to think that the NHS should NOT be privatised?

(90 Posts)
LeftWingTwat Tue 26-Feb-13 09:17:59

I am not arguing for no reform, all organisations can end up with waste/corruption etc. etc. However, reform doesn't NOT have to mean privatisation.

It is a myth the private sector is more efficient, what it is is more profitable, but profit has become the measure of success. Profit should not be the measure of success for healthcare. It should have no part of healthcare. When it does we can see the stark results in the US and it is US companies who are circling. US companies who have spent billions, billions of dollars lobbying their own government for the right to make enough off healthcare to not only have enough for themselves but have billions surplus to lobby with. While people die.

Privatisation of healthcare is based on the myth that people's healthcare experience won't change too much, that you will still be able to afford what you have now. This will not happen.

The government promised to protect the NHS. The government, elected without majority, is deliberately taking it apart piece by piece without mandate from the people, this is not democracy. The government is taking it apart without consulting the people. Governments are supposed to be the servants of the people, our representatives, rather than our masters, cutting up and parceling out what we pay for in taxes for their own profits and for the profits of companies beyond our democratic reach. Companies that will not just suck out money from the system but from our country in tax loopholes and tax havens.

This affects us all.

Callisto Tue 26-Feb-13 09:33:45

The NHS is broken and has been for some time. For some reason it is impossible to have a sensible discussion about how appalling it is and how appallingly it treats its most vulnerable patients without it descending into a bun fight about how wonderful it is and how anyone who says different is obviously a bastard right-winger who care nothing for the vulnerable (much like discussions on immigration, islamism etc).

I don't know how one would ever go about fixing this obselete money-vampire, but dismantling and putting back together in a more sensible way seems a good start.

Catchingmockingbirds Tue 26-Feb-13 09:35:42

Yanbu.

Lovelygoldboots Tue 26-Feb-13 09:47:34

I was referred to Assura last year via my gp for a skin condition. Saw the dermatologist who told me I had skin cancer and needed a biopsy for confirmation. Left appointment very distressed. Four months later and numerous phone calls Assura still would not give me a date for a biopsy. I contacted my gp and asked him to refer me to the hospital. Six weeks later I had an appointment and biopsy. A further six weeks later had surgery. My feeling is privatized elements of NHS are happy to take gp referrals but not so keen to actually treat you. My initial appointment with Assura would have cost my gp practice but was a waste of time.

LurkingBeagle Tue 26-Feb-13 09:50:35

YABU.
Forget the US. Ask the French or the Swiss or the Germans if they want our system. (They won't bite your hand off).
The NHS is what passes for religion in the UK, as Callisto says.

LeftWingTwat Tue 26-Feb-13 09:52:51

The US is important because it is US companies who are taking pieces of it. That is where the government is looking.

Looking at Switzerland is more of a smokescreen because of how the country makes its money.

LeftWingTwat Tue 26-Feb-13 09:53:38

I have NOT argued against reform.

I have argued AGAINST privatisation.

Conflating the two serves no purpose.

Lovelygoldboots Tue 26-Feb-13 09:57:04

But what would be better? Bolting privatized elements on is not working either. Leftwing is right about the proposal to exempt health care companies from capital gains tax. That is only on the table due to lobbying from these companies.

LurkingBeagle Tue 26-Feb-13 10:12:34

I am not in favour of a US system (although sadly, that is what the present government seems to want). However, the arguments against reform along the lines of a European social-insurance style model are unconvincing. The left tends to generate fear by convincing people that no NHS inherently means poor people will get no treatment. This is mendacious nonsense.

LeftWingTwat Tue 26-Feb-13 10:15:04

btw what does The NHS is what passes for religion in the UK even mean?!?

Is religion "bad"? Is it a "bad" thing to believe healthcare should be universal and free at the point of delivery?

LeftWingTwat Tue 26-Feb-13 10:18:28

* The left tends to generate fear by convincing people that no NHS inherently means poor people will get no treatment. This is mendacious nonsense.*

No it means they will get a LOWER LEVEL of treatment, based on ability to pay.

But then I believe in spreading wealth, wealth EARNED off the backs of low paid workers.

LurkingBeagle Tue 26-Feb-13 10:20:35

Obviously it means it is revered, it attracts zealots and any criticism of it treated with the reaction a spot of blasphemy would have attracted in circa 1400 hmm As your post amply demonstrates.

And all this despite the fact that it's currently killing rather a lot of people.

LurkingBeagle Tue 26-Feb-13 10:21:40

All you are demonstrating is that you know very little about the alternatives. Or are being mendacious. <shrugs>

projectbabyweight Tue 26-Feb-13 10:26:04

YANBU

Lovelygoldboots Tue 26-Feb-13 10:26:24

The only way a private health care system could work is if everyone has insurance. The proposals to make health care companies exempt from corporation tax are supposed to put private health care providers on an equal footing with the NHS. I wonder how many members of the house of Lords have shares in these companies?

meddie Tue 26-Feb-13 10:27:56

My fear with the intrusion of private businesses into the NHS is that they will cherry pick the easy single health care problems. Like varicose vein repair, cataracts etc.
If you have multiple or chronic health issues, or are elderly they wont be so interested, as these are not profitable. Care for those with multiple health issues will be disjointed and patchy or left to whats left of a severely run down and underfunded NHS.
Profit has no place in care, it becomes the over arching reason for how a company functions, when the primary reason should be care for those who are sick and vulnerable.

