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13,000 people killed by the NHS.(54 Posts)
13000 people are believed to have died unnecessarily in a handful of NHS trusts. The Care Quality Commission, the organisation tasked with investigating this sort of thing, stands accused of covering up some of the worst excesses - including the use of superinjunctions, gagging orders and big money pay off's. Despite this, no one has lost their job, their pension or been publicly censured in any way even though manslaughter prosecutions may be appropriate. The service seems to be being run for the sole benefit of the bureaucracy (producer interest) and not for its patients.
Given that the state has comprehensively failed to manage our health care, is the time right to break up this monolith and privatise as much of it as possible (maintaining the free at the point of use premise) but having it organised and run along the same lines as the French healthcare system?
The NHS is one of the most efficient healthcare systems in the world. Of course it can be improved - no organisation, private or public is 100% efficient.
Everyone makes the same sweeping judgements "cut middle management, be more efficient" without pointing to real facts. It's all anecdote.
I've yet to see a review which has said that the NHS overall is failing. It has to meet the challenge of an older population etc etc but on the whole it is not failing. Quoting dubious numbers as done in the OP is just making stuff up.
When the government said they wanted to a top down review there was uproar because it came from little more than a Tory dream to go back to the pre NHS days where doctors could fleece patients and the poor got shafted then died.
I certainly do not want a system like the US where people have to choose between eating or healthcare. It is disgusting.
The French health system is very expensive. Contributions from workers and employers are huge, to the point where it cripples small businesses. When we had a small gite business we paid over half of everything we took in contributions for health and pensions. Only 70% is refunded by the state, we pay 150 a month in top-up insurance. This doesn't cover everything and the cost of dentistry and spectacles is astronomical. The service is good, but hugely in debt and is a much bigger proportion of GDP than in the UK.
And as we now know that figure of 13,000 dead was wrong and was politicking of the worst sort from the government.
I do not think anyone should be complacent; I also think that the French system has areas that are not as good as they should be, but we don't have the same kind of newspaper stories here.
I think the alarmist suggestion that any departure from the current structure automatically means a US-style system and people dying in the streets is also too simplistic. The principle of free healthcare at the point of need (if we disregard prescription charges) stands and there has been zero suggestion that will change. The quality of the free healthcare provided, how it's delivered, by whom and how we keep the cost to the taxpayer down are the parts that can and should be constantly examined and improved.
Think of it this way. The NHS budget equates to nearly £2000/year for every man, woman and child in England. If the NHS didn't exist and we were all given £2000 to spend on a BUPA policy, we'd qualify for something pretty fancy.
I agree it is difficult to know what it is the nhs is being compared against?
Medicine is astonishingly different, the profile of the population is completely different and expectations are very different to the days of the nhs and its creation.
If you consider the logistics of keeping a family healthy and well over several generations and multiply those by many millions, the scale of managing the nhs is breathtaking.
But to go back to the OP, has privatisation ever improved any large service? Genuine question - I cannot think of one!
A 2 k bupa policy would be completely useless in the case of a car crash, ongoing illness, child birth etc.
It is very easy to make a fancy pants offering when you don't have to fund the nitty gritty of the service. Eg Royal Mail could make loads more profit if they did not have to deliver little letters to far flung places.
And screw anyone with a pre -existing condition!
Think of it this way. The NHS budget equates to nearly £2000/year for every man, woman and child in England. If the NHS didn't exist and we were all given £2000 to spend on a BUPA policy, we'd qualify for something pretty fancy
Which, in all due respect is a pretty simplistic way to think of it. We all hav different medical needs, some times we need more than others, sometimes less. Plus BUPA wouldnt touch the boring stuff and would skim off a profit.
Give me evidence that the NHS needs a fundamental overhaul.
"A 2 k bupa policy would be completely useless in the case of a car crash, ongoing illness, child birth etc."
I agree it's a simplistic point but it was offered as an illustration of the vast amount spent rather than a serious solution to reorganisation.
" has privatisation ever improved any large service?"
You may be too young to remember pre-privatisation telecoms, but if anyone suggested we went back to the days when there were only two or three types of phone on offer from one supplier and you had to wait a month to get one installed, they'd be laughed out of town. Ditto pre-privatisation utility companies. Imagine being told you could only buy a gas cooker from one retailer.
"Give me evidence that the NHS needs a fundamental overhaul."
