How do you FIX the NHS?

[Simster]

So poor people and the elderly scraping by on a state pension or benefits but two groups MOST at risk of health problems should have to fork out £20 a time?

A sure-fire way to stop people who need treatment attending their GP because simply they cannot afford to.

This, in my opinion, would be a complete contrast to why the NHS was set up in the first place.

Firstly, we're talking £20, not £200. Secondly, I agree that a facility to reclaim money should be in place to assist the less fortunate. But I do think you need to have a deterrant to clogging up the waiting rooms unnecessarily.

In the end, it all needs to be paid for - and sadly in this country, people talk about their rights without taking their responsibilities seriously. The current problem in the NHS is proof that this goes beyond a problem with CHAVS.

 

[withdeanwombat]

So poor people and the elderly scraping by on a state pension or benefits but two groups MOST at risk of health problems should have to fork out £20 a time?

A sure-fire way to stop people who need treatment attending their GP because simply they cannot afford to.

This, in my opinion, would be a complete contrast to why the NHS was set up in the first place.

Certainly,but undertakers would have LOADS of extra work,housing problems eased,and those who absolutely must have bigger boobs or birth marks removed or nose jobs or whatever could jump the queues with a quick twenty pound note (or four fivers if only the banks would issue them) et voila,problem solved!

Or ban private health entirely,or make private hospitals reimburse the cost of staff training,and invest in frontline staff at NHS facilities,and treat everybody alike.

Do it,.............NOW !!

 

[London Calling]

The National Health Service is the biggest employer in Europe and isn't the second biggest in the world after the Chinese Red Army.

That tells you a lot.

The National service needs to be broken up into at least regional divisions, managing to at least regional needs. This has effectively already been done for Scotland, Northern Ireland. It could easily be done for London and most of the other city regions. In the South East a Sussex Kent NHS could easily operate. If not to a lower administration level.

Initially a national set budget would be set for the regions, these would be gradually phased out with local taxes paying for the service.

The local Health Service would be accountable, locally driven and you would really know if it was good, bad or ugly.

This system would also remove unnecessay tiers of bureaucracy.

LC

 

[DIFFBROOK]

I think the biggest problem facing the NHS is the cost of drugs. Having said that, perhaps we need to consider whether forking out £50bn or so on a new Trident system, which we will never use, and who are the enemy anyway (homegrown terrorists), is really the best way of spending that kind of cash. Or would we rather have £50bn for life saving drugs.

 

[larus]

If you want to solve the nation's problems by making people who earn more than £45K pay, why not do the simple thing? ... TAX THEM.

That's the typical reaction of so many people - throw more money at the NHS, tax middle income/high income people.

The issue is that the NHS is so inefficient it's frightening, but it's not allowed to be privatised beacuse it's perceived to be this wonderful organisation. Wake up and smell the coffee. It needs to be overhauled and not just having more money thrown at it and wasted.

Also, if people have diseases which are self-inflicted and they won't change their life-style to reflect it, then why should the tax-payer continue to forl out. Make them pay. For example, if you smoke, drink to excess take drugs and you have health problems and refuse to change your lifestyle, why should I pay more tax to make you well. That's not just. People have to accept a degree of responsibility for their own health.

 

[sten_super]

The National Health Service is the biggest employer in Europe and isn't the second biggest in the world after the Chinese Red Army.

That tells you a lot.

The National service needs to be broken up into at least regional divisions, managing to at least regional needs. This has effectively already been done for Scotland, Northern Ireland. It could easily be done for London and most of the other city regions. In the South East a Sussex Kent NHS could easily operate. If not to a lower administration level.

Initially a national set budget would be set for the regions, these would be gradually phased out with local taxes paying for the service.

The local Health Service would be accountable, locally driven and you would really know if it was good, bad or ugly.

This system would also remove unnecessay tiers of bureaucracy.

LC

A completely localised NHS would never work though. What if a person needed an extremely complex and specialised operation... are you expecting each region to have the capabilities to perform this, even though it may only be required for say 5 operations nationwide per year? Specialisation is a must for the NHS, and is one of the benefits of having such a large organisation. To compromise this would be lunacy.

However, I do agree that many more decisions need to be taken locally. But you cannot simply allocate funding to individual hospitals or regions to do with as they please.

 

[DIFFBROOK]

A completely localised NHS would never work though. What if a person needed an extremely complex and specialised operation... are you expecting each region to have the capabilities to perform this, even though it may only be required for say 5 operations nationwide per year? Specialisation is a must for the NHS, and is one of the benefits of having such a large organisation. To compromise this would be lunacy.

However, I do agree that many more decisions need to be taken locally. But you cannot simply allocate funding to individual hospitals or regions to do with as they please.

Actually this the case. There is a national formula that decides how much funding goes to each Primary Care Trust. I agree with your point about specialisms and to a point thats what is happening.

 

[London Calling]

A completely localised NHS would never work though. What if a person needed an extremely complex and specialised operation... are you expecting each region to have the capabilities to perform this, even though it may only be required for say 5 operations nationwide per year? Specialisation is a must for the NHS, and is one of the benefits of having such a large organisation. To compromise this would be lunacy.

However, I do agree that many more decisions need to be taken locally. But you cannot simply allocate funding to individual hospitals or regions to do with as they please.

