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

I think the American system is appalling. The opioid crisis in the US was as a result of a pharmaceutical company being able to convince doctors that their drug was safe and non addictive with the FDA being partly responsible for the poor wording on the drug (yes I have simplified this). A ventolin inhaler costs over 99 US dollars and that’s with insurance. Americans as a whole are very unhealthy even with their ‘superior’ healthcare. I have heard the Australian system is better but I don’t want to spend more of my money on healthcare with current levels of taxation. I get free private healthcare with my company as a benefit. I would like to see more money spent on educating people on preventive diseases such as type 2 diabetes which costs the NHS millions each year. I have a family history of heart disease and type 2 diabetes and yes eventually I might succumb to them but I will be controlling my weight and diet and exercising so I can live as healthily as possible until that day comes. My mum put her type 2 diabetes into remission and she’s 75 and exercises and eats well. I am not victim blaming but look at Japan. They teach them at school about health and their weight is monitored by their employer. They are one of the healthiest nations.

Point taken @Putting but at least give women the agency to sign to say they can and will pay if they can.

@RosesAndHellebores Wasn’t free contraception introduced to make sure women and girls could access contraception regardless of financial situation? I’d be reluctant to put barriers in the way of that particular free-at-the-point of use part of the NHS. Your daughter may well be able to pay her own way, but what if she was in a financially abusive relationship where her partner controlled all the money she earned?

It isn't nonsense @Blossomtoes. It works perfectly well across Continental Europe, Canada and the Antipodes. I'd suggest a minimum fee for those not on benefits of £25. It would make collecting it more worthwhile .

I collected my dd's contraceptive pills when I went to the pharmacy for my ointment, above. DD is 26, post grad professionally qualified, working full-time, and has private means. Why shouldn't she pay for the contraceptive pill when she choses to pay for tinted Contact lenses and highlights?

I agree there needs to be a root and branch reform. More funding depends on the outcome of the reform. There needs to be a sensible discussion of what the NHS can and can’t do. Medicine and healthcare has moved on a lot since the NHS was founded - we simply can’t expect a free to use service to cover everything that is available now. We’d be funding nothing but the NHS.

The answer is definitely more funding and a root and branch review of how the NHS is organised. Not fiddling around the edges taking fivers off people who can’t afford it with admin costs that would exceed the money gained. The reform needs to widespread and radical. This idiotic idea is ideological nonsense.

As I've said a zillion times before, DH and I at 64 and 63 are still working full-time. We both earn more than £100k. We get free prescriptions. It's bizarre.

Actually a month or so ago I had a minor bacterial infection and needed some ointment. Boots couldn't sell it to me. I had to go to the doctor for it. It would have taken me about 45 minutes on the phone (our GP practice has stopped appointments via the app now) and much frustration for an appointment at an inconvenient time. Let's say 2.5 hours of my time. (hourly rate: £63 x 2.5 = £157.50). However I get on-line GP services through my insurance. I had an appointment with a nurse practitioner at 9.45pm - no time off work, and the prescription was with the pharmacy the following morning. The prescription cost £14.50 and was cheap at the price.

In the context of GDP calculations nobody ever includes the wasted patient/working time that arises from using the NHS.

We are already eating the cake. Ask the people waiting 18 months for a hip replacement and unable to work.

And whether you pay directly or it is paid for via tax, you still pay. We all pay. So the £5 you can't afford directly, will be taken from your pay packet anyway and you still don't receive the care you need because both staff and patients alike need a culture change.

So the answer is more funding and a culture change. Not just more funding

Exactly. Interesting that the response was more “Let them eat cake”.

How is it done in many European countries, Australia etc? These are questions that have solutions that already exist. No PhD required there.

How do we figure out the threshold for free prescriptions?

Would we rather 7 million people on the waitlist receiving care after their condition has deteriorated?
Would we rather keep spending money on public health campaigns to attend A&E only when you need to?

Yes that's a fair point

Then you're going to have someone £1 over the threshold who can't afford to pay.

And whose going to go after these payments and how much money will this waste?

Then they are exempt. Even in the horrible YS system - the really poor get access to free healthcare.
And we should not tolerate a country where significant percentages are desperately poor for prolonged periods of time.
We have FSM, out of work benefits etx, payment for NHS prescriptions with exemptions - means testing is already part of how the country is run

What about people who can’t find that money? I remember when I couldn’t have found it, I was looking down the back of the sofa to buy bread and milk. I’m so grateful I had that experience because it saves me from the “Let them eat cake” attitude so many people have.