LeftWingTwat Tue 26-Feb-13 10:32:40

Obviously it means it is revered, it attracts zealots and any criticism of it treated with the reaction a spot of blasphemy would have attracted in circa 1400 As your post amply demonstrates.

shock shock shock

You mean people are being tortured and put to death?!?!

hmm

Osmiornica Tue 26-Feb-13 10:35:01

If you disagree with the privatisation of the NHS then please please do something rather than sticking your heads in the sand .. 38 degrees have a petition here petition or you could write to your MP.

LeftWingTwat Tue 26-Feb-13 10:35:05

meddie

Exactly. Cherry picking is exactly what they'll do on the current road.

They are not looking to Europe.

And completely agree that profit has no place in care. I think the care homes scandal as amply demonstrated that.

LeftWingTwat Tue 26-Feb-13 10:35:45

BTW I've signed the petitions. I just wasn't sure whether MN would delete the thread if I started off with one.

Osmiornica Tue 26-Feb-13 10:38:51

I guessed you probably would have .. it was more of a general note to anyone else reading this smile

LurkingBeagle Tue 26-Feb-13 10:39:25

LWT - all you are proving is why it's impossible to have a grown-up debate about healthcare provision in this country. Shouldn't you be at school or revising for GCSE politics? hmm

You like the NHS - great - happy for you. YOU pay for it. I would rather give my money to BUPA and know that I am going to get a private room without MRSA and access to cancer drugs that are available to other Europeans who don't have the NHS system.

Not because I am pro-a US system, but simply because this should not be too much to ask in a civilised country in 2013.

MoreBeta Tue 26-Feb-13 10:39:39

The thing that always strikes me about the whole 'privatising the NHS' debate is that no one ever mentions that all GP surgeries and all hospital consultants are already in the private sector and always have been from the very start of the NHS. The private sector has always been contracted in by the NHS.

This is a famous and well known quote from Aneurin Bevan about his difficulties in overcoming opposition from doctors to the NHS.

"On the "appointed day", 5 July 1948, having overcome political opposition from both the Conservative Party and from within his own party, and after a dramatic showdown with the British Medical Association, which had threatened to derail the National Health Service scheme before it had even begun, as medical practitioners continued to withhold their support just months before the launch of the service, Bevan's National Health Service Act of 1946 came into force. After 18 months of ongoing dispute between the Ministry of Health and the BMA, Bevan finally managed to win over the support of the vast majority of the medical profession by offering a couple of minor concessions, but without compromising on the fundamental principles of his NHS proposals. Bevan later gave the famous quote that, in order to broker the deal, he had "stuffed their mouths with gold". Some 2,688 voluntary and municipal hospitals in England and Wales were nationalised and came under Bevan's supervisory control as Health Minister.

The private sector has always had a huge sway in the NHS and it has always been about the profit motive. Gordon Brown even launched PFI into hospitals which in many ways reversed the principle of 'nationalisation' of hospitals that Bevan implemented.

LeftWingTwat Tue 26-Feb-13 10:42:54

LurkingBeagle

What?! You are the one comparing a discussion to 15th century deaths!!

Private hospitals don't protect against MRSA, it began in the US, it's rife over there. The reason we know that it's in the NHS so much is because it's public, whereas it's too easily covered up in private organisations.

LeftWingTwat Tue 26-Feb-13 10:46:18

Oh I'm not letting New Labour off the hook for beginning this thing when they could have gone on a different course. Pissed me off at the time, pisses me off now.

But this is just taking off all the brakes.

LurkingBeagle Tue 26-Feb-13 10:48:17

Please try to keep up. You mentioned deaths, I said that criticising the NHS was treated in a similar way to blasphemy.

I live in a country with no MRSA problem in either its public or private hospitals. The healthcare staff here are appalled that we still have Crimean-style wards and shared bathrooms. They think that's revolting and backward (which it is). Of course, no one will ever admit that's an infection control issue. I have no idea whether it explains the whole MRSA issue.

The NHS should not be revered. There are 1200 deaths (at least) for which it would be responsible. Imagine the uproar if that was Nestle or ICI?

StormyBrid Tue 26-Feb-13 10:52:34

The NHS is broken and has been for some time.

This statement is made an awful lot. What is the evidence for it, please? Honest question, not trying to start a fight.

meddie Tue 26-Feb-13 10:52:34

MRSA does appear in private hospitals. I have personal experience of this from a friend who contracted it after her boob job.
The thing is in the NHS a lot of patients are routinely swabbed for it on admission or soon after and regularly throughout and the figures are published, not so in private hospitals.

