditions.
 

falcon

Member
Joined
8 Mar 2009
Messages
425
@falcon Goodness me what a silly post!

  • Hospitals are not effectively closed at weekends.
  • I don't have to wait 3 weeks to see my doctor. I can generally get in if not the same day then within a couple of days. The doctors surgery offers a range of appointment types and times and there never seems to be a problem. They are open from 0700 until 1900 every day. They aren't open at weekends but i expect that to change in due course.
  • MY A&E experience is mainly at a weekend after sporting injuries and while there was a wait I wasn't that ill and would rather they treated small children or those with life threatening injuries first.
  • I haven't called an ambulance for a long time but when my dad needed one it arrived ASAP. When it did the paramedics worked like Trojans to keep him alive then carried him down three flights of stairs to take him to hospital.
PS As to the NI point I can respond from both sides having experienced both signing on and paying higher rate tax. Sorry that you have to pay to keep the scum alive. Imagine how much you could save in your scrooge mcduck vault/swimming pool if you didn't have to.

PPS Sorry if that is to emotional for you.



I have a decent job now. I am on my second career and had a period in between when I was on the bones of my rse fighting off bailiffs, CCJ's and the temptation to nick baked beans off Morrisons so I could have some dinner. I have some experience of both sides.

I have been fairly lucky in life. I had a good education, got good qualifications and have a good job. I also know many extended family members who don't have much. They work, if the work, low paid or self employed jobs and live in hard if not abject conditions.


How is the NHS free when we pay national inurance contributions?

"Free at the point of use is a con". Have you anything to say on that?

I know of many occasions where I have waited 2 hrs for an Ambulance were broken bones were involved.(I call them for members of the public that are injured in public places).

Many doctors surguries don't offer walk in appointments and it is easy to wait 2 wks+ sometimes for as others have said non emergency treatment.

I have atteneded A&E at a weekend and been told there is no one to attend to an injury.

Waiting time in A&E are appaling and used as a tool to deter people from attending.

https://www.independent.co.uk/news/...oyal-college-emergency-medicine-a7962941.html

https://www.dailymail.co.uk/health/...reduce-patients-likelihood-walking-alive.html

If people who injured themselves through their own stupidity had to pay for there care based on risk then A&E might have more time for those injured through no fault of their own. :E

Keep the red flag flying brother . :rolleyes:
 

Warwick

Member
Joined
10 Apr 2018
Messages
353
Location
On the naughty step again.
I started this thread so Ithought I'd chuck another two pennyworth in. One of the problems of a (perceived) free to use system is that it'll get clogged up with time wasters. I can call on the experiences of my eldest sister - now retired A&E in Whips Cross, an ex crewmate's son who is a paramedic based in Sussex and my lucsious lady friend who is in a specialised unit in St. Thomas's. All three of them could regale you for hours with time and money wasters. Multiply them by the entire units throughout the land and the cost is staggering. All three of them could regale you for hours on the subject of drone managers and the like. All three of them could regale you for hours on the money wasting issue of medications that patients could and should be buying over the counter in Boots such as painkillers, suncream lotion and vaseline just to name three. The NHS has been allowed to evolve into a bloated buerocratic mess that is being treated as (wrongly in my opinion) some sort of untouchable holy cow.
 

underbank

Established Member
Joined
26 Jan 2013
Messages
1,486
Location
North West England
Hospitals are not effectively closed at weekends.

Err yes, lots are. Our two closest hospitals ARE closed all weekend. Obviously hospitals with in-patients or an A&E dept are open, but lots of hospitals don't do either. Even with in-patients and A&E depts, the majority of the hospital is usually shut down, with just skeleton staff (or on call staff) manning depts which may be needed such as x-ray, scans, pharmacy, etc. My nearest hospital has depts for out-patients, clinical investigation unit, xray/scans, audiology, dental, etc and is completely closed all weekend. Even walking through the main A&E hospital at the weekend, it's tumbleweed on most corridors with most depts and waiting areas empty. What an absolute waste of all that equipment etc. Then comes Monday and it's back to crowded waiting rooms, waiting delays for equipment, etc. Not so long ago, my wife had a consultant appointment and he couldn't even find a consulting room to see his patients so ended up in the faith room! Yet, come Friday, and that same department was yet again tumbleweed - empty waiting area, empty unused consulting rooms. Definitely needs to be spread over 7 days to make better use of the buildings and equipment.
 