If we just keep chucking more money at the NHS it will end up costing more and more. I'm all for increasing funding, but I was to see massive reform. We can't keep chucking billions into the leaking bucket.

@ExpressCheckout

Obviously adults in receipt of certain benefits would be exempt, e.g. PIP, etc.

That's where the idea fails. The people who are exempt won't bother about missed appointments etc., because it won't affect them. I'd hazard a guess (because stats aren't available) that most of the FTA appointments are from people who'd be exempt, i.e. disabled, OAPs, etc., so it would end up just yet another tax on workers!

And so we SHOULD patient blame!!!!!

The amount of time i have looked at the ED screens at work and people are coming in for stupid reasons is beyond me!

Chapped lips (yes - I'm being serious, they didn't want to buy Vaseline so hoped we had some for free)
Prescriptions (A&E is closer than their local pharmacy apparently)
Dry Itchy Scalp (Advised head & shoulders because what even the fuck?)

A charge at that level is definitely modest. If you can find money for a pint or a pack of cigarettes, and looking around our local area, most of them can and do, then expecting a contribution to the healthcare/treatment they are seeking hardly seems a huge ask. Plus as was pointed out above: once you pay for something, you expect to get it.

We pay enough tax. Our money just needs to be spent more wisely. That's the issue.

"In many respects, the Britiah public have the service they deserve due to decades of misplaced gratitude on the basis of receiving free treatment."

The British public have the service they deserve because they believed the lie that it is possible to have high quality public services but only pay low taxes. They also allowed policies regarding public services in general to be largely decided by people who do not use these services - if politicians were forced to use public transport, the NHS, send their kids to the same schools as everyone else and live in Housing Association houses then there would be instant improvements in all of these.

"NHS expenditure increased significantly over the last 14 years."

Not in real terms. Not in relation to expenditure in other countries which spend more per capita. "Spending more" might still be "still not enough" - as evidenced by the ever-increasing treatment waiting lists, waiting times for ambulances, inability to see a GP, impossibility of finding an NHS dentist, hundreds of thousands of unfilled vacancies in the NHS...

Again, you keep coming with the 'whys, wherefores and what ifs'. I am talking based on my own personal experience, which you know absolutely NOTHING about beyond what I've said here.

But taking the staff as an example: For my first visit to A&E, it was actually unusually quiet. I still couldn't have encountered a more unhelpful triage nurse. Absolutely nothing to do with funding, cuts or inadequate services and everything to do with the fact that she was grumpy, uncaring and unprofessional!

I will always pay for private healthcare, whether it's through work, or I take out a personal plan. I wouldn't be without it. As I've said repeatedly, my issue isn't with paying for PHC - it's with having to pay TWICE for healthcare with one of those payments being for a service I can't use.

@newmummycwharf1 Without changing the culture - more money into the NHS will not change outcomes. For many reasons that go beyond just funding.

Yes, the culture needs to change. I think this is starting to happen, e.g. recent discussion/criticism of the NHS being seen as a national religion.

@Sunsgoingtokeepshining Make all employers pay the UK government and in return those employees will have guaranteed, immediate healthcare.

Yes, this would be logical. But again it needs a big cultural shift. But I do think it would drive better use of the system and create a bit more accountability.

I mean, are we saying people in France, Netherlands, Germany- countries that are richer or just as rich - are somehow more able to pay small amounts towards their healthcare and we can't? British exceptionality

They invest more - we need to invest more. They also co-pay, let's try that too

That is what needs to change - the idea that we are comfortable with being a rich country yet supposedly many people cannot pay £5 for an appointment to maintain their health.

Economic growth but also prioritisation. I would rather use my £5 to do something else as would many of us - but there are similar countries to the UK, where this is standard practice and they have better health outcomes.

Without changing the culture - more money into the NHS will not change outcomes. For many reasons that go beyond just funding.

I get private healthcare paid for by my work, as to many many private sector workers. Make all employers pay the UK government and in return those employees will have guaranteed, immediate healthcare. Is that not what they do overseas? Australia for instance? If you have no private healthcare there is a more basic state paid for system. The same thing happens in many European countries.