Isn't the NHS wonderful

[Bromley boy]

The NHS enjoys an unhealthily privileged political position where it’s untouchable and verboten to discuss its failings.

Indeed. As we are seeing on this very thread!

I am very keen to challenge and fix waste an inefficiency however more money would fix things like a shortage of Doctors and nurses. It is interesting you cant concede that point. I doubt money is wasted in employing health care professionals.

I’ve said I have no problem with the NHS budget continuing to increase but it’s clear that waste has become extreme and needs to be addressed as a matter of urgency. Ever more money can never be a solution to a system that has become a bottomless pit.

More money should firstly come from saving the hundreds of millions they’re already being given and are wasting. Instead of paying £1500 for a pot of £3 ointment and wasting cash on defunct IT systems more competent management could get a grip of those issues and use the money saved to employ more doctors and nurses.

And while the NHS budget may be protected ( i disagree) other budgets have been slashed forcing the NHS to pick up the slack nor does the NHS budget increase as much as needed year on year. Government policy is directly in whole or part responsible for the problems in the NHS.

The issues with the NHS are fundamental and date back back years. Incompetent procurement and wasteful management are as much to blame as government policy (both labour and conservative governments).

the problem is that the first change starts the slide to an insurance based system.

You’re completely overreacting.

Nobody on here is asking for an insurance based approach. They’re just making perfectly valid criticisms of the existing system, which is clearly failing.

perhaps if they paid tax like we have to we might be able to afford better service and I would be less suspicious about their motives to "reform" the NHS.

This has nothing to do with the issues in the NHS. Incompetent procurement and wasteful management are more to blame than mythical tax-avoiding-Tory-banker-pinstriped-bogeymen...

So only your bad experiences of any evidential value but my good experience on what was the worse day of my life so far is worthless. What a roaster.

With the greatest of respect you shouldn’t go down that road when it’s quite clear that other posters have had the worst days of their lives made even worse (or even created in the first place) by the failings of the NHS.

Your own experience sounds dreadful, and is no less valid, but it certainly doesn’t nullify theirs. It also doesn’t cancel out some of the worst healthcare outcomes in the developed world.

I am off for a cup of tea and a clam down.

Probably for the best old chap.

For god’s sake go and have and have a lie down. You appear to have put your “Mr Irrationally Grumpy” hat on today.

 

[Ianno87]

The NHS may not be perfect and have its occasional failings, but it's there and (in my view) better than the alternatives.

I have a multitude of personal reasons to be grateful for it.

 

[AlterEgo]

The NHS may not be perfect and have its occasional failings, but it's there and (in my view) better than the alternatives.

Why are our health outcomes poorer than many developed countries with alternative systems then? Cancer survival rates here are diabolical. The NHS performs below average in 8 of the leading 12 causes of death, so not just cancer but heart disease and mental health provision. A higher than average number of babies die shortly after birth too.

The NHS is a very poor model for healthcare provision. But it’s forbidden to touch it because it saves lives.

 

[DarloRich]

Indeed. As we are seeing on this very thread!

Discussion of failings aren't forbidden. However, it should be forbidden to suggest we bin the NHS and replace it with an insurance based system. It should also be forbidden to suggest there are not good parts of the NHS and that the service received by people is often good. We can only base our assumptions on our own experiences. Mine have been really good. Perhaps I have been lucky but those are my experiences and I will not be told they are invalid.

I’ve said I have no problem with the NHS budget continuing to increase but it’s clear that waste has become extreme and needs to be addressed as a matter of urgency. Ever more money can never be a solution to a system that has become a bottomless pit.

More money should firstly come from saving the hundreds of millions they’re already being given and are wasting. Instead of paying £1500 for a pot of £3 ointment and wasting cash on defunct IT systems more competent management could get a grip of those issues and use the money saved to employ more doctors and nurses.