My friends private surgeon, refused to treat her festering breast, but eventually offered to remove the implant to allow the infection to clear (at a cost) and to re implant at a later date (again at a cost).
She was eventually treated by the NHS at NO cost, as the private hospital basically wiped their hands of her.
She is having a hard time getting any information for the legal case she is trying to take out against the private provider who have left her badly scarred. they are not interested at all.

sleepyhead Tue 26-Feb-13 10:52:39

We could have a system like France or Germany if we wanted, but we'd have to pay a lot more for it. Is that ok everyone?

UK spends 7.5% of GDP on healthcare
France spends 9.4%
Germany spends 10.8%

US spends 13.9%

LeftWingTwat Tue 26-Feb-13 10:53:58

Please try to keep up.

I'm starting to enjoy your little put downs! Do you know you're doing it?!

It's not treated in the similar way to blasphemy! If only people in history were merely talked at a little forcefully if they blasphemed!! That was my point.

But Nestle does cause deaths, but apparently third world babies are too niche an issue...

As I've stated, there IS a place for reform. I do not think that reform should be mass privatisation.

Anti-privatisation DOES NOT equal anti-reform!

sleepyhead Tue 26-Feb-13 10:54:12

(Switzerland spends 10.9%)

LurkingBeagle Tue 26-Feb-13 10:56:04

Sleepy - if it were all about GDP we would have seen a huge improvement when the % increased to 7.5% from its previous, abysmally low level. <waits for someone to blame Thatcher> Instead, we saw healthcare staff get exponential pay rises.

Meddie - that's all anecdotal. FWIW when I lived in the UK, I was only ever swabbed for MRSA while being admitted to my local BMI hospital. Incidentally, it also had A&E and intensive care.

LurkingBeagle Tue 26-Feb-13 10:58:42

Of course I know I am doing it. You are also proving my point about the number of capital letters and exclamation marks used in a sentence being indirectly proportional to the writer's IQ.

Are you familiar with the expression about the person who is not a socialist at 18 having no heart? I hope you are under 30. wink

LurkingBeagle Tue 26-Feb-13 11:00:30

I would start reform with staff pay and (more importantly) pensions. Then I would sack the Chief Exec. People involved in what is basically torture at Stafford should be punished pour encourager les autres.

BridgetBidet Tue 26-Feb-13 11:04:45

Too late, it already is. Many providers are private companies now. Most GPs are, care services and private providers are moving in to all areas of the NHS. They still operate under the NHS umbrella but they are most definitely private.

Support services such as auxillary nursing, porters, laundry, food, cleaners etc have already been privatised in the majority of places and the rest will follow.

Very sad. Look at where privatising the utilities and trains has got us.

sleepyhead Tue 26-Feb-13 11:04:46

Fine, LurkingBeagle, but my experience of people in the UK is they want great services for fuck all.

I know a lot of people living in Europe under various state/private healthcare systems. They never wax as lyrical about them as British people do (moan about the bills a lot though, or the amount of slack families are expected to take up in the care of relatives in hospital). Maybe familiarity breeds contempt wherever you are.

LeftWingTwat Tue 26-Feb-13 11:06:16

LurkingBeagle

I know you know you're doing it, I was highlighting your mode of argument which includes subtly belittling people as a form of undermining them.

Sorry to disappoint in all your assumptions about me, I see message boards as an extension of spoken language not a modified form of essay, and so I type here more closely to how I speak! With a bit of bloody passion!!

LeftWingTwat Tue 26-Feb-13 11:08:34

my experience of people in the UK is they want great services for fuck all.

Mass unfounded generalisation!

LeftWingTwat Tue 26-Feb-13 11:09:09

Oh fuck, I'm getting sucked in to the pointlessness! So easy to do apparently!

LurkingBeagle Tue 26-Feb-13 11:09:38

I have never waxed lyrical about the NHS (other than to complain about appalling care).

The fear of NHS treatment is one of the main reasons why I no longer live in the UK (although I appreciate my experiences were extreme). Here, my employer pays my insurance (so it costs me nothing) and the hospitals are sparkling. It's all private.

Even 7.5% of GDP is too much for an organisation that has killed 1,200 in the worst circumstances imaginable. It's terrifying how the left-wing media just wants to sweep that under the carpet.

LurkingBeagle Tue 26-Feb-13 11:10:40

LWT - If I was subtle, I apologise. I certainly didn't meant to do that.

Yadnbu. The NHS stands for National Health System & was created to benefit all.
If this government comes in & throws it all away, there will be many of us that won't be able to afford treatment or contraception.
Can you imagine the impact on the country if this is taking place?-It will be catastrohic, and clearly wrong on all levels.

Cancer treatment, diabetes, thiroid treatment, aids/hivtreatment, birth care, postnatal/prenatal care, dementia....the list goes on-Only the heavily rich will be afforded treatment.

