[Misc] The NHS

[Two Professors]

Can you define what you think a NHS doctor is?

You obviously have an agenda of some sort,and with 557 posts in 10 years are probably a sock-puppet,but I will play your silly games.An NHS doctor does the major part of their working week paid for by the tax-payers,then probably earns extra in private healthcare.What do you think an NHS doctor is?If ,indeed,you think independently?

 

[Hampster Gull]

The whole point of the NHS is the provision of free healthcare for all. If high earners were restricted from using the service then how could we demand they contribute to the financing of it? It would be counter productive as they seldom use the service anyway.

I understand but I am challenging that. funding of the NHS is like the funding of everything else the government does, through its taxation process, there is no ring fencing, NI doesn’t fund what the NHS requires. The tax rate of individuals is a policy decision of government. The NHS cannot continue as it is given the ageing population so I suggest we change it - pay for useage unless you can’t. I think a really simple example is prescriptions which is the same.

 

[Two Professors]

German health care and German railways?

Not everybody thinks euthanasia is a good thing.

 

[Hampster Gull]

Because having the lovely efficient NHS both as an alternative and for private patients to be fed back into makes his healthcare plan about 5 times cheaper.
Also when he or his family get something horrible and their insurance company refuses to renew the NHS is all they will have.

Exactly to my argument. When they can no longer afford it the NHS is there, as it shou,d be for all who can’t afford it. If you can you pay on useage, not through general taxation.

 

[Hampster Gull]

Not everybody thinks euthanasia is a good thing.

 

[portslade seagull]

Depends on how you view progress, if you like overcrowded dirty trains running late between bleak unmanned stations with expensive tickets and still subsidised by the taxpayer you are obviously happy with that.

I thought that was your dream though everything re-nationlised and paid for by the taxpayers

 

[Two Professors]

NHS seriously needs to split A&E into Timewasters & Emergency.

Ever had the misfortune to have a loved one admitted to hospital by ambulance round about pub closing time on a weekend? I have. I'd estimate it's about 10% Emergency, 90% pissed-up white trash. But I guess that's the Medway Maritime for you. Reflects the demographic of Gillingham and Chatham innit

My how the Medway towns have changed since I lived there.No more sword fights or stabbings among the non-white population,trash or otherwise?

 

[Westdene Seagull]

So, we all have opinions, what do you think, what does anyone think, we should do for the NHS?

Make it a standalone public nobody like HMRC - that will minimise it being a political football. It get's all NI plus x% plus an inflation plus 2% increase each year. To get that it would need to bring back free dentistry and free eye care.

 

[Half Time Pies]

It's not simple to build and open any business. When a business starts up and builds a factory, it's an outlay, an investment with a view to creating a successful business which will pay those initial costs and more. That's how things work. You don't end up with a monopoly except where that monopoly has been achieved honestly, because a product or service is very very good and nobody can provide it any better, in which case it's not such a problem. Any time there is a gap in the market, any time a product or service is not being provided at the standard people want and things can be done better, that becomes an opportunity for someone else to come in, meet that need, and reap the rewards. This is how markets work.

Its not the way things work in practice with segments of the market like health care. It has been proven time and time again that the market fails to provide choice for consumers. Mobile phones for example are produced globally so it is very difficult for a provider to have a monopoly. Health care services are provided within a local area like Brighton for example where there is unlikely to be more than a couple of hospitals simply due to the number of people/ customers. In a free market there would be nothing to prevent a provider from owning both of those hospitals and monopolising all of the health services in the area, and, if they didn't provide a decent standard of service what choice would the people of Brighton have? Other providers would find it very difficult to enter the market place in the short term because hospitals and health facilities take years to build and its almost impossible to get planning permission for anything in Brighton and Hove. Thats why we need to have a monopolies and mergers commission in this country to prevent this sort of thing from happening.

 

[The Clamp]

Not everybody thinks euthanasia is a good thing.

Introduce them to you, they'll soon change their minds.

 

[dazzer6666]

Reduce the use of agency nurses, or reduce the cost of agency nurses?

Agency nurses provided by agencies........don’t know how this works in the NHS but if it’s anything like Financial Services, the agency nurse will get little more than the NHS nurse, but the rates charged by the agency are astronomical by comparison. Agency owners are the ones making the money.

How much of an issue is the price of drugs ?