More money should be spent to recruit more doctors and nurses. It should be spent now. At the same time waste should be attacked and attacked hard. I am very happy to see this happen. I do have some experience of saving tax players money and see lots of waste in the NHS. We need to fix that and I think lots of it can be fixed easily if not quickly. It is our money being wasted afterall. However, we also need more doctors and nurses and cant afford to wait. Many of the problems we see reported are caused by lack of staff or facilities. Why not fix that while also fixing any waste at the same time?

The issues with the NHS are fundamental and date back back years. Incompetent procurement and wasteful management are as much to blame as government policy (both labour and conservative governments).

Indeed - but we didn't have such long waiting lists and such a shortage of doctors and nurses under the labour government.

You’re completely overreacting.

Nobody on here is asking for an insurance based approach. They’re just making perfectly valid criticisms of the existing system, which is clearly failing.

Change is the first step towards the insurance based system many Tories want. Perhaps my terrible northern working class lefty views are coming through but we as a family would find funding health care very difficult. Our family health history isn't great. Insurance would be hard to find and harder to fund. I have seen enough of my family members die of industrial illness ( mainly Mesothelioma & CWP - that's what you get for years in the mines and ship yards) to know the inestimable value of "free" health care. I am lucky that I don't have to work in that environment and my job might offer me insurance but most of my family work in low paid or self employed jobs. How do they pay for care?

While that may not be what many want it is the ultimate destination when we start to fiddle with the NHS. I am not against change - Clearly we need to make changes but I am simply terrified we will "chuck the baby out with the bath water" once we start to change the NHS. Inch by inch we will move to a system no one wanted at the start. We have to be certain any change is for the best and delivers good quality free at the point of user care to all, not just those with resources.

This has nothing to do with the issues in the NHS. Incompetent procurement and wasteful management are more to blame than mythical tax-avoiding-Tory-banker-pinstriped-bogeymen...

No problem with attacking waste. I would also like us to attack those who cheat us by not paying their tax. Their hidden money is money those of us less well off then them need for our services. The hypocrisy and sanctimony makes my pi$$ boil!

BTW I am happy to pay more tax to fund the NHS. I wonder if those chaps are happy to pay any tax?

With the greatest of respect you shouldn’t go down that road when it’s quite clear that other posters have had the worst days of their lives made even worse (or even created in the first place) by the failings of the NHS.

Your own experience sounds dreadful, and is no less valid, but it certainly doesn’t nullify theirs. It also doesn’t cancel out some of the worst healthcare outcomes in the developed world.

I would rather free care than expensive care many can't afford!

I don't seek to devalue or nullify anyone's views, although suggesting nurses shouldn't talk to each other make it difficult to take the rest of the points seriously!. All views are valid as we all need to use the NHS at varied and important stages of our lives. I simply ask that those posters don't suggest my good experiences are less valid than their poor ones and perhaps acknowledge the truth is likely to be somewhere in the middle. After-all NHS saved loads of people today aren't headlines the press want to run!

Why are our health outcomes poorer than many developed countries with alternative systems then? Cancer survival rates here are diabolical. The NHS performs below average in 8 of the leading 12 causes of death, so not just cancer but heart disease and mental health provision. A higher than average number of babies die shortly after birth too.

The NHS is a very poor model for healthcare provision. But it’s forbidden to touch it because it saves lives.

Conservative policy, a lack of money, a shortage of doctors and nurses ( and other health care professionals) coupled with waste and inefficiency.

 

[Ianno87]

Why are our health outcomes poorer than many developed countries with alternative systems then? Cancer survival rates here are diabolical. The NHS performs below average in 8 of the leading 12 causes of death, so not just cancer but heart disease and mental health provision. A higher than average number of babies die shortly after birth too.

The NHS is a very poor model for healthcare provision. But it’s forbidden to touch it because it saves lives.

Don't know. Just offering my own opinion* on this discussion forum. I'm very sorry for offending you, resulting in me being shouted down for offering that opinion.