DarloRich

Veteran Member
Joined
12 Oct 2010
Messages
29,182
Location
Fenny Stratford
How is the NHS free when we pay national inurance contributions?

"Free at the point of use is a con". Have you anything to say on that?

You know exactly what this means are are simply trying to be argumentative. You may be happy to hand your credit card over to fund your care. I am not. Mainly because i don't have a credit card................
 

WelshBluebird

Established Member
Joined
14 Jan 2010
Messages
4,923
"Free at the point of use is a con". Have you anything to say on that?

How is it exactly a con?
The way we finance the NHS means that, if you get ill, you do not have to pay for treatment (ignoring dentists and a few other things for simplicity).
Sure yes, it is paid for somehow. But that is the same as anything.
Our roads pavements are free to walk on for example, that doesn't meant they aren't paid from something (general taxation).

As for the specifics of NHS funding.
There are two main methods of funding healthcare. General taxation or insurance. Despite its name, national insurance is essentially just a form of general taxation where the money gets ring fenced for certain things. Certainly there is no concept of your NI rate increasing because you happen to have a costly illness (as would be the case with what most people would see as "insurance").

1. I am frightend I have to pay.

Why is that not a legitimate fear of other healthcare systems?
If we did introduce some kind of real insurance scheme here, how much do you think would have to be spent to make sure that the poorest (who couldn't afford real insurance costs) would not be left without access to healthcare? How much do you think would have to be spend to make sure that those with expensive to manage / treat illnesses would not be left with very expensive insurance costs or without any access to healthcare? How much do you think would have to be spend to make sure that those the potential for serious illness (e.g. a family history of genetic cancers) would not be left with very expensive insurance costs or without any access to healthcare?
 
Last edited:

Barn

Established Member
Joined
3 Sep 2008
Messages
1,463
Err yes, lots are. Our two closest hospitals ARE closed all weekend. Obviously hospitals with in-patients or an A&E dept are open, but lots of hospitals don't do either. Even with in-patients and A&E depts, the majority of the hospital is usually shut down, with just skeleton staff (or on call staff) manning depts which may be needed such as x-ray, scans, pharmacy, etc. My nearest hospital has depts for out-patients, clinical investigation unit, xray/scans, audiology, dental, etc and is completely closed all weekend. Even walking through the main A&E hospital at the weekend, it's tumbleweed on most corridors with most depts and waiting areas empty. What an absolute waste of all that equipment etc. Then comes Monday and it's back to crowded waiting rooms, waiting delays for equipment, etc. Not so long ago, my wife had a consultant appointment and he couldn't even find a consulting room to see his patients so ended up in the faith room! Yet, come Friday, and that same department was yet again tumbleweed - empty waiting area, empty unused consulting rooms. Definitely needs to be spread over 7 days to make better use of the buildings and equipment.

Absolutely right. A shocking waste of all the capital spend. It's not just the equipment though - the medical staffing levels of maternity wards (and the seniority of those staff) and operating theatres are higher during 'office hours', as if babies should know that that is the most convenient time to be born.

GP surgeries should also significantly improve their evening and weekend service. At the moment, GP appointments are effectively impossible for anbody who cannot easily take time off work. That means either that people have to call in sick to go to an important-but-not-acutely-urgent appointment, thus damaging productivity in the economy, or just delay going, thus increasing the risk of late diagnoses of serious conditions.
 