 

[Sussex Nomad]

Make it a standalone public nobody like HMRC - that will minimise it being a political football. It get's all NI plus x% plus an inflation plus 2% increase each year. To get that it would need to bring back free dentistry and free eye care.

It's like budget day isn't it? They take a percentage off your tax and increase VAT, so you don't actually get any concession. Petrol has gone up 3p in the pumps in the past week and if you have a big f'ck off car that's a lot of money, no-one moans, except to themselves. The NHS has a new high in inpatients and emergencies and we sit here, healthy, shrugging our shoulders. What's if it was us? We'd want them like yesterday? Wouldn't we? People die, it happens, but I wonder how many could be saved if we weren't so inefficient.

 

[GT49er]

How about, instead of paying in money and having the government dish it out, people pay into a health savings account which can only be used for medical expenses, but can be directed by the person to a health care provider of their choosing?
Governments were never supposed to provide products or services, they are not capable of doing it, only an open and free marketplace can.

Ah yes, I remember this. The free market will solve everything, the market is paramount, and there is no such thing as society. Oh, and greed is good............

Well, we've been there before, experienced it, suffered it, and ditched it (not entirely, unfortunately - chunks of it are still left stinking the place out, such as PFI and contracting out). The woman who inflicted this philosophy on our country is dead - let's bury the bloody philosophy with her! Time to stop laundering taxpayers' money into the private pockets of shareholders via the NHS.
Remember, for every hour of an agency nurse's time that the NHS pays for, the nurse only gets a bit of it - the rest goes to boost the profits of the agency.

 

[Tom Hark Preston Park]

My how the Medway towns have changed since I lived there.No more sword fights or stabbings among the non-white population,trash or otherwise?

I had the misfortune to live there in the Seventies. It was ALWAYS all about the white trash. Recently had to go back there to the Medway Maritime to be with me dear old mum (RIP). It's STILL all about the white trash. It's like the NHS was/is sponsored by Jeremy Kyle. Sake!

 

[Triggaaar]

No Trig, we still pay into the pot as we have always done.

I was asking dingodan, as he had is own idea on how to improve things.

What I am trying to say, from post 1, is we have a business that runs our NHS and not politicians

But you're not accepting the fact that it's still politicians that would have to decide how big the budget is, and what they expect to be provided for that budget.

In a free market the costs would go down, not up, so healthcare would be more affordable.

We already have aspects of a free market as different providers bid for contracts with our current NHS.

Healthcare costs today are insanely high, because it's a government run monopoly without competition where funds are directed politically.

That's incorrect, as there is competition already. Are healthcare costs in the US low?

Also what I described could still work like a form of mutual insurance similar to how it works today, the only difference being that the patient directs the funds towards the service they want to use, forcing providers to compete with one another to provide services people want.

You didn't answer my question. This was it:
"So when we need health care, can we only use the amount of money we personally have put it, or can we use the overall pot everyone paid into. If the first, then poor people die, if the latter, how much can we use?"

Yes healthcare is better than it was in the 50's, is that because the healthcare system is well run and efficient. Like you say, that's because of technology.

Technology etc would be the main factor - we can't really tell how well or badly its run in comparison, as the number of patients is so much higher.

Is the NHS providing a better service this year than last year? Will it be better next year than this year? Comparing apples for apples, things get worse over time not better, that's pretty clear I think.

I think it's pretty clear the opposite is true, that things get better over time, not worsse. You accept things are better than decades ago, so you accept that generally, year on year, things get better. Or would you like to try and say which years they got better and which they got worse? Looking at the general trend, I'd say that things will probably be better this year than last. Medical advances will pay a part in that, but those cost money.

I think there are cases where lives are lost which don't have to be too.

Given the volume of patients, that must be a certainty, but not indicative of a failing system.

For every good story about the NHS there seem to be more horror stories

Not in my experience.

we aren't having this conversation because the NHS is working, we are having it because it's not.

No, we're having it because the NHS isn't perfect - but then it's not possible to have a perfect health system.

 

[Hastings gull]

A few points. Apologies for any repetition.

The NHS was considered the MOST EFFICIENT health provider in the world, at least prior to Cameron's reorganization to CCGs to increase privatisation.
Seriously MOST EFFICIENT IN THE WORLD, but because it is socialist in nature dogma means the Tories had to change it.