I think the increasing regularity of discovery after shock discovery that yet another PCT has been covering up poor behaviour and closing ranks is very worrying. Complaints about GPs are rising. As patients we have no realistic alternative to the NHS services on offer. We can't 'vote with our feet' unless we're prepared to pay for the privilege.
Well for any other non-military organisation, 13000 dead might be considered pretty conclusive evidence of the need for a fundamental overhaul, starting with the sacking of the CEO.
The quasi-religious reverence in which the NHS is held in this country cannot be a healthy thing IHMO. (Praising the NHS to the rafters is one of the sure-fire ways of getting a cheap round of applause on Question Time of ANy Questions.) NHS worship was of course recently on display in the Olympics opening ceremony.
This also scares of all political parties from addressing its fundamental problems.
On most international studies, the NHS doesn't come particularly high in the league tables, around 14th out of about 30 European countries IIRC.
It seems to me to be complacent in the extreme to think we cannot learn from other countries that seem to do it better, possible examples being France, Netherlands, Singapore, Australia.
Privatisation (or part privatisation ) of the NHS would be a disaster for anyone who has ever been to see their GP. Any pre-existing condition would not be covered. Women of child bearing age would pay a fortune for maternity cover . Since having a baby is not an accident or emergency free at the point of need would not apply. A&E would be free if you were in a car crash but if you need long term rehab or continuing care you would be pretty stuffed !
A little example: an ICU bed costs around £2000 -£3000 a day in staff equipment and consumable. Average length of stay is 4 days ( though can be much much longer). So one person can use up a family of fours yearly "allowance" in less than a week.
The NHS is far from perfect, but changing the focus from health to shareholder profit is not how to fix it.
Hmm, things that are better post privatisation... Ok, telephony, energy companies, heavy goods transportation, cross channel ferries, airlines, mobile phone providers, travel agents and Triumph motorbikes immediately spring mind. Similarly, great private industries which were destroyed by nationalisation include Austin cars, British coal, the railways, the entire British aircraft industry and shipbuilding.
I think that the main argument against privatisation is the complete balls ups that recent governments have created, such as the fiasco that is the railways or the post office (splitting parcels from mail was grossly incompetent). Most privatisations are barely noticed - my local council outsourced refuse collection many years ago and there was never a drop in standards.
Deaths & using money to cover them up, deflect blame etc. of course never happens when companies run things
> I think the increasing regularity of discovery after shock discovery that yet another PCT has been covering up poor behaviour and closing ranks is very worrying. Complaints about GPs are rising. As patients we have no realistic alternative to the NHS services on offer. We can't 'vote with our feet' unless we're prepared to pay for the privilege.
Firstly, before the Tory scum got their hands on the NHS, satisfaction with the NHS was at a historical high:
NHS satisfaction 'at record high'
GP writing a prescription Two thirds of the British public are satisfied with the NHS
Public satisfaction with the NHS has reached record levels, according to a leading health economist.
Writing on the BMJ website, Professor John Appleby said 64% of people were either very or quite satisfied with the NHS.
Critics have questioned why the government is reorganising the NHS when the public is happy with it.
You will now continue to see more disasters and more complaints whilst the NHS is has its funding cut and is being privatized and sold off to the chums of MPs.
MrJudgeyPants all your examples of things that have got better through privatisation are things that need to be paid for !
If you can't afford a mobile phone, ferry crossing, holiday, motorbike etc, you don't get one. If you don't pay utilities you get cut off...
Food at the supermarket is more expensive than ever before and a good chunk of that is due to increased transport costs (haulage).
Now apply the above to chemo, hip replacements and drugs for long term conditions like diabetes and heart disease. Can't afford, don't get is a horrific prospect.
"64% of people were either very or quite satisfied "
If M&S got those approval figures the CEO would be out on his backside. 36%... over a third of the population... are not satisfied with their only source of health-care That's terrible
"Can't afford, don't get is a horrific prospect."
Outsourcing services has nothing to do with what patients can afford but what the state can afford. If outsourcing means the state can afford better services or more services than they can provide in-house, I don't see the problem
Majority of public satisfied with NHS, survey finds
Over 60 per cent of the public are satisfied with the way the NHS runs, according to a survey of British social attitudes published today.
Public satisfaction with the NHS stabilised last year after a 'record fall' in 2011, finds a survey published by The Kings Fund.
The 2011 fall - from 70 per cent in 2010 to 58 per cent - coincided with the first year of the NHS' spending squeeze and sustained media coverage about the Governments NHS reforms.
