[Misc] The NHS

[Hastings gull]

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.

Going by other posters on here over other threads, I thought PFI was enthusiastically encouraged by Tony Blair's government?

 

[Sussex Nomad]

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.

Some people can't be civil and the crunch or bite is all they need to try to knock someone off their perch.

 

[dingodan]

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.

Government dishing out contracts is not a free market.
The U.S. does not have a free market in healthcare, not at all. Medicare, medicaid. Inflation in medical care is huge. "Defensive medicine" and medical related lawsuits in the U.S. is a factor. Over testing also a big problem in the U.S.
I did answer your question, mutual insurance is basically what we have now, i.e. a big shared pot of funds, the difference was that when used the funds are directed by the patient.
"The NHS is improving over time" - seems to be your view, not sure how many would agree with that.
Generally you seem to think the NHS is doing Ok, fair enough, rose tinted spectacles though IMO.

 

[Daddies_Sauce]

Some people can't be civil and the crunch or bite is all they need to try to knock someone off their perch.

Too true.

I know a number of posters on here work within the NHS (secondary care) I have a number of years experience of working in General Practice (Primary care) until recent retirement so know how that side works.

 

[dazzer6666]

NHS technology?

My daughter told me last week that when a patient transfers from her hospital to Edinburgh (city, in a different ‘region’) they have to print out the records and fax them to the new hospital because the regions operate on different systems and they can’t communicate with each other. This is just one tiny example of crippling inefficiency and waste of resources.

 

[dingodan]

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.

 

[Brighton Mod]

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 ?

Agency costs, contractor costs, suppliers cost, its all the same. A fragmented NHS run by different trusts allows for multinational corporations to increase rates. As for agency nurses, they are much needed, patients do not present ten an hour every hour uniformly throughout the day, so thhe troughs have to be filled.

 

[Triggaaar]

Government dishing out contracts is not a free market.

I said "We already have aspects of a free market as different providers bid for contracts with our current NHS", which is correct.

I did answer your question, mutual insurance is basically what we have now, i.e. a big shared pot of funds, the difference was that when used the funds are directed by the patient.

You didn't, I asked "how much can we use?". So I get ill, how much money from the pot can I use to get the treatment I'd like? Who decides?

"The NHS is improving over time" - seems to be your view, not sure how many would agree with that.

You think it's better than it was 50 years ago, so I guess you agree.

 

[Triggaaar]

You have this quote thing downpat... respect.

Thanks, that means a lot to me

 

[dazzer6666]

Agency costs, contractor costs, suppliers cost, its all the same. A fragmented NHS run by different trusts allows for multinational corporations to increase rates. As for agency nurses, they are much needed, patients do not present ten an hour every hour uniformly throughout the day, so thhe troughs have to be filled.

Yup.......every layer adds huge cost.

 

[dingodan]

I said "We already have aspects of a free market as different providers bid for contracts with our current NHS", which is correct.

You didn't, I asked "how much can we use?". So I get ill, how much money from the pot can I use to get the treatment I'd like? Who decides?

You think it's better than it was 50 years ago, so I guess you agree.

A market is either free or it's not. You can't have "a touch of pregnancy" and you can't have a free market which is a "little bit free". It's not a free market, period.

I didn't say you could get the treatment you like, I said you could use the service provider of your choice.

I think your comparison with 50 years ago is deliberately obfuscating.

 

[portslade seagull]

Politicians don't run the NHS, they set the budgets, the NHS is run by trusts which have governance structures in place and management similar to the way companies run.

And that's where the money gets wasted. Top heavy management and not enough foot soldiers. No amount of money will correct this. Needs an independent think tank excluding all political parties to do a drains up

 

[Sussex Nomad]

A market is either free or it's not. You can't have "a touch of pregnancy" and you can't have a free market which is a "little bit free". It's not a free market, period.
.

Queen Mary did, just an aside.

 

[Hampster Gull]

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.

I am knowledgeable of the tiered tax system. My proposal is that I would remove free at use for the NHS, that would only apply to those who can’t. That in my opinion is what a State should do, protect the most vulnerable. Those who can pay then don’t have free access to the NHS can chose between a charged NHS service and a charged private service. There would need to be some taxation rebalancing as the NHS would less tax receipts and would rely more heavily on earned revenue.

 

[portslade seagull]

I am knowledgeable of the tiered tax system. My proposal is that I would remove free at use for the NHS, that would only apply to those who can’t. That in my opinion is what a State should do, protect the most vulnerable. Those who can pay then don’t have free access to the NHS can chose between a charged NHS service and a charged private service. There would need to be some taxation rebalancing as the NHS would less tax receipts and would rely more heavily on earned revenue.

Maybe more along the lines of the NHS Dentist. You still have to pay for that private or not. A nominal charge say £25 everytime you visit A&E. Might remove some of the time wasters

 

[Triggaaar]

A market is either free or it's not. You can't have "a touch of pregnancy" and you can't have a free market which is a "little bit free". It's not a free market, period.

That's nonsense. If you have competing private companies bidding for contracts then the prices will be competitive.

I didn't say you could get the treatment you like, I said you could use the service provider of your choice.

But who decides what treatment I'm getting? Can I have the new drugs that are best at treating my condition, or are they too expensive? One service provider might offer me radiotherapy for my prostate, another might offer me surgery, but the prices are different. How much can I spend when choosing treatment and provider?

I think your comparison with 50 years ago is deliberately obfuscating.

It's not, looking at a longer period of time makes it easier for everyone to see that things have improved. Do you think it improved until the 90s and has gone backwards since then? When do you think it stopped improving and started getting worse? It's easy to make inaccurate comparisons from one year to the next as it's difficult to prove wrong, which is why looking at a longer time period is helpful.

 

[Hampster Gull]

Maybe more along the lines of the NHS Dentist. You still have to pay for that private or not. A nominal charge say £25 everytime you visit A&E. Might remove some of the time wasters

Yes, perhaps something along those lines as another approach.

 

[Triggaaar]

And that's where the money gets wasted. Top heavy management and not enough foot soldiers. No amount of money will correct this. Needs an independent think tank excluding all political parties to do a drains up

Personally I think Labour and the Conservatives should join together to get such a think tank to help run the NHS. They should try and set parameters by which each government can try to tinker with the overall package when it's their turn, while the new think tank stays to keep the overall course steady and professional.

 

[vegster]

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

The government is and has been subsidising the rail companies since de-nationalisation... I thought that sort of thing was YOUR dream, privatise something and push the costs on to the company running it ? Seems a bit odd to sell it off then effectively " bribe " private companies to run things ? oh, but still make money for their shareholders !

 

[Technohead]

My girlfriend is an admin in the NHS, so I have a teeny bit of inside knowledge. I worked for the MoJ for four years so I know the machinations of the civil service. It is nothing about being a vital job and all about keeping employment figures up. This is why I am saying take it out of politicians hands, unemployment may go up, but the NHS at frontline would gain from it.

Working in the the NHS on the "frontline" as you call it I can assure you that it will not be better if put into private hands. We already have plenty of private sector involvement, the vast majority of which cherry pick the income generating services and leave the NHS to pick up the costly ones, such as A&E services, ITU, etc. Where you have private sector provision, other than supplementing extra capacity, inevitably it is brought back into NHS organisation over time because they just dont provide cost effective high quality care. A case in point is the Orthopaedic Treatment Centre at Haywards Heath which for 5 years was run by a private company, but when the contract came back up for tender was rapidly brought back in house.