DarloRich

Veteran Member
Joined
12 Oct 2010
Messages
29,182
Location
Fenny Stratford
GP surgeries should also significantly improve their evening and weekend service. At the moment, GP appointments are effectively impossible for anbody who cannot easily take time off work. That means either that people have to call in sick to go to an important-but-not-acutely-urgent appointment, thus damaging productivity in the economy, or just delay going, thus increasing the risk of late diagnoses of serious conditions.

or you go to the walk in centre - if you have one.

My GP is very good. No problems ( usually) getting access. They open from 07:00 to 19:00 and offer a range of appointment types although you tend only to get a future appointment if it is a call back from your doctor. If one can do it ( and my GP in North Yorkshire offered a similar arrangement if over less hours) why cant all?

As an aside I agree entirely that a 7 day NHS should be the norm. The problem is we need to pay for it. I am happy to pay more tax to support that. I wonder if everyone is prepared to do that? From many of the posts here I doubt that.
 

Barn

Established Member
Joined
3 Sep 2008
Messages
1,463
or you go to the walk in centre - if you have one.
My GP is very good. No problems ( usually) getting access. They open from 07:00 to 19:00 and offer a range of appointment types although you tend only to get a future appointment if it is a call back from your doctor. If one can do it ( and my GP in North Yorkshire offered a similar arrangement if over less hours) why cant all?

Good question - all should.

Mine does annoying things to meet targets. Such as not giving you an appointment in a a few days' time but rather requiring you to join the four dozen other people calling at 08:30 each day for the same day allocation.

Walk in centres are fine for things like "I think I may have tonsillitis; could you look down my throat". They are pretty rubbish for things like "I'm worried I might have diabetes" or "I'm finding it difficult to deal with stress and feelings of depression", both of which are really important but not to-the-minute urgent and liable to be put off.
 

underbank

Established Member
Joined
26 Jan 2013
Messages
1,486
Location
North West England
Mine does annoying things to meet targets.

Have to agree with that. You can tell what GP surgeries get extra funding for. Mine started offering evening appointments, but only at one rural surgery and they weren't available to book in advance. It was as if they didn't actually want anyone to go to them, but by offering them it was "ker-ching" with the funding! Likewise with online appointments - yes, they offer the service "Ker-ching", but there are only ever 1 or 2 appointments available, always about a month in advance - again, they're offering the service to tick boxes to get funding but clearly don't actually want anyone to use the service.
 

thejuggler

Member
Joined
8 Jan 2016
Messages
1,186
"The NHS IS an insurance based system the premium is called National Insurance Contributions."

As soon as I read this completely incorrect statement (so much wrong in so few words) I knew the rest wouldn't contain many facts.
 

Bromley boy

Established Member
Joined
18 Jun 2015
Messages
4,611
I have a decent job now. I am on my second career and had a period in between when I was on the bones of my rse fighting off bailiffs, CCJ's and the temptation to nick baked beans off Morrisons so I could have some dinner. I have some experience of both sides.

That sounds like an extremely tough situation. Fair play to you mate for turning it around.

I don’t fully agree with you on this topic, as you know, but I certainly respect where you’re coming from.
 

DarloRich

Veteran Member
Joined
12 Oct 2010
Messages
29,182
Location
Fenny Stratford
That sounds like an extremely tough situation. Fair play to you mate for turning it around.

I don’t fully agree with you on this topic, as you know, but I certainly respect where you’re coming from.

Thanks - it was a very hard time.

Mine does annoying things to meet targets.

You can tell what GP surgeries get extra funding for.

I am fairly certain that mt Drs must be getting incentivised for offering the appointments and the other services like Phlebotomy ( great word!) but as i said if there are incentives to offer the service why aren't all surgeries willing to take the plunge? I get horses for courses and a small rural practice inst going to offer the same services as a large town practice but still!
 

DynamicSpirit

Established Member
Joined
12 Apr 2012
Messages
8,024
Location
SE London
My GP is very good. No problems ( usually) getting access. They open from 07:00 to 19:00 and offer a range of appointment types although you tend only to get a future appointment if it is a call back from your doctor. If one can do it ( and my GP in North Yorkshire offered a similar arrangement if over less hours) why cant all?