I hope to never see the day this happens in mine or my childrens life.

It may not be perfect, but it's there and for some life-saving as well as life-improving.
Remember we as people don't see all sides of the NHS, we only hear of the bad on the News & in the tabloids.
It doesn't mean there isn't any excellent work being done, they just don't report it.
Having seen all the help my late brother got for his cancer & the treatment he was given, i can truly say there is very good being done by the NHS, yes some bad points in one hospital but without the NHS he wouldn't even have lived for the short space of time he did without the treatment he recieved. And yes i am thankful to the NHS for giving me extra time with my little brother.

JustGiveMeFiveMinutes Tue 26-Feb-13 11:22:47

In my experience (as somebody with a DH who has complex medical needs) I believe parts of the NHS are broken. We've been forced to revert to private services which we don't want to do and which costs a fortune. If we didn't do this DH would be unable to walk. He'd have no quality of life and wouldn't be able to walk. His needs are concerned with one of the 'Cinderella' aspects of the NHS. Not glamorous, underfunded, undervalued.

If anybody believes we are immoral for using private healthcare, pm me. I'd be happy to explain in less vague terms (don't want to be outed) why that's an unfair accusation.

EuroShaggleton Tue 26-Feb-13 11:32:54

The NHS is not a good system. I would be surprised if anyone who has lived in Europe and experience the healthcare systems in most European countries would come back and think the NHS is great.

The US system is a terrible system, and I would not like to see it adopted here. However, I would like to see the best elements of the systems that operate in other European countries introduced here. I've experience two European systems when living overseas and they were both far superior to the NHS. It annoys me that whenever this debate comes up, the line about not wanting the US system here is always dragged up, when in fact just about every other developed country has a non-NHS system that is superior to the US one. We should be looking to those.

meddie Tue 26-Feb-13 12:38:45

Under private systems what would happen with people who had severe and lifelong complex needs? I,m thinking particularly of children born with either a congenital problem or for example extremely premature infants left with cerebral palsy/epilepsy/severe developmental delay?

Their care and treatment costs must run into millions if you include benefits, house adaptions, mobility allowances,physio input, respite care, hospital admissions, special educational needs, long term tube feeding,incontinence products, wheelchair adaptions as they grow, sleep aids. long term drugs.home care packages if required.

Would they just get the basics, like drugs and hospital admissions and a very basic wheelchair. How willing would private companies or insurance policies be to take on the complex needs of these children.

crashdoll Tue 26-Feb-13 12:46:36

I don't think anecdotes about good and bad care are really that helpful when looking at the system as a whole. I've had good and bad both privately and on the NHS - there are flaws in both systems as well as huge advantages.

Exactly my point meddie, not everyone will have to funds to support their needs.
The NHS should stay free imo, that's what taxes are for.
This government should keep their filthy rich hands off our NHS, because not everyone has a golden goose to afford being alive.

Lets hope we never go back to the days of before the nhs, workhouses etc.

elastamum Tue 26-Feb-13 12:49:47

The NHS desperately need reforming. No where else could you have a scandal thet kills 1200 people through neglect (thats 300 jumbo jets full BTW) and NOBODY is prosecuted. There are 5 other trusts being investigated and a further 15 that should be. But becuase its the NHS, there is silence from the politicians on this. Can you imagine what would happen if a private compnay did this.

My own personal experiences of the NHS in recent years have been similarly depressing. My mum died of advanced cancer after having been seen by several doctors and discharged from hospital because 'there was nothing wrong with her. ' WE found the tumour in her jaw, by looking in her mouth. We took her false teeth out - not exactly radical.

My DS has been seen 6 times by various different HCP's recently. Thats 6 assessments over a 3 month period and no one is yet treating him. He is now being treated privately, because it is the only way we can stop him being bounced from doctor to doctor, with each person just wanting to get him off their list. He is being treated because we have the knowledge and resources to get round the system. The old, the weak and the vulnerable are being failed on a daily basis.

The money wasted on non core services (such as trust marketing WTF!) is shocking. No private company would survive on that basis. And its not free BTW - we pay for it by taxes.

I'm not sure privitisation is the answer. But until the government accepts that the NHS system is broken - it wont get fixed

I'm not saying, it doesn't need reforming. It indeed does, but in no way, shape or form should it ever be privatised.

iliketea Tue 26-Feb-13 13:01:28

The problem with privatisation us that healthcare then becomes profit-driven. It doesn't make things better (look at social care provision as example). And has been said before, there is it profitable treat healthy(ish) individuals who need one.intervention every so often, but what about those with the most complex needs? I am worried how thr most vunerable people in society will be affected - and in changes with any health / social care provision it is the most vunerable who are.affected most severely. I think reform is necessary, although reforms must be given time to be effective. For many years, the NHS has undergone constant reform, and it seems that none are ever implemented long enough to show full effect.

