[Misc] How can the NHS survive in its current form ?

[HalfaSeatOn]

Yes but delaying morbidity is simply kicking the can down the road and shifting the age of the patient when they become a healtcare burden from their 50s to their 80s. Great for the individual as they live longer, but no cost saving to the NHS. Removing type 2 diabetics (for example) from the health service may largely keep more people alive longer but they will pop up later in the health system with prostate cancer, arthritis, COPD, heart failure and cancer. The problem is that in the long run we are all dead, and unless it is by a sudden and swift stroke or MI, there will be a costly interlude between the end of good health and the appearance of death. I may be exaggerating this but I have seen an increase in 'diseases of age' over the last 40 years as general health (and wealth) has increased, so it has become an issue when it wasn't an issue 50 years ago. My uni created a center for age related diseases 20 years ago. So the removal of type 2 diabetes (etc.) may give an illusion of less strain on the NHS, but if the result is an increase in other types of diseases 20 years later then the financial and logistic burden will be unchanged. Swings and roundabouts. Ironically the health care costs would fall greatly if we went back to the 1890s where it was common for mother and child to not make it through childbirth. Neither would go on to develop chronic illnesses later in life presenting a cost burden to the health system, whatever it may be.

I think where I was at was that the delay of calling off health care to 80 rather than 50 would help protect a certain level of demand on the nhs and save money for 30 years. It would not eliminate the inevitable demand ‘down the road’ as you point out. I could see a 2090 equivalent to your 1890 outcome being ready acceptance of euthanasia. This is depressing for a Friday. I think I’ll move to the ‘what’s the best song….’ thread

 

[Harry Wilson's tackle]

I think where I was at was that the delay of calling off health care to 80 rather than 50 would help protect a certain level of demand on the nhs and save money for 30 years. It would not eliminate the inevitable demand ‘down the road’ as you point out. I could see a 2090 equivalent to your 1890 outcome being ready acceptance of euthanasia. This is depressing for a Friday. I think I’ll move to the ‘what’s the best song….’ thread

Mate, there is not a lot we can do about it. My plan is to eat healthy, drink, and be as merry as I can. Once the family is all taken care of (I'll be a grand dad in November if all goes well, and I have to help out the boy; the missus is sorted) my work here will be done. I shall then do what I always do - cause trouble wherever I can, and make myself get out of my comfort zone; fight all my autistic instincts to hide, and exhale, and on we go.

You will enjoy my 'best song' of the day, I hope. It is a cracker

 

[marcos3263]

due to work and personal experience I have seen/ dealing with several people who are old and have multiple issues and on lots of medications.
None of them seen to have a particularly enjoyable life and are almost just waiting to die. they just watch TV all day and not much else.

These people are a drain on the NHS but without really getting anything from it. - other thank more dreary days of existence.

No idea what the answer is but being on 12-15 pills a day and in constant pain is not a life.

Also at current costs of £1500-1600 + a week in nursing homes etc that isn't sustainable as the population gets older.

Any real solution will be looked upon as cruel and callous or just evil but can we just pump more and more money into the system?

has anyone watched the Japanese film about euthanasia Plan 75 - https://www.theguardian.com/film/2023/may/08/plan-75-ageing-japan-euthanasia-suicide

actually just reading this back makes it look like I am suggesting euthanasia which I'm not, I was mealy rambling on a hot Friday afternoon when I should be working.

 

[Colonel Mustard]

Only the Tories will convince you it can't: because they want to privatise it.

The UK without an NHS is a horrifying thought.
In the USA, 500,000 families a year go bankrupt due to medical bills. Imagine that? Nice house, car, money for holidays.. all gone because you got cancer and didn't have the correct insurance.

I get really annoyed when people use the US as the alternative to the NHS. It must be the worst health service in the developed world. If you’ve lived in mainland Europe (and many other countries, I’m sure) you’ll know that a government-subsidised and regulated insurance model can offer a far superior service with much better health outcomes. But even suggesting such an idea in the UK is tantamount to burning the Koran. People become totally irrational when discussing the failings of the NHS.

 

[Commander]

I get really annoyed when people use the US as the alternative to the NHS. It must be the worst health service in the developed world. If you’ve lived in mainland Europe (and many other countries, I’m sure) you’ll know that a government-subsidised and regulated insurance model can offer a far superior service with much better health outcomes. But even suggesting such an idea in the UK is tantamount to burning the Koran. People become totally irrational when discussing the failings of the NHS.

Spot on. It’s amazing how many otherwise sensible people seem to think the answer is either the current system but with more money thrown at it, or the US system. Like there couldn’t possibly be anything in between. Dare to suggest adapting the model slightly and people pretty much accuse you of wanting a system where thousands of people die because they can’t afford healthcare. It’s bizarre.

Fact is, the NHS was designed to a LOT less people than there are now. If the game changes, you need to adapt the system.

 

[Colonel Mustard]

Spot on. It’s amazing how many otherwise sensible people seem to think the answer is either the current system but with more money thrown at it, or the US system. Like there couldn’t possibly be anything in between. Dare to suggest adapting the model slightly and people pretty much accuse you of wanting a system where thousands of people die because they can’t afford healthcare. It’s bizarre.

Fact is, the NHS was designed to a LOT less people than there are now. If the game changes, you need to adapt the system.

Not just the number of people in the system but the far greater range and complexity of health issues and treatment options than was the case 75 years ago.

 

[drew]

I get really annoyed when people use the US as the alternative to the NHS. It must be the worst health service in the developed world. If you’ve lived in mainland Europe (and many other countries, I’m sure) you’ll know that a government-subsidised and regulated insurance model can offer a far superior service with much better health outcomes. But even suggesting such an idea in the UK is tantamount to burning the Koran. People become totally irrational when discussing the failings of the NHS.