*Speaking as somebody, for zero cost at point of service:
-Who has a bilateral cleft lip and palate, fully repaired as a baby with 16 years' worth of follow-up treatment and corrective work
-Who has had two children born on the NHS
-Who watched the last 10 days of his Dad's life be made comfortable in the care of the NHS by the best nurses possible
-Supplies a multitude of my wife's epilepsy medication

The NHS has worked for me (like I said, I recognise its not perfect), for treatment worth many thousands of pounds. Sorry about that.

This forum needs to grow up, sometimes.

 

[DarloRich]

i know I get wound up about this but it is important to me and I am terrified that change leads to a system that many cant afford or take part in. We have to be very careful not to lose the parts of the NHS we should rightly be proud of.

 

[bramling]

We should certainly celebrate the good bits, but we should also lament the bad bits: profligate waste; gross inefficiency; health outcomes and cancer survival rates that lag behind much of the developed world. I’m sure you’ll agree none of those are “wonderful”?

It strikes me that the NHS is similar to the railway in many respects: institutional, old fashioned with good bits, bad bits, things that could be done better etc. The difference is that, while the railway is everyone’s favourite whipping boy, people are blind to the failings of the NHS for irrational reasons and it therefore gets away with murder!



I’d like to know the money being spent already isn’t being wasted. If hundreds of millions per year are being squandered (and it seems they are), hundreds more millions won’t help.

Keep in mind the NHS budget increases every year and was ringfenced from austerity. I’m not for one minute suggesting it shouldn’t have been, but I’d like a bit more budgetary oversight to prevent stories like this:

https://www.thetimes.co.uk/article/nhs-forced-to-pay-1-500-for-2-pot-of-moisturiser-3d0ckn3gh



And this:

https://www.independent.co.uk/news/...ry-tim-briggs-professor-quality-a7876326.html





Nobody is asking for the NHS to be given up, they’re simply asking why it never seems to improve and we see the same old Groundhog Day headlines year after year, despite its gold plated, ringfenced budget.

I don’t really see the relevance of the comments about rich Tories not paying enough tax (that has the makings of another long discussion about tax!) when the NHS’s budget has been ringfenced?

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.

 

[DarloRich]

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.

indeed - and that is in large part because of inadequate funding. The wait for a referral in MK for mental health treatment is now upwards of 6 months. That isn't on and fails those waiting for help and support. I would hope emergency interventions are quicker!

 

[AlterEgo]

Don't know. Just offering my own opinion* on this discussion forum. I'm very sorry for offending you, resulting in me being shouted down for offering that opinion.

*Speaking as somebody, for zero cost at point of service:
-Who has a bilateral cleft lip and palate, fully repaired as a baby with 16 years' worth of follow-up treatment and corrective work
-Who has had two children born on the NHS
-Who watched the last 10 days of his Dad's life be made comfortable in the care of the NHS by the best nurses possible
-Supplies a multitude of my wife's epilepsy medication

The NHS has worked for me (like I said, I recognise its not perfect), for treatment worth many thousands of pounds. Sorry about that.

This forum needs to grow up, sometimes.

If you feel that someone pointing out their own opinion which is contrary to yours is being shouted down, then you need to grow up, and not “the forum”. I made a very inoffensive, reasoned and rational post - with a question in it - in response to a post based on emotion. And where did I ever suggest I was offended? I wasn’t.

The NHS delivered me from the womb, saved my life from pneumonia, and then again from two strokes, etc etc, like anyone else I can rattle off a load of personal experiences...

...and I still think it’s a bad model for healthcare.

 

[TubeMapCentral]

Indeed. As we are seeing on this very thread!

With the greatest of respect you shouldn’t go down that road when it’s quite clear that other posters have had the worst days of their lives made even worse (or even created in the first place) by the failings of the NHS.