I doubt there are few very few operations that need to be done at a national level because they rare. Lets take London. A population of 7 million, greater than most countries in the world. I expect under a good Health Service that all operations can be delivered within the boundaries of lOndon.

If we still need to have a national centre for unique operations, they can be undertaken at a centre of local/regional/national expertise but directly billed to the patient host authority.

Most of the world delivers its health services locally, so why can't we? Germany, France, Sweden, especially Sweden a population of 9 million, a little larger than LOndon, Doesn't seem to have problems with the management of the rare operation or two. And boy, they have a health service originally based on the NHS and a service to be proud off.

Lets break up the national health service and lets have a locally managed health service, that is not the poodle of central government.

 

[Marshy]

When i think of the answer to this question i think where do i start.

I see a horrific waste of money wherever i go in the NHS.

 

[Storer68]

Doctors salaries.................. GP average £118,000 per year

How doctors came into the money

GPs have been enriching themselves by increasing the proportion of their budget they pay themselves and decreasing that spent on practices. They are paid a gross sum to run practices - hiring staff and buying equipment. What is left after paying these expenses is their "profit".

In 2003-04, GPs earned a "profit" of [pound]82,019 - 40 per cent of their gross earnings of [pound]203,613. But in 2004-05, the first year of their new contract, this grew to 45 per cent.

Between 1998-99 and 2004-05 the amount they spent on their practices declined from 62 per cent of their gross earnings to 55 per cent, while the amount they took as income for themselves increased from 38 per cent to 45 per cent, figures from the NHS Information Centre show. Private earnings - fees for medical examinations, travel vaccinations, etc - amounting to a few thousand pounds per head, are included in these figures.

NHS Employers, the body that negotiated the contract, admitted it was "disappointed" that the contract had "resulted in such significant increases in individual GP incomes".

Changes in the way employers' superannuation payments (pension contributions) were made reduced the real rise for GPs by 5-6 per cent in 2004-05, and the proportion of their earnings taken as income by 1.2-1.5 per cent, the NHS Information Centre said.

Gross earnings for 2005-06 are not yet available but average income for GPs is expected to be [pound]116,000-[pound]118,000, a 44 per cent increase in two years, according to the Association of Independent Medical Accountants, which provides financial services to 7,000 GPs.

In 2002-03, average income was [pound]72,324, according to the NHS Information Centre. The increase to [pound]118,000 in 2005-06 is a rise of 63 per cent in three years.

Copyright 2007 Independent Newspapers UK Limited

 

[London Calling]

We left our local surgery, following continuing bad pratice, inappropriate medication, hasslement of Ms LC and always a complete absence of soap in their toilets, and rarely any paper.

 

[Caveman]

3 Main Problems, as I see it

1) People are living much longer, so there is many more people than the service can cope with
2) Science is advancing rapidly and so more and more expensive treatments are becoming available
3) There is never going to be enough money in the pot to pay for everything

So how do you resolve this?

1) Refuse any treatment that is cosmetic (you want that, great, go pay for it)
2) Reduce management costs, empower the Healthcare Trusts
3) Introduce a sliding payment scheme where folks make contributions based on how much the treatment costs, and ability to pay

2) Yet still millions die every year of Cancer and Aids.

 

[severnside gull]

How do you FIX the NHS?


Move abroad?

 

[cjd]

I think it,s one of those problems, that the more money you give the NHS, the more people are given life saving treatments , operations, etc,etc. In the end, we just live longer.....and need the NHS more. I,m sure it was Ed who said some time ago, that the better roads we built, the further people travelled to work,leading to more congestion on the roads. The harsh answer is probably to reduce their income, and above all, our expectations.

 

[Cian]

Cancel NPfIT. Yeah, it'll put half my colleagues out of a job, but it'll stop the NHS wasting absolutely massive sums of money...

 

[Beach Hut]

3 Main Problems, as I see it

1) People are living much longer, so there is many more people than the service can cope with
2) Science is advancing rapidly and so more and more expensive treatments are becoming available
3) There is never going to be enough money in the pot to pay for everything

So how do you resolve this?

1) Refuse any treatment that is cosmetic (you want that, great, go pay for it)
2) Reduce management costs, empower the Healthcare Trusts
3) Introduce a sliding payment scheme where folks make contributions based on how much the treatment costs, and ability to pay

Resolution 3 is already accounted for by paying National Insurance so I take it you mean those that don't pay NI make a contribution ?

 

[Gully]

I was going to suggest something similar for option 3, that we all pay tax in accordance with our incomes, the highest earners pay the most and thereby make the largest contribution to the exchequer. If someone needs to use the health service then it should be there for them, regardless of how much they have contributed...those who have paid the most have more than likely opted out and subscribe to something like BUPA, yet they continue to contribute to the NHS via taxation, despite rarely drawing on their investment.

 

[British Bulldog]

Take some the weight off them by a sort of means testing. Anyone earning say 45K+ should not be allowed to use it, but have private health insurance.

Edit - didn't think that through properly. Anyone earning that kind of money is likely to have private health care anyway

So the people who contribute more in the way of tax and national insurance should be entitled to less? Does'nt that sort of penalise people for trying to better themselves?