I suspect the problems vary geographically, with London one of the worst places. For my part, I've pretty much given up going to my GP, unless it's something that looks like a long-term issue - because typically, if I call for an appointment, I'll be offered one in about 3 weeks time. There is the option to try calling around 8am to get a same-day slot, but the surgery emphasizes that's intended for emergencies only, and it's quite a pain having to spend half an hour repeatedly calling till you get through, with no guarantee of success. So, on a personal level, I feel that for all practical purpose, I no longer have reasonable access to a GP under the NHS. The situation is bad enough that I have looked into registering with a private GP practice (yes, I'm lucky enough that I could afford that if necessary), but last time I looked, there were none within easy travelling distance of where I live.


As an aside I agree entirely that a 7 day NHS should be the norm. The problem is we need to pay for it. I am happy to pay more tax to support that. I wonder if everyone is prepared to do that? From many of the posts here I doubt that.

Personally, I'd be very happy to pay more tax to improve the health service, if it meant we could all have better access to healthcare when we need it. But at the same time, I still want a sustainable healthcare system, and I'm fairly sure that will only be possible with fundamental reform, as well as a serious debate about precisely what should and should not be free at point of use. I'm fairly sure that, without such reform, all that would be achieved by increasing tax to give more money to the NHS is a temporary postponement of the current crisis by a couple of years before soaring demand puts us right back where we are today (except with higher taxes).
 

Senex

Established Member
Joined
1 Apr 2014
Messages
2,752
Location
York
I am fairly certain that mt Drs must be getting incentivised for offering the appointments and the other services like Phlebotomy ( great word!) but as i said if there are incentives to offer the service why aren't all surgeries willing to take the plunge? I get horses for courses and a small rural practice inst going to offer the same services as a large town practice but still!
The practice I'm registered with (city-centre, about a dozen GPs) has given up doing its own phlebotomy on the grounds that it takes up too much nurses' time and we're now all ordered off to go to the local hospital for blood-tests. This is where, as I've commented before, you generally have to wait three weeks for a non-urgent appointment, with very little choice of whom to see (and then, of course, the 10-minute appointment for one health problem only). The rot really seemed to set in after amalgamation with another city-centre practice a few years ago. Until then getting appointments was very much easier. But there's clearly an incentive for 'flu vaccination; all of us aged persons have had a circular letter asking us to turn up at the practice's clinics rather than go elsewhere because the practice gets money according to how many of us it vaccinates!
 

Barn

Established Member
Joined
3 Sep 2008
Messages
1,463
I'm always amazed that nationalisation campaigners don't go after GP practices. They're predominantly profit-making partnerships operating under outsourced NHS contracts. Why isn't there pressure for them to become NHS employees?
 

DynamicSpirit

Established Member
Joined
12 Apr 2012
Messages
8,024
Location
SE London
I'm always amazed that nationalisation campaigners don't go after GP practices. They're predominantly profit-making partnerships operating under outsourced NHS contracts. Why isn't there pressure for them to become NHS employees?

It's an interesting point. And not only that, but - to judge from my experience and what I've read of some other's experience, they don't exactly seem to be a shining example of privatisation working well either.

I'm guessing a big problem with how GPs are set up is that they are intended to serve the patients but they get all their money from the Government. And I would also surmise that means that basic human nature and the need for GPs to earn a living means they end up following all the targets and financial inducements etc. that the Government sets rather than focusing on what their patients want. Hence the 8am-phone-calls-to-get-appointments farces. Although having said that, there may not be that much GPs individually can do about the shortage of GPs in some parts of the country leading to 3-week appointment waits. It'd be interesting to see if anyone here who works with the NHS can confirm if my guesses are correct?
 

underbank

Established Member
Joined
26 Jan 2013
Messages
1,486
Location
North West England
I'm guessing a big problem with how GPs are set up is that they are intended to serve the patients but they get all their money from the Government. And I would also surmise that means that basic human nature and the need for GPs to earn a living means they end up following all the targets and financial inducements etc. that the Government sets rather than focusing on what their patients want. Hence the 8am-phone-calls-to-get-appointments farces. Although having said that, there may not be that much GPs individually can do about the shortage of GPs in some parts of the country leading to 3-week appointment waits. It'd be interesting to see if anyone here who works with the NHS can confirm if my guesses are correct?