Nicely put. That the NHS can often do its job is not something that should surprise people, that is what it is paid to do. It is the horror stories that everyone has, up and down the country, in chillingly similar forms, irrespective of location, that point to institutional failure. One wonders what sort of gruesome experiences would have to happen to die-hard NHS supporters to change their minds, not the sort of thing I would wish on anyone. I will keep my NHS dental hospital horror story to myself, only private dentists are doing any treatment on my teeth from now on, I don't care how much it costs.

Yes, I do have do some suggestions.

1) Every patient on ward who is waiting for a scan is given date and time of scan. It is on the computer, but getting it out of nurses requires theatening to make a formal complaint. After recovering from the initial agonsing cramps and vomiting, my partner was fasted for 24 hours in order to have a scan before it turned out the scan was scheduled for another 48 hours after that.

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.

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!

4) The NHS pays for sick pay. The problem with the NHS is that everytime it gets incentivised by a badly thought through government target, it finds a way to circumvent it. I well remember a few years ago, with a government drive to reduce waiting lists, that the Local hospital got around this by introducing a waiting list to get onto the waiting list. If the NHS had to pay for people not to work versus treating them, managers might take getting waiting lists down more seriously. The sole purpose of state healthcare is surely to keep the state running smoothly by keeping its citizens up and running.

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.

 

[507021]

I've never had any complaints about the NHS. It's always been there when either myself or a family member have needed it.

 

[tsr]

I think this thread really shows the very polarised experiences people have of a system which is operated under the same badge but has so many different strands and layers as to be virtually untenable as one organisation.

There is no single change or single person who will be able to make the NHS better, or indeed learn from many things it does very well, in order to put them into practice elsewhere. There is no doubt they generally do emergency medical care at least as well as could be reasonably expected, often much much better depending on the type of incident and location. The same competency does also apply to the spirit of many staff (not all), some of the medical training (though again not all!), and many other human factors.

On the other hand, parts of the organisation are perennially embroiled in restructuring, endless middle management layers, resource misuse, useless admin, distraction from poor premises, you name it. Sometimes the NHS is so impenetrable that qualified, experienced medical/clinical staff have no idea how to navigate it.

I am reminded of the stories from when I was born - procedures carried out in the nick of time which prevented me from being seriously disabled (and luckily, as it turned out, not at all), with a reasonable process to monitor a baby and efficiently get a theatre and on-call staff ready at literally 5 minutes' notice, maybe not even that. This was obviously some time ago, and the hospital in question is on the way up again, after some "ups and downs" since. I am also reminded of the episode when my mother turned up on Christmas Day with a non-life-threatening but painful condition and was seen at once by a specialist doctor and several nurses, who made sure she was looked after. They didn't expect the tin of biscuits or the warm thanks, they just did it.

But I also think of the fact that they could have done more to save an elderly relative who died of a relatively straightforward cardiac condition after several agonising days. His family and local community have never fully come to terms with his death, decades on. Another elderly person could not be found in a hospital by any of the staff over the course of a whole day, including after extensive queries by someone who actually used to work there themselves; they were discharged later by surprise, fortunately to a home which was ready for them to return, and in a reasonable condition.

I think less should be made of the fact that it is "the NHS", where people, money and things can get lost very easily under one umbrella. The country (and other countries) need a better overall culture of healthcare and perhaps a more holistic view, if that's the right word, of its place in society, without needing to make a political football out of a blue and white logo. Both others and myself will remain eternally grateful for many good things, but whenever someone gives up their therapy or nursing job because they have no stamina left, or when someone is abandoned within the system, it has to be asked whether it is less than the sum of its parts.

 

[underbank]

I think the GP/practice end of things desperately needs a radical overhaul. It's a relic from the bygone days where your GP did virtually everything, i.e. surgery, attending accidents & emergencies, attending difficult childbirths, and even ward-rounds. In those days, it was right that they were always the first port of call and were responsible for virtually all your health issues.

Today, it seems little more than a gatekeeping role, and a poor one at that. Two recent instances have reinforced my view.

