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

With my private health insurance in Germany, I have to pay 50€ every visit to the GP and dentist appointment for myself or my DC. I then have an excess to pay on medication. It is almost impossible to find an Obgyn even in a major city and I had to put my name down literally the day I got a positive line. I can't imagine what it is like out in the countryside where there are even fewer. If I want a GP, you don't make an appointment. You take a morning/day off work and you sit in a waiting room and wait until it's your turn to be seen. I am lucky as the GP works on the ground floor of my apartment building so I just go downstairs but there have been times when I get there at opening times and am waiting 2 hours to be seen. I also find the care here favours homeopathic treatments and I've been misdiagnosed numerous times. I went with fatigue and cluster headaches to be told I needed homeopathic oils. They did no tests. I started waiting till I was back in the uk and was diagnosed quicker here for anaemia.

The problem is that being a GP is shit

You slog your guts out getting into uni, study for a medical degree, train to be a doctor, fighting to get your rotations in, bouncing up and down the country chasing placements in the different disciplines, accruing debt the entire time

There aren't enough consultants to train and mentor all the trainees that are needed, so you are constantly aware of how 'lucky' you are

After getting all your rotations in, to be a GP, you have to step off the hospital merry-go-round, foregoing all the perks of working in a hospital and ending up in a GP practice

Meetings, mentoring, safeguarding, social services, practice management, hiring, firing, continuing personal development and all at your own personal cost - exams, courses, registrations, insurance and all associated costs are on you

Who'd be a GP?

The NHS is demotivated. Its an organisation in crisis.

its been strangled of proper funding for 13 years. The Tories would love to kill it off becayse it wasnt theur idea, labour brought it in.

They are now

• monitored and measured so much that if they're like every other company/ each trust will be green washing the data
• the choice is to go to a private service that the nhs funds - it's morally wrong, no wonder there's no money - and noone holds those services to account.
• forced to make a profit so trusts don't buy from the nhs
• poor salaries and lack of funding for key items
• poorly trained people plus others too focussed on how much the Corp team is earning to pay attention to their own jobs

The last goes on.

The Tories have nearly killed it off. But we need to get behind the new government and get it back to what it was like when Tony Blair/Gordon Brown were leading this country. It worked then, it worked well and it can again.

@OptimismvsRealism you should not be asking for it to be killed off fgs. Have you seen healthcare in the USA? That def let's people down. People due because they can't afford insurance!

Yes I have family in Germany. I don’t know much about any of the alternative models people are mentioning here, but one thing I do know is that my family member had to pay a significant amount for health insurance even when not earning loads.

I think people like to imagine there is some special model where everyone can pay less and get more. The truth is we just need to pay more, one way or another. So why not do it through the current system rather than instituting a new model, which would in itself cost billions upon billions?

Re:
OptimismvsRealism · Today 20:04
"The department of health would decide
Fucking obviously"

That's an answer to the who question...

*@OptimismvsRealism Any ideas / answers for the rest?

"In your vision for the UK healthcare system,

How and who would decide what "essential care" is?
Would that be the same as "getting what's available"?
How and who would decide whether people can "pay a bit" or "absolutely can't"?

Aide memoire:
GreatReader · Today 19:59
In your vision for UK healthcare,

How and who would decide what "essential care" is?
Would that be the same as "getting what's available"?
How and who would decide whether people can "pay a bit" or "absolutely can't"?

OptimismvsRealism · Today 19:53
I think that the entire funding system should be changed so that people pay a bit, unless they absolutely can't and if they absolutely can't they get what's available (which is probably better than what's currently available for anyone). I don't know if transgender care is essential any more than I know if prostatitis is liveable with.

GreatReader · Today 19:51
My question was about funding for transgender support, medications and support.

What are your views on that?

** "what are your views on NHS funding for transgender support, medications and surgery?"

OptimismvsRealism · Today 19:49
Funnily enough while looking at a really agonising crack in my perineum I started thinking about how sore it must be to mess with this area for that purpose. Personally I'd counsel against it.

The NHS pays so much to employ agency staff because there are gaps (not vacancies) in medical, nursing and other clinical staffing because of poor organisation in numbers of junior doctors training posts and not advertising for replacements for people leaving or going on maternity leave until the person walks out of the door - recruitment takes about four to six months by the time they have selection, interviews, pre-employment checks and worked notice. Also will retain experienced staff if they allowed more part time staff as clinical staff have childcare, elderly care and just haven't got the energy to do a 48 hour working week like many doctors do

I don't know who you are speaking to. The vast majority of people I know are receiving good treatment - sometimes same day visits to GPs (where a physical visit is required), usually a call back within 24 hours. Of course waiting times are longer but that has been a variable thing over the past 40 years.

Your 'sample' population is one thing. My 'sample population' is another. It doesn;t make either of us right.

It’s not a predictable part of ageing, it’s a lottery as to whether you need it or not. And it isn’t a consequence of your choice, like childcare. No-one chooses dementia. It’s more akin to your house burning down - which, while a dreadful experience, is covered by insurance.

