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

Exactly, yet people on here are saying that any privatising of parts of the NHS is bad. Clearly some things work very well like hearing aids. My MIL also got her cataracts done by a private provider which likewise went like clockwork with easy to book appointments at our convenience (lots of choice, again within a couple of weeks), good follow up checks, etc. All done within a month of referral from the optician - cutting out the "NHS" completely in terms of not having to go to the local hospital for referral etc.

It what the NHS needs more of. Get rid of the antiquated inefficient practices and get them subcontracted to private providers who can do it better without the NHS baggage. Likewise, reduce the "gatekeeping" role of GPs and let more people "self refer" for common issues. It's what happens with NHS dentistry and NHS opticians (and I believe starting to be rolled out for NHS physiotherapy). You contact them directly and they kind of "triage" you at a first appointment to see what needs doing, then claim from the NHS for treatment/consultation under the NHS guidelines with no involvement or referral required from your GP. More of it please!

Just needs good control of the contracts, i.e. proper competitive tendering, quality control over the service, proper contract negotiation by people who understand legal contracts. (Unlike the ruinously expensive PFI contracts that seem to have been checked over by idiots who've never seen a contract before)! Just need to make sure that the private providers do the job properly and aren't screwing over the NHS via contracts in their favour (extras, limitations, auto price increases, etc etc).

The reason the NHS can not provide these services

does not the resources
does not enough trained staff
does not have the finances to provide this
does not have the finances to put in to continuously improve services provided

With a positive test (or after in some cases a consultation) you can get medication after a telephone consultation with a doctor (often services are 24hr) and pick them up from a local pharmacy the same day (if they have correct medication in stock which often now they do not)

Presumably the NHS paid for your Specsavers hearing aids @taxguru? The service has been subcontracted to them for at least a decade and is a prime example of the NHS reforming and working more efficiently.

There’s no reason why the NHS can’t do the latter. That’s precisely the kind of reform that’s needed. There are many, many tests the NHS already does that way. The STI example is pretty pointless unless the provider delivers the appropriate antibiotics along with the test result. I’m sure you’d have mentioned it if it did.

Yep, nail on the head.

I have hearing aids. For the first two pairs, it had to be the audiology dept at our local infirmary. First time took best part of a year to get them issued and adjusted from the first GP appointment to walking away with correctly fitted/set aids. Second time quicker as it didn't need the initial GP appointment again as I was "on the system", but still took a few months. That's with several different appointments for different things with different staff in different places.

Third time I went to Specsavers. Everything done within the single appointment which I had complete freedom to make at a time and branch of my choice. Appointments were available within 10 days! That the hearing test, consultation, fitting of the aids and initial adjustments. Able to go back any time if they need "tweaking", again easy to book an appointment within a week or two at a time and date of my choice.

That's exactly what can be done better by the private sector without the weight of NHS bureaucracy and outdated procedures.

The specsavers staff involved were also more friendly, professional and had more respect. Sadly the NHS staff involved in the prior two occasions were usually running very late, happy to leave me sat waiting in reception whilst they gossiped at the desk, and had the usual "you're lucky we're doing this for free" attitude!

It's not always as simple as NHS is good, private is bad. Some services are better delivered privately. Would you rather phone up and book an appointment at a sexual health clinic, travel to the clinic, find somewhere to park, wait in the clinic, get seen, have tests done, drive home and await results?

Or: order a testing kit online, it arrives in the post next day, test yourself, send kit back, get results within 24 hours?

The NHS can't do the latter, but private companies can.

Actually the most damaging thing for the NHS since 1948 has been our "first past the post' voting system. The swinging pendulum has removed mindful consensus and turned the NHS into a political football. Proportional representation may have helped the arguments pertaining to the provision of healthcare more balanced and with some continuity.

Thing is we will end up with the usa system if we don’t reform the nhs. It will happen by stealth. We need to reform towards some of the successful European systems of co pay, state backed insurance to make it future proof and viable. It’s the people who won’t accept it has to change who are the ones who’ll cause the inevitable collapse resulting in the USA system which no one wants.

It's already failing, and already being privatised. The UK public are in for a nasty shock though, because once it's done we won't be able to go back. It'll be too late. And we won't like the alternative.

Pre-Covid.
Luckily we didn’t have a Labour government in Covid (Jeremy Corbyn -much? ) We would be eating grass now.

YANBU. and I haven't read the whole thread.

