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

Definitely needs a root and branch reform, with actual health- not illness- at its heart. For example, 10% of the total NHS budget (10%!) is spent on diabetes care, the bulk on complications. Not all of that is preventable, but a good chunk is, especially if things like planning systems (build stuff people can walk to, no food deserts, early community intervention, simply reducing poverty) also swing in. But it needs serious joined up policymaking.

Lots of things cost the NHS more because we intervene too late when things get complicated or are in crisis. It's also structurally sexist and racist as we see in outcomes for women and BAME people.

Tweaks won't work. The Kings Fund has some interesting stuff on other models. It can't be preserved in aspic forever but that doesn't necessarily mean people can't access care, there are lots of other ways of doing things.

It’s highly amusing you trust any UK government to adopt the European models when everyone knows full well they will adopt the USA model and it will become all about making profits and not about care.

Well aren't you lucky you can afford to pay eh. What would you propose for the majority of people who couldnt?

All of these countries, regardless of their funding models, spend more per capita on healthcare than the UK.

www.statista.com/statistics/236541/per-capita-health-expenditure-by-country/

https://www.statista.com/statistics/236541/per-capita-health-expenditure-by-country/

The thing is, an average person cannot plan for it in advance - there is no such thing as a long-term care insurance policy you can take out, so you are left either selling your home or ploughing through savings (obviously people have different views on whether this is fair or not) or your local council has to fund it for you.

This used to exist. I don’t know whether it just became uneconomic or whether people didn’t want it any more.

Agree, the NHS isn't working and at this rate, can't be projected to work. The definition of madness is to keep doing the same thing and expect a different result: I hope the current government has the balls to introduce a percentage charge at the point of use and for medicine. That would be a start, it would discourage abuse, and maybe even start dismantling the assumption that we should be grateful for any care at all, good or bad, because it's freeee.
It really doesn't have to be 100% free or the American system, there are many effective models to learn and take from, if only we wanted to evolve.

I agree. It's a complete waste of time. I'd rather pay and get a proper service rather than be conned by saying treatment is free when it isn't available in the first place. If its not available it isn't free.



Yes, let's get rid of one of the only things we still have to be proud of and should be prioritising for help.

I'd happily get rid of the Royals way before I even considered getting rid of the NHS.

I would be happy with a European style model with some level of insurance and some payment up front.

However I think everyone has to pay something for their healthcare, even if it's a very small amount for the lowest income groups.

I think allowing some groups to get it for free leads to overuse by those groups as they have no reason to limit their demands.

See massive overordering of pharmaceutical products by those who have free prescriptions - often having to be binned by family in whole bin bags at the end of life.

Hypothetically, if you were a minimum wage worker, how much would you be prepared to pay?

Until relatively recently our system was the envy of the world... BUT 14 years of under funding has damaged the system so much. You really can't underestimate how badly the Tories screwed the NHS up...I want politicians to be brave enough to admit that failure and say they will fund it properly. There should be no need for private health care in the UK but politicians are afraid to say that because of this.... Private health firms donated £800,000 to Conservative Party | openDemocracy

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. There's also an upper limit/cap in the other direction. So it doesn't cost nothing, but it's fair.

Meaning locum doctors. *

It’s not a Tory issue or a labour issue- it’s a government issue. It’s been awful for many years even when Gordon brown was in.

It is a predictable part of ageing that needs to be planned for in the same way that people should plan for children.

The thing is, an average person cannot plan for it in advance - there is no such thing as a long-term care insurance policy you can take out, so you are left either selling your home or ploughing through savings (obviously people have different views on whether this is fair or not) or your local council has to fund it for you.

My dad's care was £1,645 per week, he was in care for 2 years and 7 months. He paid a total of £230,300. Who has the ability to save this up and keep it to one side in case they need social care when they're older?

My own wildly controversial view is that social care should be funded out of taxation and this particular tax should come from people's estates. That way the burden is collective, so society is fairly sharing the risk. There would obviously have to be a sliding scale, like stamp duty, so if your estate is less than a certain amount you'd pay nothing, and above a certain amount you'd pay between 5-10%. I'm plucking these figures out of thin air but you get the gist.

Eg, you have an estate of £300,000. When you die, you pay £15,000 social care tax. You still get to leave £285,000. But the care you needed in your final years was free.

I'm sure it's all way more complicated than this and people will offer reasons why this is a terrible idea. But later life care is a lottery. Need care due to something like liver or lung disease? You probably won't pay. Need it for a brain disease like dementia? You'll probably pay a fortune. Spreading the burden across the whole of society removes that lottery, with a small impact on your estate that won't even affect you as you'll be dead.

Sure, this is idealistic and doesn't solve the other issues like lack of facilities and trained staff, but unless social care is sorted, and people can be discharged from hospitals in a timely way rather than clogging up beds, the NHS will never get on an even keel. THIS is the main issue blighting the NHS, and if it was resolved we could then start tackling waiting lists and all the other reasons why people are not currently getting the care they deserve.

I've just been to San Francisco. You certainly see the result of a healthcare system that isn't free at the point of entry.

Women standing in the streets taking their clothes off , men with broken wheelchairs. It's absolutely awful.

Go yourself and have a look at what our future could be!

I’m terms of new medication not being available my brother died because of this reason. It was sat in the shelves and 2 weeks after he died it was released for NHS patient, complete rage and heartbreak

I just looked up the tax rates for the Netherlands.

As a higher (not even additional) rate taxpayer, I’d pay about the same tax there as I do here, when everything’s included.

it’s average earners who seem to pay more. I think the issue with the UK is that we have too few net contributors.

It might have had 'huge satisfaction levels', but that's irrelevant really. What actually matters is outcomes. NHS outcomes are, and always have been, worse than many other countries.

We should set our sights higher, not be satisfied with an inferior service. Deification of the NHS has led us to being pathetically grateful for a healthcare system that lags behind other countries. I say that as someonlne who has worked in the NHS for decades.

Yes the NHS needs radical reform. I know the NHS up close and it’s an inefficient money pit. So much money wasted on “managers” who are not clinical or medical and therefore send 7 doctors to a quiet medically stable ward, and then send 1 junior doctor to a busy ambulatory unit. Stupid. These managers should be made up of ex
/retired doctors but arnt. There is also so much bureaucracy. Also so much money wasted on foreign medical doctors including consultants - who frankly some of which are not up to UK standards and outright dangerous. It’s hard to criticise the NHS because it has been almost cannonized/sanctified.

The nhs needs to be completely overhauled before u put more money in.

And which funding model would provide this drug?

Answer = none

Genius idea....except their numbers are dwindling and expected to reduce further.

We can chase the rest away though - and then just tax the rest of us. There should be some people left. Let's hope that covers it!

Whilst Lecanemab may not be the magic bullet - there are many more Alzheimer's treatments in various phases of clinical trials. We can expect (and hope and pray), that one or 2 deliver even more efficacy. Many have failed and 100s of millions spent to get us to this stage.

When this more efficacious drug/treatment comes along, the NHS will not be able to fund it - unless something is done now to fund it better. Or to fund healthcare better. Looking at the European/Canadian models is smart as we need to respond to the times - an aging population, increase in ultra-processed foods, more sedentary lives and expensive R&D.

Investing in UK pharma and home-grown research also needs to be factored in - hence we now have a life science minister (science and research), office of life sciences etx