JustGiveMeFiveMinutes Tue 26-Feb-13 13:06:29

Why are people's anecdotes not helpful? Collectively they are the entire experience people have at the hands of the NHS.

meddie DH has a long term congenital condition. In our experience getting the help he needs (some of which you've listed) has been difficult bordering on diabolical.

meddie Tue 26-Feb-13 13:15:02

I,m sorry to hear that justgiveme I work with kids who suffer life long and terminal conditions and I worry that privatisation will make it even more difficult for them to get the services they need to survive. my concern is that to private health care providers they would be seen as a bad risk and therefore not worth insuring.

LurkingBeagle Tue 26-Feb-13 13:16:28

The care system has been privatised from the supplier end, e.g. council puts services out to tender, private companies bid, council select lowest bidder. Obviously, the resulting care is crap.

The point everyone misses in this debate is that the privatisation should benefit the patient, not the provider, i.e. patient requires care, has insurance (either self-funded or if low income, part funded by the state), selects provider of her choice that must compete for her custom in order to survive. This drives standards up. To put in another way, the state provides funding, but it does not supply healthcare. Consequently, there is no monopoly.

It's frightening how little many people know about other countries' health provision. It's rather parochical to assume that French people on low incomes (France has a private system) get no access to doctors or contraception.I can only assume that lots of people on this thread read Pravda (or whatever passes for commie propoganda these days).

meddie Tue 26-Feb-13 13:16:50

I think ultimately for me. the thought of someone, somewhere making a profit on the back of another human being for having the misfortune to suffer an illness just doesn't sit right with me.

photographerlady Tue 26-Feb-13 13:18:38

I grew up in the States where health care is privatized. You get sick and uninsured than you live with incredible debts or just not get treatment. It's sickening to talk to ppl in the states who are pregnant and can't afford to go in for a checkup when they have bleeding/a problem.

meddie Tue 26-Feb-13 13:20:38

the problem with privitisation in healthcare is the lack of competition to drive up care, except if its for some common procedure that is easily fixed ie boob jobs, varicose vein removal etc, where you have the luxury to shop around.
unfortunately for most people they have no say in when their health care issue pops up and you have no time to shop around or look for the best, you are limited to using your local facilities.

WhoPaintedTheLion Tue 26-Feb-13 13:26:21

I agree fully with Callisto on page one of this discussion.

Although it is frightening that the government are looking to the US of all places. I like the I US but their health system leaves a lot to be desired.

RedToothBrush Tue 26-Feb-13 13:33:32

Instead of going public service = good private service = bad

Why aren't we looking at the best and worst aspects of both?! Why so blinkered? Why do we assume private = USA model?

Sorry, but I do think blanket thoughts like that are necessarily to our benefit.

As long as the fundamental principles of universal, free at point of service are maintained and the interests of patients are not compromised I do think this can be achieved with proper safeguarding in place.

Or are we saying that we should renationalise GP surgeries etc?

Callisto Tue 26-Feb-13 13:34:37

I stated that the NHS is broken.
Cancer survival rates in the UK are woeful.
The treatment of patients, especially the most vulnerable, is beyond appalling and this seems to be endemic throughout the NHS.
The NHS employs foreign workers who can't even speak English.

There are loads more but I don't have time to put them all down atm.

sleepyhead Tue 26-Feb-13 13:44:49

Free at the point of service is the rub, RedToothBrush. Most systems based on insurance, state funded or otherwise, have co-pays which may or may not be reimbursed at a later date - usually dependent on what level of insurance you have, or what your income is.

Most systems based on state funded insurance systems also have a high take up of "top-up" private health insurance (see France as an example) which in effect means 2 tiers of care. Fine if the lower tier is adequate, but people shouldn't kid themselves that it means that everyone gets the lovely room or the latest drug/therapy.

I am not saying the NHS is wonderful, but it would be good to see some debate on the strengths and weaknesses (for eg barriers to seeking healthcare in a timely manner than can arise from needing to pay upfront - see threads passim where Irish mnetters have debated whether they can afford to visit the GP) of other systems and not just NHS=crap, any change must be better.

RedToothBrush Tue 26-Feb-13 13:51:29

You make it sound like we DON'T have two tiers of health care in this country. The truth is, that actually we do. With all this rationing bollocks going on, what effectively is happening, is that people who know and understand alternatives and are prepared to be forceful are more likely to get different (and better care) than people who don't. Unfortunately this means that certain groups - less educated, more vulnerable, less well and with little family support get a raw deal anyway under the NHS.

Not to mention postcode lotteries over access to certain types of care and procedes because NICE is only a figure head for best practice and not enforceable leading to the fact that some people being able to get certain things that someone who lives a mile away is not allowed to have.

There isn't universal care in UK. We believe in this myth that we do, but the reality is very different. Its what we should be aiming for; whether it be through public service or making private services a greater part of the system.

sleepyhead Tue 26-Feb-13 13:57:51

A very small percentage of British people have private health care (I think it's something in the region of 10%).

Over 90% of French people pay for private health insurance on top of state health insurance.