I seem to recall (this came up on Any Questions) that the 13,000 was over so many years and so many hospitals, it worked out as 2 additional deaths per week at any of the institutions. Most those people were already very ill, what we're talking about in a lot of cases is premature death, not that they should have gone on to die of something else many years later instead.
I wouldn't mind a co-pay system at all, but that doesn't need to mean privatisation at all.
Private means profit, what private company would offer anything less?
Health care cannot be 'profitable' because however much money is spent the end result is the same. Nobody lives forever, but some have a better quality of life than others.
To make the most profit, companies would need people to die before they used up too many resources.
Procedures like hip and cataract surgery can be done in vast numbers for a good profit. Private companies would be happy to outsource these and charge the state, but care of the elderly and all the other 'boring' 'expensive' areas would be left to the state.
It already happens with hip replacements. The NHS is outsourcing the surgery to cut waiting lists but any complications and the patient is bounced back to the NHS. The private company gets their fee and the NHS gets the bill cleaning up their mistakes
I think the point is that you could have a service like the French one, but every single person would have to pay more in NI contributions, which are far higher than the UK, and in top-up insurance.
Would people be prepared to do that?
Christ on a Kawasaki, how many people on this board actually understand what I'm suggesting? I am NOT suggesting that we abolish the NHS and replace it with an American style health system. What I am suggesting is that we continue to fund healthcare through taxation but rather than SPEND that money through the one-size-fits-all NHS, we open up the provision of services to private businesses. There has been no suggestion from me that the principle of 'free at the point of use' should be any different from what we have now.
When there is a plurality of providers (aka competition) the patient can choose which service provider they go with. If hospital A has a poor record with hygiene the patient can choose to go to hospital B. If enough people do this, hospital A closes down and another company, with better ideas, takes over its running. If the privatisation is thought through properly - something that I accept has been hit and miss in the past - the NHS would be nothing more than a big procurement department.
Likewise, some of the more egregious things that happened at mid-staffs wouldn't happen because a) a plurality of providers means the scale of coverups would be smaller, b) there would be other potential employers for whistleblowers c) any errant 'franchise' holders who don't match up to government standards can be stripped of that franchise and the operation of the hospital awarded to a rival in an easier manner and finally d) privatisation is one of the most effective ways of pruning back empire building managerial rent-seekers.
The NHS already outsources much of its work and has done since it was created so there is no need to feel squeamish at the thought of evil capitalists making a profit. Remember, any drugs that a doctor prescribes are bought in from the private sector, as are bandages, as are the various bits of office supplies and stationery. No one would seriously suggest that the NHS should have its own paper mill to make paper to print prescriptions on - if it makes sense to outsource care, where is the problem?
Finally, Ttosca makes the point that in 2010, 70% of people were satisfied with the NHS. Even when things were going well more than 1 in 4 of us thought it was a bit shit. So, even though the NHS patches you up free of charge (at the point of use) nearly a third of people were still not satisfied with the system!
I would suspect that is because most people have no experience of other systems and no comprehension of the cost of their care. Of course that's not to say that there haven't been or continue to be cock ups or that communication is always good (I used to manage a NHS complaints and risk management department so have no illusions there).
But there is a permanent misperception that the NHS would run or so much better if it wasn't managed (all systems need managing and the NHS spends less than most). all healthcare systems are worried about costs, and all have significant exposure to adverse events (some talk about it more than others of course).
Also I think people don't understand one of the biggest stresses on the NHS, that is there are too many hospitals, but whenever it is suggested some close there is a huge stink and some ineffective and expensive compromise is adopted instead, with poorer clinical quality and greater cost.
The privatize and let them sink or swim approach is all very well, but what if it is you or your friends/family at the crap place that is just waiting to fail? For many people there is little or no choice about where to go simply because of geography and few have the information to make good decisions about who to be treated by and where.
My final point is that where services have been commissioned the costs often go up and the service frequently declines. Think about all those contracted out cleaners where infection control was compromised or the waiting list cuts made at significant expense (plus some of the services had serious quality concerns). Of course plenty of private contractors did very well indeed, but that's not really the aim of a public healthcare system is it?
^ If enough people do this, hospital A closes down and another company, with better ideas, takes over its running^ all sounds lovely in principle. However why not make sure each hospital meets a minimum standard, not leave them to the "forces of the markets". Tescos don't do it that way - they make sure all their stores are of a certain standard and they close them if they don't make a profit. Not quite the same as what you propose.
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