Firstly, my son had an ingrown toe nail. Several appointments to see different practice nurses who each gave different "advice", from bathing in salt water, to buying off the shelf ingrown toe nail treatment - not actually "doing" anything, except looking at it and fobbing us off with half-baked "advice". After six months, and by the time my son was barely able to walk, finally got them to refer him to the podiatry dept only after we googled about it and virtually insisted, i.e. refusing to leave the surgery, until they did the referral. What a revelation in podiatry, people who actually knew what they were talking about, aghast that he'd had it so long without a referral and any proper treatment. They had him in and the toe nail removed within a week, and then regular follow ups until it was normal again.

Secondly, my own referral for a hearing aid. Again, like pulling teeth to get a GP appointment in the first place with the GP saying there'd be a 3-6 month waiting list, then after three months of waiting for an appointment, I phoned audiology directly to ask where I was in the queue only to be told they had no queue and appointments were being sent out within a week or two of receiving referrals - they confirmed they had received nothing from my GP. So, phoned up GP surgery to chase it up, they confirmed the referral hadn't been sent, so I thought it would be easy for them to do it - no, I had to see the GP again, another 3 week wait! This time, he actually did the referral, and yes, I had my first appointment within a couple of weeks - just a shame it was now six months since I first tried to get it, completely unnecessarily, just down to GP incompetence.

 

[A Challenge]

Indeed - but we didn't have such long waiting lists and such a shortage of doctors and nurses under the labour government.

Which is probably because we haven't had a labour government for 8 years. I am not sure it would be any better (or worse) if we'd had a labour party government, or even a Liberal Democrat majority government.

 

[underbank]

Indeed - but we didn't have such long waiting lists and such a shortage of doctors and nurses under the labour government.

The Labour government were masters at manipulating statistics, but my own experiences were very different.

My FIL had to wait several months for an operation re his pancreatic cancer - it was one excuse after another, with the scheduled operation being cancelled over a dozen times. That was 2006 well into the so-called "saving" of the NHS by Labour. One operation date was never going to happen as the consultant was already booked on a residential course abroad months beforehand, so heaven knows why he was booked in for it, and even prep'd on the morning of the op, only for nothing to happen. Left hand doesn't know what the right hand is doing! He got moved between 3 different hospitals over that time for no apparent reason - perhaps moving "re-set" the clock for the treatment??

My mother got an urgent referral from her GP for suspected cancer. She did indeed get an appointment within the target date (16 days I think?) - it was bang on the last day at the time. But she didn't actually see a specialist. She saw a junior doctor who really hadn't much of a clue and just booked her in for more tests and an appointment with the actual consultant a month later. So it was more like a month and a half to see the specialist not the 16 days, yet again, probably "ticked" the boxes for the statistics!

 

[Barn]

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.

 

[DynamicSpirit]

I don't agree and I wont ever agree. I have my own personal reasons why I don't agree but I don't really want to go into them. All I will say is that the doctors and nurses worked inhumanly hard despite looking dog tired, were professional beyond reproach, displayed a level of compassion and empathy that was incredible and supported us at an very difficult time.

It's great that those doctors and nurses were so professional and that -from what I can gather, you therefore had a good experience of care. But surely, what that shows is that those particular doctors and nurses were wonderful. You can't necessarily deduce from that that the NHS as a whole is wonderful. Indeed, couldn't you argue that a truly wonderful organisation would have been set up so as to be able to provide adequate treatment without having to overwork doctors and nurses in the process.

The hospital was spotless and the facilities top notch. There is absolutely no chance that we could have ever paid for that service. There is little chance my dad could ever have afforded insurance to pay for it even if he was able to get it - With his health issues he would have been declined anyway.

I'm not sure that's necessarily true. Presumably it's possible to have an insurance-based system with legal safeguards to prevent individuals from being refused insurance, as well as Government welfare support to ensure that noone is denied insurance through inability to pay. My understanding was that was how most Western European countries tended to operate, though I may be mistaken?

