To think the time has come to abolish the NHS healthcare model

@GETTINGLIKEMYMOTHER

I’ve seen too much of people gaily stockpiling free prescriptions they don’t need, which only end up being thrown away.

Not always their fault.

My OH has cancer and gets a monthly sack full of different prescription drugs. Some he never takes (such as anti sickness and anti diarrhoea). Some he takes less frequently than prescribed, i.e. omeprazole every other day instead of every day. Fair enough, these aren't expensive. But the killer is his cancer drugs. One he is prescribed 3 per month, the other 21 days. Both are hugely expensive. He has agreed with his oncologist to only take the first every 2 weeks, so only 2 per month and the other to take every other day so only 14 instead of 28.

You'd think it would be easy to get the prescriptions changed for the lower amounts. Nope. Oncologist won't change the "package" as she says it's more trouble than it's worth because any changes have to go to some kind of "committee" and that if she reduces the amounts, she may have trouble getting this "committee" to increase them again. It sounds absolutely bonkers. She's said a few times that "it's ok", as her department are given the funds for the full prescription so it doesn't affect her departmental budget if fewer are actually used!

OH must have thousands (or even tens of thousands) of pounds of drugs in his cupboard. One of the tablets costs over a thousand pounds per tablet and he has several of them.

I've had similar with my drugs (T2 diabetes and high blood pressure). I used to order via the pharmacy and would hand them the "tick box" repeat form, with only the items I needed ticked. Many times, I'd pick them up to find everything had been prescribed. Pharmacy would say the GP had done it, and blame them. When I contacted the GP, they'd claim the form came through fully ticked. No way of knowing who to believe. I also ended up with a stockpile of drugs I never ordered. But again, neither the GP surgery nor pharmacy were remotely bothered when I told them.

It's as if they don't care about waste.

And that's now happening as the rule rather than the exception, and the waiting lists are even worse.

In 2013 i didba hip replacement 9 days after the GP referral was made, now it's 9 months until anyone even gets seen in clinic and a further year, minimum, before any surgery happens.

The NHS has been utterly wrecked in the last 10 years moving it from one of the best performing systems, especially per £ spent, to one of the worst, frankly, given how slowly things changenin the NHS, its astonishing how the Tories have managed this, it almost seems deliberate.

True.

At another level obesity is also risk stratified with poverty.

Poverty costs the NHS an enormous amount of money to treat.

https://www.kingsfund.org.uk/insight-and-analysis/press-releases/poverty-health-nhs-services

At times, it feels like we're displacing money away from people who need it to pay people to treat them for the consequences of not having that money and everything that flows from that (e.g., housing, food, education, opportunities).

@newmummycwharf1 "Those countries are richer than the UK. Germany's GDP was over 4 trillion in 2023 versus over 2 trillion for the UK in the same time period. I have no doubt our government could make different choices with the money we do have - but just to say Germany is a significantly richer country."

According to the World Bank, Germany's GDP in 2023 was $4.45 trillion, and the UK's GDP was $3.34 trillion (not "just over 2 trillion") - but there are millions more people living in Germany (84.5 million) than in the UK (68.6 million)

Germany's GDP per capita is only 6% higher than that of the UK, yet Germany invests over 30% more per capita in healthcare than the UK does.

In the UK, the total economic cost of sickness absence, lost productivity through worklessness, informal care giving, and health-related productivity losses, are estimated to be over £100bn annually. This is the government's own figure. When the government says that it cannot afford to invest in the NHS, the response should be that it cannot afford not to invest in healthcare.

Obesity costs NHS a lot of money and we still don't take any real actions to fix it https://healthmedia.blog.gov.uk/2023/06/07/government-plans-to-tackle-obesity-in-england/

We pay about £7, in patient care is limited to a maximim of £7 per day in charges, you also don’t pay more than about £89 per year due to a charges cap.

Medication/prescription charges vary depending on the cost of the item, the yearly cap is about £160. Similar for dental care, but the cap is much lower for adults until they reach 25. Obviously no charges for children.

The mechanism to work it all out costs more than the fees actually raise.

To improve the NHS, I believe the first step is to improve the flow. We need to start with social care, rather than health care.

We also need to start focusing on prevention and taking personal responsibility for our health.

According to a Swedish friend, virtually everyone in Sweden pays a small amount for visits to GP and A&E, ditto for prescriptions (with an annual cap for those who need a lot) and something towards the ‘board’ element of hospital stays.