As far as being able to shout/negotiate/research your way to better care in labyrinthine systems go, please do show me the system in the world today where that isn't the case. Insurance companies of any stripe are not known for their transparent practices. Knowing when you can work your way round "computer says no" is a valuable health care tool in many systems.

Postcode lotteries re: differences in available services/treatments depending on where you live are common gripes in other countries. Again, France springs to mind.

But, this is all secondhand knowledge - I'd love people in other countries who live with other systems let us know what's good/bad/irritating/fabulous about their system.

JustGiveMeFiveMinutes Tue 26-Feb-13 13:59:48

All the failing NHS Trusts are in areas of acute deprivation. That really pisses me off.

LurkingBeagle Tue 26-Feb-13 14:54:28

Sleepyhead - the percentage of Brits with private healthcare is increasing exponentially though. Personally, I don't have a problem with co-payment. I prefer that to the current system, where you basically don't know what the NHS will provide in advance. Nobody would buy insurance on that basis.

I don't get the argument that universal healthcare should be free at the point of delivery when (say) food isn't.

maisiejoe123 Tue 26-Feb-13 15:00:36

I agree with the posters who are saying - have a look at both systems, look at other countries where state care is working well. The NHS is broken. The Staff scandal is shocking - 1200 people in one health trust!

I beleive that more and more people are expecting the NHS to cover things that IMHO should never be covered, gastric bands, IVF up to 42 (which has a fail rate of 90%). Allowing people from other EU countries to visit/live and use the facilities having not paid a single penny in.

I am going to admit I do have private medical insurance, I had one child under the NHS and one privately so can compare the two. People who smugly say they will have their baby in an NHS hospital privately 'in case something goes wrong'. Really, do you think doctors are going to be there waiting for you to have an emergency god forbid.

Last year I had the misfortune to visit A&E. The drunks, the language and the sense of entitlement from some people made me think - thank God I dont come here often

Ploom Tue 26-Feb-13 15:18:44

I'm now in one of those European countries with a better healthcare system after years of working in the NHS.

I've got a foot problem - I've been to my GP who tried to treat it with ultrasound which didnt work. He then gave me a referral to an orthopaedic doctor & its up to me to decide which one I go to. There is a website here where people can rate doctors so I chose one with a good rating - I phoned this morning & I've got an appointment tomorrow morning. Thats the good side of the system - it is free at the point of contact now (previously had to pay 10€ per quarter) but we obviously pay more from dh's salary than we paid in National Insurance in the UK.

The bad side is that doctor tomorrow will do every test under the sun whether its indicated or not because he can then charge the insurance company for it. Patients in Intensive Care are sometimes kept ventilated longer as the hospital can then charge a higher rate. Its so corrupt that corrupt has now become normal. And this all leads to higher costs for health insurance.

Part of the problem in the NHS is the shear bureucracy involved - a foot problem like mine would involve a letter going to a secretary, then to appointments, then to medical records all of which takes time & costs money. Patients are quite capable in organising appointments themselves if they are allowed but god forbid that would happen in the NHS - that would put half the admin staff out of a job.

I think there are good aspects of the NHS that could be combined with the good parts of private health insurance but this requires a massive shift in attitudes that I dont think people are ready for.

maisiejoe123 Tue 26-Feb-13 15:50:23

And looking at all those people kicking off in A&E last year they are likely to have paid little into the system. They dont have to pay for it, others will do that, they then spoil it for others who are trying to queue and having screens up to protect the receptionists from attack - how vile.

I do think we need to go back to basics and not have people assuming that the good old NHS will fund it.

SnoogyWoo Tue 26-Feb-13 17:09:54

Something will happen. The UK government is £1 Trillion in debt and adding to that by about £100 Billion a year to pay for the current services.

Scary stuff.

Yup, scary stuffsad

iliketea Tue 26-Feb-13 18:47:00

ploom in the system you describe (which sounds like a good one btw) - what happens to people who don't have the mental capacity to make a decision / ability to make the appointments etc, if they don't have someone to do it for them. Who makes the decision about where they go etc? And are there professionals who specialise in complex needs (like geriatricians who can visit at home etc). Is there always a choice, or are there some cases where there is only one specialist to see if you are unable to travel long distances? Who provides transport for those unable to get to an appointment themselves?

orangeone Tue 26-Feb-13 20:07:17

I work in the NHS.

I believe in the NHS and I work very hard along with many of my colleagues.

Moreover I am saddened when people make sweeping criticisms of a massive system based on some areas that need careful rethinking and improvement.

I can promise you all that despite the problems of the NHS, the alternative is worse. Maybe not if you are rich but definetly for the average person on the street.

However, I fear that like most things people won't realise what they had until it is gone.

So true the alternative would be very dire for those that cannot afford private care/insurance. I for one believe the NHS was made to benefit us all rich or poor, to change it would be to demonise the poor & working class.