Obvs not a socialist. Let's get the US private companies in to make a few zillion bucks like you want. As did the Tories

Many GPs are going to a Triage system, where patients (or call handlers) fill in online forms, detailing issues

The form is submitted, triaged by a medical professional, who then decides whether the patient needs to be seen that day, the next day, that week, within two weeks, or whether a pharmacy, walk in centre, urgent treatment centre, same day emergency care or emergency department are more appropriate

However, although it's fairer for patients who can submit requests from 8am to 4.30pm and not desperately scramble for appointments at 8am, relying on us to guess how urgent it is and where to fit them in, the call queues are immense, as many patients don't have Internet and they now have to havr an excruciating call, where we ask questions prompted by the forms, while the patient may be in a relatively public place, detailing private issues for the form

We're doing our best, but the doctors are overworked and we're handling hundreds of calls

I absolutely agree with you Tryingtokeepgoing

The admin system is on it's knees as there are too few people prepared to answer and direct calls, type up referrals, send letters, send text messages and do all the general admin-y stuff needed to oil the wheels

Gingernaut - are there GP practices where this is all more or less automated and others where it isn't? Because some seem to be very efficient and others that are notorious for their delays.

Yes of course we should. And the sensible thing to do is to understand how other countries consistently provide high quality patient centric healthcare more effectively than we have done for generations. Even when the last Labour government poured cash in and burdened the NHS with PFI contracts and debt, it stil delivered worse service and outcomes than the best heath care systems in the world.

I really don’t understand why we wouldn’t look at what has been proven to work around the world, and why we should be afraid of learning from that. To blindly do what we’ve done before, knowing it leads to worse outcomes, is letting ideology trump what’s best for patients. And that’s wrong.

In all honesty, and I am as guilty as anyone, why do we not have civilian volunteers stepping up for some of the admin tasks? I am retired but my brain hasn't. I know a reasonable amount about medicine and I could probably be reliable backup support for two or three afternoons a week of making calls and sending referrals for one doctor. Instead of wasting hours on MN (much as I love you all), I could do more valuable input helping out volunteering (free of charge) just making the calls that there isn't capacity for. However. There's always a however.... Data protection issues prevent me volunteering because I would have to know more patient information in many cases cases to be competent in directing their cases. At some point in the medical system we have to stop stressing about data protection. Do you want the right care? Quickly? Efficiently delivered? At which point I think it becomes the patient's responsibility to say over to the doctor.

I can do loads of the admin, but only protected from the public because I am not willing to answer calls from them.

I'm a GP Call Handler

I'm paid ~ minimum wage

The admin system is on it's knees as there are too few people prepared to answer and direct calls, type up referrals, send letters, send text messages and do all the general admin-y stuff needed to oil the wheels

GPs are doing their best, but when a referral spends weeks in an Inbox because the secretaries only work half days, the patient access teams at hospitals rely on part timers, the admin teams for all the specialties are only part time and the secretaries who type up clinic notes and investigation reports only work part time, then it will take weeks for the whole process

"Serious question, why do you not move to somewhere in Europe with better healthcare?If you are very well paid I assume you have highly saleable skills; are they only saleable in the UK?"

Even more serious questions

• why the fuck is UK healthcare so poor and underfunded compared with most of the rest of Europe?

• why can I see a doctor just by walking in, and see a consultant within 2-3 weeks of getting a referral, and have minor surgery within another 2-3 weeks in the country where I live, but my brother in the UK cannot get a GP appointment, has waited months to see a consultant and will wait many more months to actually have any treatment?

• why does the UK population put up with having over 10% of the population on a NHS waiting list (and that's just those who have actually managed to see a GP)?

• Why does the 6th wealthiest country on the planet not also have the 6th best (or better) heathcare service?

And yes - GPs are self-employed- so not employed by the government

AQPs provide 60% of all cataract surgery in England. Cataract surgery is the most commonly performed operation in England. Wes Streeting said he planned to use them even more to address wait lists - across specialties. So not sure where you are getting your data from. Very mistaken

https://www.health.org.uk/publications/long-reads/waiting-for-nhs-hospital-care-the-role-of-the-independent-sector-in

https://www.patients4nhs.org.uk/private-companies-involvement-in-the-nhs/

NHS GPs are self-employed (and have been since 1948) and almost all are contracted exclusively to the NHS. In almost all other business settings, this would make them de facto employees, as anyone who has faced an Inland Revenue IR35 investigation will attest.

The AQP initiative was only limited to certain services and has not been a success and in the last 10 years, use of AQP has decreased.

Nope - GPs are private providers. Not employed by the NHS. And there are now tonnes of AQPs (any qualified providers) delivering NHS care. They are also private.

Fact is the government is already privatising the NHS. The public would just rather pretend it isn't happening. Fair enough

I have had excellent NHS care. Emergency and otherwise.

I’ve had a very quick mammogram when I found a lump and have had several scans and tests to rule out various things. Excellent maternity care and when I had other issues. Several members of my family have too. Mostly in Wales.

We are putting the system under unprecedented strain due unhealthy lifestyles.

I was referring to when Labour was last in power huge amounts of money was allocated to the NHS it was not sustainable as a huge amount was from very high interest loans

What done is done we can not undo that damage the Tories did

Invest in what a system that is broken that has not worked efficiently for years its far more than investment that is needed. Thankfully people have wised up than an extra 1p to the rate of income tax is not the answer