Not with social insurance.

Yes the lack of control people with my condition have do their care is astonishing. Their life is at the whim of insurance companies owned by shareholders.

I was just about to say the same thing @LostGardens! I've a friend who does my exact job (teacher), gets paid the same headline salary and is the same age as me who is just moving back from Germany. She got good healthcare when there, and excellent public transport (amongst other things) but her tax bill was unbelievable. I really don't think most middle earners in the UK can imagine it - they'd certainly not be able to afford their current mortgages!

It's not one or the other. Both different extremes. Many countries have hybrid systems that work well

Lateness is a huge issue. If someone turns up late I have a choice between

• saying to them sorry you have to rebook, getting a mouthful of abuse from them, and making wait lists go up further
• seeing them, and getting abuse from the patients after them that we ran late, and working late myself and potentially getting a fine from my children's after school club for a late collection

I appreciate life happens, but I give them my direct work mobile and ask them to message me if running late so can try to rejig things. Some will, and are very apologetic, some come in with an air of entitlement, don't apologise for being late, but are the first to moan if kept waiting.

The problems in funding the health service are due to more and more treatments coming to market ( which all cost money), better medical interventions ( including for very premature babies) meaning more people living with complex ( and expensive) conditions, all combined with an increasingly Unhealthy population ( obese and inactive) who get conditions due to being unhealthy.

These pressures exist however healthcare is funded.

Don't forget that insurance companies also make deals with certain clinics so if you need to access a particular service it will be the insurance company who decides where you go. You won't be able just to go to your nearest hospital to have your procedure done.

I'm in an EU country. I pay between 6000 and 7000/year for my statutory (i.e. not private) health and social care insurance, as a % of my (modest to middling) pre-tax income. I'm self-employed; if I were employed, my employer would cover half of this. It's a huge expense - looked at like that, it does cost me 'thousands', and - as most years I probably don't cost as much as I pay - I'm partially subsidising others. I get relatively speedy access to the healthcare I need (certainly no waiting months to years for necessary ops or investigations), can see my GP whenever I need to, and would also get sick pay for 1.5 years at 70% of previous income. If I earned less I would get all that and pay proportionally less.

@TheLittleOldWomanWhoShrinks that sounds fabulous, the bit where you can get sick pay for 1.5 yrs at 70% of previous income. If you were employed, which I imagine the majority of people in your country are, the employer pays 50% of your healthcare ? I am sure the employers of the UK would be more than happy to do that, a healthy workforce is more productive ? What are state pensions like ? how about redundancy pay outs ? And more importantly which EU country is this ?

There are over 7 million people on the NHS waiting lists currently. 7 MILLION!

I don't think whatever the rejigged model, tax should decrease. The tax we pay + social insurance should mean we can deliver a better more robust service. That would also need reforms in how the care is delivered, what is considered core service and what the social insurance covers.

It seems to me that the “better” models people are talking about would require the majority of people to pay much more than they do now, through a combination of insurance, tax and possibly treatment charges.

Why are people open to this but against simply paying more in taxation?

Some other posters suggested introducing competition would improve things so we wouldn’t need as much funding, Are there formerly public services that are doing better under privatisation or part privatisation? I am not seeing it with dentistry, water, the royal mail etc. What can people point to that supports this?

Maybe we have a better telephone manner than the op

I can easily speak to my GP, I can equally easily get a face to face appointment if I need - rather than want - one. I don’t resent paying tax either.

I've never had an issue getting a doctor when I need one.

Whilst another model may have potential to work better I have no faith that it would be implemented that way. If they scrap the NHS you can guarantee that there will be absolutely no reduction in tax we pay, but now we all just end up having to pay monthly private insurance premium + paying a deductable at each point of use. This additional money it costs us will just goto private insurance companies, none to the hospitals or staff - so the service stays the same/maybe feels just slightly better (for the majority) since poor people will stop using it.

That's who.

@OptimismvsRealism In your vision for the UK healthcare system,

How and who would decide what "essential care" is?
Would that be the same as "getting what's available"?
How and who would decide whether people can "pay a bit" or "absolutely can't"?

Aide memoire:
GreatReader · Today 19:59
In your vision for UK healthcare,

How and who would decide what "essential care" is?
Would that be the same as "getting what's available"?
How and who would decide whether people can "pay a bit" or "absolutely can't"?
OptimismvsRealism · Today 19:53
I think that the entire funding system should be changed so that people pay a bit, unless they absolutely can't and if they absolutely can't they get what's available (which is probably better than what's currently available for anyone). I don't know if transgender care is essential any more than I know if prostatitis is liveable with.
GreatReader · Today 19:51
My question was about funding for transgender support, medications and support.

What are your views on that?

** "what are your views on NHS funding for transgender support, medications and surgery?"
OptimismvsRealism · Today 19:49
Funnily enough while looking at a really agonising crack in my perineum I started thinking about how sore it must be to mess with this area for that purpose. Personally I'd counsel against it.
GreatReader · Today 19:35
** what are your views on NHS funding for transgender support, medications and surgery?