Ploom Wed 27-Feb-13 05:53:18

iliketea - I have no idea what happens to elderly people or people who struggle to organise their own care - I asked dh but he also didnt know. The GP is quite able to do a lot of care so maybe its him/her who organises the care.
Because of the competitive nature of medicine here there is always a choice of doctors to go to - we live very rurally but between 2 small towns & I probably had a choice of 10 orthopaedic doctors to go to.
I'm going to ask round about eldery care - someone must know.

Sirzy Wed 27-Feb-13 07:30:35

Part of the problem is things are so variable and that's what needs looking it. Some areas are doing it fantastically so why aren't others?

DS was in hdu at 8 weeks old, his care was outstanding, he was due to see a consultant for an unrelated issue so instead of rearranging the appointment the consultant came to us at the end of her clinic.

When he was reffered to a pediatric respiritory specialist he came to see us while we were still on the ward to get wheels in motion.

Its that sort of care that should be available everywhere. I'm not convinced that privatisation is the way to go, I do think top down reform is needed though

KeatsiePie Wed 27-Feb-13 07:38:24

US spends 13.9%

Good grief! What the FUCK are we spending it on?! [goes to look up]

I don't know what's involved in reform, but cannot imagine that reform is not a better option than privatization.

lhoom Patients are quite capable of organising appointments for themselves

As an NHS worker I have to disagree with this.

In our dept we recieve a GP referral.
Patients are not autonmatically sent an appointment by post as this lead to a very high non-attendance rate. (Either people not getting the letter/saying they didn't get the letter/ not wanting the appointment anyway but not bothering to cancel)

So they are sent an information letter, a "Please contact us by phone to arrange the appointment" letter and a CarePlan Form (their details) to fill in at home and bring in.

They phone and are booked a 40 minute appointment. The Call Centre double check with them that they know where they are going, date/time and bring the CarePlan Form.

So- why do so many turn up at the wrong place? Many times at the Main OfficeClinic because that's what on the letterhead?
So that's a wasted 40 minutes of NHS time (they have a longer appointment for new patients)
And the careplan? "Oh I didn't get one"
In the letter/
Oh, I didn't see that, it's not filled in confused

I don't assume that everyone is the same, but don't assume that everyone can do their own appointments.

Theshriekingharpy Wed 27-Feb-13 09:19:04

Message withdrawn at poster's request.

Theshriekingharpy Wed 27-Feb-13 09:22:06

Message withdrawn at poster's request.

shriekingharpy - confused

do you think the NHS should provide gastric band surgery?

On one side, consider the benefits- prevention of diabetes, joint problems, heart problems ... the list goes on.
But it's not just the operation there's the skin reduction after.

And what about the patients' responsibility?
This doesn't happen overnight.
And if someone has such poor health and mobility that they become obese then chances are surgery would be too much of a risk.

What I wouldn't provide on the NHS would include
tattoo removal - you have them done, you pay to have them removed
vasectomy reversal- again you choose to have it done (and go through the counselling before) you pay to reverse it
cosmetic surgery like varicose veins
and if someone goes off to a private clinic or abroad to have cosmetic surgery (often against medical advice) then why should the NHS pay to mop up . And alot of NHS cosmetic surgeons say the majority of their case load is repairing someones elses mistakes hmm

meddie Wed 27-Feb-13 12:47:37

I,m actually on the fence regarding band surgery.
It seems wrong to offer something for a problem that on the whole is reversible with diet and exercise, BUT if someone is so big or had repeatedly failed at dieting they will cost the NHS more in chronic medical problems due to their obesity than the surgery would cost in the first place.
I dont think they should do skin removal though, unless it was impacting their mobility.

maybe we should look at charging for missed appointments. Dentists do this currently and no one is up in arms about it.
Did not attends cost the NHS a lot of money and also waste appointments that could be used by others. thus reducing waiting times.
I do feel that people take the NHS for granted. GP appointments for a cold or flu are pointless and I think if we had to co pay something towards it, it would reduce these.

Theshriekingharpy Wed 27-Feb-13 12:58:56

Message withdrawn at poster's request.

sashh Wed 27-Feb-13 13:14:01

* The healthcare staff here are appalled that we still have Crimean-style wards and shared bathrooms. They think that's revolting and backward (which it is).*

Very few hospitals have Nightingale wards any more.

I've been in and out of hospitals the last couple of years. I've also worked in them, NHS and private.

I do not want to be in a private room, I want to be in the sight of nursing and other staff.

There is a reason ICU, HDU, CCU and PICU don't have individual rooms, even in hospitals where all other rooms are single or double.

People who smugly say they will have their baby in an NHS hospital privately 'in case something goes wrong'. Really, do you think doctors are going to be there waiting for you to have an emergency god forbid.

Yes actually they are. Well someone is. They are not sitting twiddling their thumbs, they are working but they are on site.

On the other hand private hospitals don't have to have any medically trained staff on the premiss at all times. Most (probably all) do. Many have contracts with NHS hospitals to provide doctors to cover. If the hospital has maternity services they will usually have a obsgyn registrar.