 

[DynamicSpirit]

And could that, perhaps, be due to cuts in funding and a declining number of staff overseen by our Tory government? Could it? Nah bound to be incompetence.

Ummm, what funding cuts? See this graph that I nicked off https://fullfact.org/health/spending-english-nhs/




Bear in mind that this is a graph of changes in health spending (real changes - after accounting for inflation). So anything above zero means that inflation-adjusted spending increased compared to the previous year. The graph does show a small reduction in spending in 2011 but it's insignificantly tiny, and far outweighed by the increases in the neighbouring years. The graph also shows that the rate of increase in spending slowed when the Conservatives came to power, but spending was still increasing.

 

[radamfi]

I'm not sure that's necessarily true. Presumably it's possible to have an insurance-based system with legal safeguards to prevent individuals from being refused insurance, as well as Government welfare support to ensure that noone is denied insurance through inability to pay. My understanding was that was how most Western European countries tended to operate, though I may be mistaken?

All European countries are considered to offer "universal health care", even if they are insurance-based, which many of them are.

https://en.wikipedia.org/wiki/Universal_health_care

explains it well.

 

[rdeez]

My experience as someone who works in the NHS (so I'm far from impartial, and admittedly my experiences are from just one small corner of a vast organisation)...but I've genuinely been struck by the dedication and passion of so many who work there. My role brings me into contact with a wide variety of people, and from secretary to executive director there are lot of talented and hard working people working hard to make the NHS the best it can be. Inevitably in an organisation so vast there are exceptions, but they are in my experience exactly that - the exceptions to the rule.

I'm proud of the NHS, both as someone who is fortunate enough to work for it and also as someone who in the past has required its services more than I would have liked. It's not above criticism, and never should be, but the old adage "you don't know what you've got until it's gone..." certainly applies here.

 

[muddythefish]

The French experience was a revelation, efficient, clean (all British hospitals I have ever set foot in smell dirty no matter how they look), effective. The specialist had his diary on computer, booked straight into a time slot, with availability from SEVEN days ahead, the anaesthatist was seen in advance, all relevant medical history checked out before surgery commenced. I joke about French bureaucracy, but it does the job. .

Look at how much France and Germany and other European countries spend as a proportion of GDP on health compared to us and it's easy to see why the NHS is struggling. Those countries also have much higher taxes - the problem is the British want European quality healthcare but they don't want to pay for it

 

[DynamicSpirit]

Look at how much France and Germany and other European countries spend as a proportion of GDP on health compared to us and it's easy to see why the NHS is struggling. Those countries also have much higher taxes - the problem is the British want European quality healthcare but they don't want to pay for it

Do we spend less? Differences in each country's system make precise comparisons very difficult but.... According to the Nuffield Trust

Another common line is that we don’t spend as much as other comparable countries. This is a really compelling argument – if Spain and Portugal can afford to spend more, then why can’t we? This argument is in part what led to governments finding more money for the NHS in the early 2000s, and it continues to play well to this day. For instance, in 2012 OECD data suggested that we spent below the EU-15 and OECD averages.

But a new, comparable definition of health spending adopted by the OECD in 2011, and finally by the UK last year, suggests that the UK actually spent above the EU-15 and OECD averages – as a percentage of GDP – in 2014.

Compared to the old definition, what now constitutes spending on ‘health’ (at least for the purposes of international comparisons) includes much more of what we in the UK have traditionally thought of as ‘social care’, as well as spending on the NHS and preventative care. Notably it excludes ‘capital spending’. This has meant a large accounting switch from social care to health care spending in the new OECD figures.

The UK is spending what we would expect given its wealth. We spend $530 per person less on health than, say, Belgium, but our per person wealth is less than the Belgians’. So does this mean that we’re spending the right amount on the NHS and we can all move on from this debate? Of course not.

 

[DarloRich]

Ummm, what funding cuts?

it is a bigger picture than shown by your little graph. Take a look at Social Care "savings" since 2010. Then consider how they might impact on the NHS.