And Sweden is popularly supposed to be a socialist Utopia, with relatively high taxes.

TBH I can’t ever see any U.K. govt. - of whatever colour - proposing any such charges - they’d be too terrified of annihilation at the next election. ‘Free at the point of use’ has become such a sacred cow.

IMO some people do take the piss, though - I’ve seen too much of people gaily stockpiling free prescriptions they don’t need, which only end up being thrown away. I once counted over 60 items in an elderly friend’s bathroom - all ultimately thrown away more than once. He could have well afforded to pay a small amount for each that he needed, and TBH since he was tight with money, even a £3 charge would have stopped him stockpiling so many. And I wouldn’t mind betting he’s not alone. I read somewhere that even the cheapest prescription item costs around £7 in admin costs.

It's going towards private healthcare anyway for many conditions and will continue to need more and more.

The problem is when private doesn't equal good care, but shoddy care just done quicker.

Private hospitals are all very well for elective treatment/surgery, but AFAIK they don’t do emergencies.

If anything we need to go backwards.

So many services are now outsourced the NHS is paying for patients to be treated privately.

Virtually all cataract surgery is done in the private sector.

We used to have NHS cleaners who were proud to do the job, that got contracted out to people who didn't care and then we get an increase in MRSA.

I don't think Lecanamab should be available. Its effects are limited, for the costs involved.

The NHS Healthcare model actually needs to be reinstated. At the moment, it is a privatised system to all intents and purposes, but funded by governent. It is also deliberately being starved of cash to bring about people saying we cannot afford it.

What needs to happen is for Trusts to be abolished, the purchaser/provider split removed, and the link with social care reinstated. By removing competition, services can be provided much more cheaply as the paperwork is slashed and the layers of management removed.

There's loads more I could say, but once the privatisation is done (it only takes the stroke of a pen) people will find that, like all public services that are privatised, the private services are far more expensive.

Look at how well the privatised utility services work for everyone except their shareholders, and see the future of healthcare.

@R3dSho3s ah ok, I was talking about other country models. I have had experience of France & Ireland and minor experience of Spain.

These people had the choice to pay for critical illness insurance, but chose not too.

What a load of crap, it must be amazing to live such a blinkered life!

One of my friends had a stroke in her early 20s and another had a form of leukaemia. Critical illness insurance is extortionate for them or excludes many conditions. Then what about people who are born disabled?

I’ve only had experience of a top private hospital in the uk years ago. The amount they charged for tiny things like blood tests was insane. They then bungled my care and my husband was left to bundle me into our car to get me to the local NHS hospital for high dependency. They didn’t even have an ambulance. They sent flowers though. 🤔

• We could make getting hold of basic medications easier. I need monthly Asthma inhalers but can only get them on prescription so a Dr has to give permission each time. Perhaps reduce it to only the yearly review but if meds are working more could be given at one time.

Easier to get antibiotics for things like urine infections. If someone knows what's wrong they are taking an appt away from someone with something more serious that needs checking.

Make social care and hospital care run alongside better so people ready for discharge can leave and free up beds quicker.

On the whole though I have no complaints about NHS, they have cared for my parents with different illnesses well.

This is such a ridiculous and ill-informed comment that it has angered me. You cannot obtain critical illness cover if you have many diagnosed chronic illnesses. Those of us who were born disabled or were diagnosed as children did not get that option. Shall we just die off to save a few pounds from your taxes? (Which, by the way, I’m sure the government will find another way to spend so you would likely never see the benefit anyway.)

Oh, and by the way, lots of us also work and pay into it just like you do, before you try and pull that one.

I’m not English & as I said previously I prefer the French model which also isn’t perfect. I don’t think anyone expects perfection, what other alternatives do you have experience of @R3dSho3s

I have had experience of the private system when younger and trust me my experience of crap within that system was far worse than anything I’ve experienced in the NHS.

We’ve had incidents of crap but the overall model and good/ excellence we’ve experienced in the NHS outweigh an alternative model and the pressures put on the NHS.

You can afford private healthcare. What do you expect to happen to those who can’t?

@R3dSho3s I have had excellent and crap, it’s very inconsistent imo. But it’s good you have only had a positive experience.

There is also a wider problem of young people & high housing costs, wage stagnation which doesn’t necessarily encourage a career in health or even staying in the country where you were born.

Most European countries health care systems are struggling because of aging populations & low birth rates.