Far Superior!! That's a bold claim. In 2014, the Washington based Commonwealth Fund juddged the NHS to be the best in the World and again in 2017.

 

[Colonel Mustard]

Far Superior!! That's a bold claim. In 2014, the Washington based Commonwealth Fund juddged the NHS to be the best in the World and again in 2017.

It’s a bit like those 'best cities to live in the world' surveys published by loads of different organisations and businesses. Depends entirely on the criteria. There’s no possibility on earth that the NHS could objectively be described as the best in the world unless you’re using very narrow or specialised criteria.

 

[drew]

It’s a bit like those 'best cities to live in the world' surveys published by loads of different organisations and businesses. Depends entirely on the criteria. There’s no possibility on earth that the NHS could objectively be described as the best in the world unless you’re using very narrow or specialised criteria.

The point I'm making is that you claimed other systems are far superior yet the NHS still ranks highly. Perhaps if we spent the same % of GDP on our health service as other nations do then the NHS would be deemed better than it is perceived. If you look at 2019, ie pre pandemic, compared to Germany, that would add about another £30b to the budget which is about another 20% of the budget at the time. There's nothing wrong with the concept of the NHS but it just never gets the funds needed.

 

[Colonel Mustard]

The point I'm making is that you claimed other systems are far superior yet the NHS still ranks highly. Perhaps if we spent the same % of GDP on our health service as other nations do then the NHS would be deemed better than it is perceived. If you look at 2019, ie pre pandemic, compared to Germany, that would add about another £30b to the budget which is about another 20% of the budget at the time. There's nothing wrong with the concept of the NHS but it just never gets the funds needed.

Other systems ARE far superior. The Commonwealth Fund you quoted is an annual study of 11 "high income nations'. The UK is pretty average even in those 11, and way down the rankings of wider surveys. I’m not even sure how much to trust those findings when they have Switzerland as 10th out of 11th. I know the Swiss system well as I lived there until recently. Healthcare is superb and virtually instant I.e. no waiting times for GP appointments, routine operations within a week of diagnosis, and so on, so I’ve no idea what criteria they’re employing that puts the NHS above it.

As for 'the NHS would be great if only we gave it more money' I’m afraid this has been the mantra for 75 years now. Despite what people think, even the Tories [spit] have pumped extra money in real terms into the NHS but it continues to disintegrate, even with record numbers seeking private healthcare year on year. It’s very probably a basket case that needs radical rethinking. The only reason I say 'very probably' is that no one really knows because we’re not allowed to have a serious discussion about it. It’s a religion, something that must never be criticised. What’s needed is a government sponsored in-depth study to examine all options. But (to come back to my very first point) it doesn’t help when people always quote the worst healthcare system in the world, the US, as the only alternative. Pretty much all of Western Europe offer a range of superior options.

 

[One Teddy Maybank]

Other systems ARE far superior.

As for 'the NHS would be great if only we gave it more money' I’m afraid this has been the mantra for 75 years now. Despite what people think, even the Tories [spit] have pumped extra money in real terms into the NHS but it continues to disintegrate, even with record numbers seeking private healthcare year on year. It’s very probably a basket case that needs radical rethinking. The only reason I say 'very probably' is that no one really knows because we’re not allowed to have a serious discussion about it. It’s a religion, something that must never be criticised. What’s needed is a government sponsored in-depth study to examine all options. But (to come back to my very first point) it doesn’t help when people always quote the worst healthcare system in the world, the US, as the only alternative. Pretty much all of Western Europe offer a range of superior options.

They really aren’t.

I’ve presented in Switzerland and reviewed health systems in a number of European countries, and they have taken ideas from the UK.

Scandinavia was impressive but not due to care, but more culturally and how they managed things like lunch breaks, and dietary options.

In terms of an extensive review, this is precisely what every new government does. The mantra of resolving the NHS etc. etc. Followed by a shake up, Long Term Plan, improved outcomes etc…..

Having worked in it for 33 years, it does boil down to money.
New high cost drugs cost more.
Workforce salaries, do not encourage recruitment or support retention.
Technology costs money, and then implementation is delayed due to lack of technical staff, again salaries.
Social care packages inadequate because lack of infrastructure and funding, so staffing levels low.

I could go on.

I do agree that considering the US system as a credible option, is frankly bollocks.

 

[Weststander]

I get really annoyed when people use the US as the alternative to the NHS. It must be the worst health service in the developed world. If you’ve lived in mainland Europe (and many other countries, I’m sure) you’ll know that a government-subsidised and regulated insurance model can offer a far superior service with much better health outcomes. But even suggesting such an idea in the UK is tantamount to burning the Koran. People become totally irrational when discussing the failings of the NHS.

A political football.

Sometimes when a (non far right wing) politician gently mention reform, a crowd pleaser will churn out for mass applause “Ah, so you don’t value our wonderful nurses”.

 

[abc]

An adult non party political debate as to the future of the nhs is desperately needed but will sadly never happen. Ultimately it’s due to the failings of us ‘the public’ rather than the politicians because ‘we, the voters’ simply won’t allow it. The leaders of every party know the current system is terminally broken but to acknowledge this means electoral oblivion

 

[Biscuit]

I get really annoyed when people use the US as the alternative to the NHS. It must be the worst health service in the developed world. If you’ve lived in mainland Europe (and many other countries, I’m sure) you’ll know that a government-subsidised and regulated insurance model can offer a far superior service with much better health outcomes. But even suggesting such an idea in the UK is tantamount to burning the Koran. People become totally irrational when discussing the failings of the NHS.

Apologies, my intention was not to annoy you. I, like many, are terrified at the prospect of healthcare that isn't free at the point of use. Especially considering we bear such a heavy tax burden to pay for such things.