 

[DynamicSpirit]

it is a bigger picture than shown by your little graph. Take a look at Social Care "savings" since 2010. Then consider how they might impact on the NHS.

The graph is based on the OECD definition of health care spending, which includes social care.

Health spending measures the final consumption of health care goods and services (i.e. current health expenditure) including personal health care (curative care, rehabilitative care, long-term care, ancillary services and medical goods) and collective services (prevention and public health services as well as health administration), but excluding spending on investments.

 

[DarloRich]

The graph is based on the OECD definition of health care spending, which includes social care.

Graph number one or graph number or both?

BTW - Regardless what your graphs say, I don't trust the ever so generous Tories with the NHS.

 

[Bletchleyite]

Graph number one or graph number or both?

BTW - Regardless what your graphs say, I don't trust the ever so generous Tories with the NHS.

Nobody's going to abolish it, as it would be a guarantee of them being out of power for a very long time if they did.

 

[DarloRich]

Nobody's going to abolish it, as it would be a guarantee of them being out of power for a very long time if they did.

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?

 

[DynamicSpirit]

Graph number one or graph number or both?

BTW - Regardless what your graphs say, I don't trust the ever so generous Tories with the NHS.

So far as I can tell, they both use the OECD definition, which includes social care.

 

[DynamicSpirit]

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'm fairly sure it's a case of soaring demand. We have a massively growing population of elderly people, many of whom have lived very unhealthy lives, and who therefore need constant ongoing care. Medical technology is constantly improving, which means that conditions for which people would simply have died 30 or 40 years ago can now be treated, but often the cost is significant - and of course, as soon as a treatment becomes in principle possible, then people immediately demand that the NHS starts to provide it, no matter what the cost. Add to that that as society gets wealthier, what we expect in terms of standards of patient care goes up too.

Combine that with a fundamental economic problem that, if you make something that's good free, demand for all practical purposes tends to become infinite (strictly speaking, it grows until the marginal benefit to the consumer drops to zero, but for something like healthcare that's effectively going to be infinity). And the result is that, we have an NHS that, no matter how much you spend on it, it's never going to be enough. I'd say that's where you need to look for the explanation of why the NHS is in constant crisis despite ever-increasing amounts of money being thrown at it by both Labour and Tory Governments. And that's before you consider whether having one monolithic organisation leads to inefficiencies (my suspicion based on a few experiences is it probably does).

Personally, I think it's amazing that the NHS is there when it comes to emergencies. But the current system is very evidently failing when it comes to non-emergency treatment, and that does merit a serious debate about how we can get to and pay for a long-term sustainable healthcare system.

 

[Bromley boy]

I'm fairly sure it's a case of soaring demand. We have a massively growing population of elderly people, many of whom have lived very unhealthy lives, and who therefore need constant ongoing care. Medical technology is constantly improving, which means that conditions for which people would simply have died 30 or 40 years ago can now be treated, but often the cost is significant - and of course, as soon as a treatment becomes in principle possible, then people immediately demand that the NHS starts to provide it, no matter what the cost. Add to that that as society gets wealthier, what we expect in terms of standards of patient care goes up too.

Combine that with a fundamental economic problem that, if you make something that's good free, demand for all practical purposes tends to become infinite (strictly speaking, it grows until the marginal benefit to the consumer drops to zero, but for something like healthcare that's effectively going to be infinity). And the result is that, we have an NHS that, no matter how much you spend on it, it's never going to be enough. I'd say that's where you need to look for the explanation of why the NHS is in constant crisis despite ever-increasing amounts of money being thrown at it by both Labour and Tory Governments. And that's before you consider whether having one monolithic organisation leads to inefficiencies (my suspicion based on a few experiences is it probably does).

Personally, I think it's amazing that the NHS is there when it comes to emergencies. But the current system is very evidently failing when it comes to non-emergency treatment, and that does merit a serious debate about how we can get to and pay for a long-term sustainable healthcare system.

An excellent post. I agree with every word.