Whatever large numbers are bandied about can we be real about how well funded it actually is? Our level of spending does not match most European countries, and our appalling social care and lax attitude to public health issues puts far greater demands on ours.
A culture of doing the bare minimum causes cost issues elsewhere in hospitals. This is what contracting out inevitably causes.
The issue of agency's creaming multi millions out the NHS for cover nurses and doctors was brilliantly addressed by the NHS. They set up their own agency which charged less, paid more to the staff and returned money to central NHS funds. So the Tories privatised it.

Really? By whom? Not saying you are wrong, but a claim such as this would need far more back-up. The whole system? Parts of it? This whole seems so vague.

 

[Johnny RoastBeef]

I understand but I am challenging that. funding of the NHS is like the funding of everything else the government does, through its taxation process, there is no ring fencing, NI doesn’t fund what the NHS requires. The tax rate of individuals is a policy decision of government. The NHS cannot continue as it is given the ageing population so I suggest we change it - pay for useage unless you can’t. I think a really simple example is prescriptions which is the same.

I think this is crudely already handled through the varied taxation rates for high earners. Don't forget that the 40% and 45% tax brackets are aimed at ensuring those who can contribute more, do so.

 

[dingodan]

Its not the way things work in practice with segments of the market like health care. It has been proven time and time again that the market fails to provide choice for consumers. Mobile phones for example are produced globally so it is very difficult for a provider to have a monopoly. Health care services are provided within a local area like Brighton for example where there is unlikely to be more than a couple of hospitals simply due to the number of people/ customers. In a free market there would be nothing to prevent a provider from owning both of those hospitals and monopolising all of the health services in the area, and, if they didn't provide a decent standard of service what choice would the people of Brighton have? Other providers would find it very difficult to enter the market place in the short term because hospitals and health facilities take years to build and its almost impossible to get planning permission for anything in Brighton and Hove. Thats why we need to have a monopolies and mergers commission in this country to prevent this sort of thing from happening.

If there are two poorly run hospitals in B&H then a third and maybe a fourth would be built, because a new well run hospital is needed and will be successful. When it is successful the other two poorly run hospitals which nobody uses anymore go bust and become flats. Circle of life.

If our current hospital building record in this country seems slow and inflexible, I'd suggest that might be because they are publicly managed operations, business tends to be a lot more efficient and flexible than government.

Btw, according to the Argus there are 10 hospitals in Brighton & Hove.
http://www.theargus.co.uk/li/hospitals.in.Brighton and Hove/

 

[Sussex Nomad]

I was asking dingodan, as he had is own idea on how to improve things.

But you're not accepting the fact that it's still politicians that would have to decide how big the budget is, and what they expect to be provided for that budget.

We already have aspects of a free market as different providers bid for contracts with our current NHS.

That's incorrect, as there is competition already. Are healthcare costs in the US low?

You didn't answer my question. This was it:
"So when we need health care, can we only use the amount of money we personally have put it, or can we use the overall pot everyone paid into. If the first, then poor people die, if the latter, how much can we use?"

Technology etc would be the main factor - we can't really tell how well or badly its run in comparison, as the number of patients is so much higher.
I think it's pretty clear the opposite is true, that things get better over time, not worsse. You accept things are better than decades ago, so you accept that generally, year on year, things get better. Or would you like to try and say which years they got better and which they got worse? Looking at the general trend, I'd say that things will probably be better this year than last. Medical advances will pay a part in that, but those cost money.

Given the volume of patients, that must be a certainty, but not indicative of a failing system.
Not in my experience.
No, we're having it because the NHS isn't perfect - but then it's not possible to have a perfect health system.

You have this quote thing downpat... respect.

 

[Daddies_Sauce]

You obviously have an agenda of some sort,and with 557 posts in 10 years are probably a sock-puppet,but I will play your silly games.An NHS doctor does the major part of their working week paid for by the tax-payers,then probably earns extra in private healthcare.What do you think an NHS doctor is?If ,indeed,you think independently?

I fail see see what my post count has to do with anything, because I do not have '000's of posts of crap (not saying all yours are full of crap) then my knowledge can be dismissed. I also do not know what a "sock-puppet" is, probably some derogatory youth term, so thank you. So an "NHS doctor" is employed by the NHS where as a private doctor is self-employed or works as part of a health proving organisation (large or small)? And by "NHS Doctor" are you referencing a General Practitioner?

Please be civil, I have no agenda, just trying to understand what you think the difference is between NHS and Private.