Fine if you go into labour. Not so fine if you have a massive heart attack in the middle of the night.

The NHS has it faults. It has a lot of faults that have simple remedies. It is not prefect.

Private hospitals are better on the admin side. There is also less waste, as something like a medical implant dropped on the floor is billed to the patient/insurance company.

The private sector also does little if any training. One thing I would do with the NHS is that staff who have their training paid for by the NHS such as nurses should have to work a number of years for the NHS before going abroad or working in the private sector. That if you do leave then you should have to pay back some of your training.

I also think they should do more to retain their staff. I became too disabled to do my job for the NHS, so went to a private hospital. I wasn't given any options of retraining or redeployment.

RedToothBrush Wed 27-Feb-13 13:37:33

sashh - How many private maternity hospitals are there in the UK?

I'll give you a big clue - its ONE. There are a couple of private MLU units but how that ends up being different to an NHS standalone MLU where you would also get transfered to another NHS hospital, I'm a bit clueless about. Perhaps you might care to enlighten.

Maternity is not something that other private hospitals cover. You will either be treated as a private patient in an NHS hospital, a private patient on a private ward in an NHS hospital or will go completely private.

So quite where you are plucking your comments about staffing on private maternity from, I'm not entirely sure. The one private maternity there is, does have 24 hr staff on hand at all times.

Might I politely suggest your comments about private maternity are comments that are coming straight from out of your backside.

RedToothBrush Wed 27-Feb-13 13:40:04

*or will go completely private at the sole maternity hospital in the UK.

maisiejoe123 Wed 27-Feb-13 14:48:11

Sashh - I beg to differ. The NHS cannot cope with the number of patients they have, I am not suggesting that they are sitting the staff are sitting there doing nothing, I am suggesting that they are dealing with other patients hence the reason they might not be there for you!

And having had two children - one at a large teaching hospital and one at the Portland - there was a reason I went private the second time. The NHS was complete rubbish! There werent enough staff, I was left alone for hours at a time, my DH had to literally haul someone in when the buzzer was left unanswered because there was an emergency and my DS was in distress etc etc. Despite the buzzer going off he found a couple of nurses laughing and joking around the nurses station.

And when I went up to the private room I had booked on a quiet floor of the hospital and asked a visitor at the end of the day to take my DS to the nursery he said there was no one about and he could have literally wheeled my son out without being stopped.

And if the remedies are so simple why havent they been implemented already.

RedToothBrush Wed 27-Feb-13 15:09:40

I forget to mention, that the problem I have with the idea that the NHS "can not afford X,Y and you should go private" is its not coupled with the ability to actually allow you to do that. Its particular true when it comes to maternity services for the above mentioned reasoning.

If for example you WANTED to go totally private, the rules allowing the cost, planning, building and running of private maternity facilities are so difficult in the UK that no one has done it outside London. And the rules of the NHS don't allow you currently 'top up' your care from within the NHS either.

So if you were outside London and WANTED to make a choice to have access to services the NHS doesn't provide as standard (such as an ELCS) then you actually have no ability to do so.

Rationing healthcare is one thing, but if its rationed you also need the ability and means to provide these by alternative means - especially if they are sanctioned by NICE as actually being best practice. They have to be supported by the people who are advocating rationing; who invariably tend to be those most strongly opposed to the idea of private health care or a two tier service.

So either you get the NHS to stop rationing certain services somehow OR you allow private services to become the norm and to set up in business so people have the opportunity to get best practice at a price. Otherwise everyone in this country gets substandard care, and healthcare in the UK ceases to be 'world class'

There isn't a third way to ensure we keep up with healthcare standards available in the rest of the world.

MrsMorton Wed 27-Feb-13 19:57:41

meddie NHS dentists aren't allowed to charge for missed appointments any more. I would explain what the new contract will entail but I was flamed last time for suggesting that dental problems are on the whole preventable.

meddie Wed 27-Feb-13 20:46:20

My son has always been charged if he missed an appointment MrsMorton. When did it change?

MrsMorton Wed 27-Feb-13 20:51:36

2006... shock Are you in England? IIRC they can still charge in Scotland (and NI?)

LurkingBeagle Wed 27-Feb-13 21:06:54

Very few hospitals have Nightingale wards any more. I've been in and out of hospitals the last couple of years. I've also worked in them, NHS and private.

Sash - I have too. I have either been in a 4 or 6 bed bay or in the Crimea (on one occasion it was mixed, to boot). It might be more palatable if they actually cleaned the wards properly (i.e. to get rid of the smell of other people's piss), but for most patients it just means no dignity or privacy. I could not contemplate being hospitalised in those conditions under any circumstances. It's the main reason I would never, ever be without private healthcare in the UK, at least as long as there is no decent alternative to the NHS.

I have left the UK now and the difference in healthcare - as well as the basic stuff like cleanliness and staff attitudes - is a huge and welcome bonus. I think it's sad that people think the NHS is the only gig in town - it isn't.

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