Not helped by the 62% marginal tax rate on earnings over £100k (which most partner GP's earn), meaning they're incentivised to work fewer hours/days to get their earnings below £100k, thus worsening the shortage of GPs.

On a different topic, it's also time GP's were paid according to number of appointments actually used and treatments given, not the "£x per patient per year". That would, at a stroke, increase the number of appointments available if the GP's were paid by appointment. As it stands, there is no incentive for them to offer more appointments - the practice gets paid the same whether a patient has 1 or 5 appointments so it makes sense for them (financially) to offer less appointments, hence saving wages costs, to get the same income.
 

Barn

Established Member
Joined
3 Sep 2008
Messages
1,463
Or maybe just be paid a salary and then rostered according to need, like hospital doctors.
 

Butts

Veteran Member
Joined
16 Jan 2011
Messages
11,323
Location
Stirlingshire
It seems going back to the original post that The NHS is wonderful if you live in Scotland :

Free Prescriptions
Free Dental Check Up
Free Eye Tests
Free Hospital Parking

Wales and Northern Ireland also have Free Prescriptions.

Poor old England gets sod all. Whatever happened to "Free at point of use" maxim the NHS was set up with ?

United Kingdom (excluding healthcare charges !!)
 

DynamicSpirit

Established Member
Joined
12 Apr 2012
Messages
8,024
Location
SE London
It seems going back to the original post that The NHS is wonderful if you live in Scotland :

Free Prescriptions
Free Dental Check Up
Free Eye Tests
Free Hospital Parking

Does this make the NHS wonderful in Scotland? Can everyone get a GP appointment easily? A hospital appointment without waiting months. Is the bureaucracy efficient? Are GPs and hospitals responsive to what their patients need? Can people who need weekend appointments get them? I think those would be the real tests of whether the NHS is wonderful in Scotland!

But taking these points in turn..

Free dental check-up and eye tests... Yes, that's a great idea. Encouraging people to have check-ups potentially saves a lot of suffering and medical expense later on. Would be good if that was done throughout the UK.

Free prescriptions... Well in England quite a few people do get free prescriptions. But I'm not convinced that free prescriptions for everyone is a good idea (although I think the charge in England is on the high side and could do with being lower). For people like me who can afford it, paying for prescriptions gives some additional income to the NHS, and it perhaps helps to discourage over-dependency on drugs. The English system of giving free prescriptions to people in certain groups (on benefits, with certain long-term conditions, etc.) rather than to everyone seems like a good balance to me (although I do wonder whether the bureaucracy involved in distinguishing who gets free prescriptions is worth it?)

Free Hospital Parking... Well, a fact check reveals this is not completely true. Parking is free at some hospitals. But aside from that, how is this a good idea? It's basically subsidising people who choose to cause congestion, pollution, and harm their own health by driving to the hospital, at the expense of people who do the right thing where possible and use some other means to get to hospital (Or does NHS Scotland also arrange free bus fares for everyone who goes to hospital by bus?). No-one who's too poor to own a car would benefit from this. It may be useful for some people who are not well off, live in areas without public transport, or are too ill to travel other than by car, but you can bet the majority of beneficiaries are people who are perfectly well off and able to afford to pay parking fees, and are simply too lazy (or selfish) to use a more eco-friendly way to visit the hospital. And that money being used to subsidise them is money that could have been spent improving health care for everyone. Of all the possible ways to spend valuable NHS money in Scotland, this surely has to be one of the most stupid!
 
Status
Not open for further replies.

Top