How would you fix the NHS?

Also to add often in the chemist I appear to be the only one paying for a prescription,many times I've counted and it's generally 1 or 2 in 10 that pay

I'd certainly pay the better doctors and nurses more, simply for being better. At the moment, it seems everyone is paid the same (on the same scale) whether they care or not, whether they're competent or not. How about a performance related pay enhancement based on patient satisfaction, positive outcomes, etc?

Not sure at all why some of the really crap doctors and nurses I've endured are paid the same as the really good ones.

We need to stop prescriptions for cheap to buy things like paracetamol,ibuprofen and aspirin as they're so cheap over the counter

Having experienced French Swedish & UK health systems in the 2000s, really don't get the love for the NHS under Blair, yes loads better than it is now but how they rated it top of the list is beyond me.... eg our cancer survival rates have always been shite, as has AE waits...... & we had few NHS Dentists under Labour either...now we have none.

More emphasis on healthy lifestyles and prevention - rid the country of the attitude of "I'll do what I want because there'll be a drug/jab to cure it!"

Stop cosmetic and lifestyle procedures (or at least charge for them).

Better organisation and management, stop all the wasted time/effort and inefficiency.

Make it "patient centred" rather than all about targets and box ticking where patients are nothing but a RTX number on their screen!

Integrate it. I have two chronic health conditions, and have to suffer dealing with two different hospital trusts and the GP (and their primary care trust). They're incapable of communicating with each other, so it's a constant battle to get one of the three to actually deal with things as they always glibly tell me to ask one of the others whenever I have a new problem. It's just loads of buck passing which wastes everyone's time!

Offer enhanced services at a cost to compete with the private sector and enable the NHS to actually make some profit on better services, i.e. higher spec hearing aids, charge for a side room, etc.

@Leniriefenstahl funnily enough yes I do think nurses should be paid better

@Leniriefenstahl

The millions I am conjuring up will be covered by the part privatisation/ part insurance model I am implementing, plus the reduction in scope of what the NHS does. I won’t repeat what waste I will cut because there are plenty of posts about waste upthread.

Wes and I are catching up tomorrow. 😁

If this charging was based on who gets free prescriptions, then 95% of appointments would be free. The working population, the main ones funding the NHS, would be the only ones excluded from, free at point of need, treatment.

What waste ?
I think you better call Wes. You seem to be magicking up millions to fund these great ideas that no one wants to pay for.

Do you know many PAs there are currently ? Do you think the medical profession will agree to this ? You’re dealing with massive vested interests like the BMA. What about nursing staff numbers ? Will you pay them more to attract decent candidates ?

I would partly privatise it immediately, incentivise the public to take out insurance, cut out a lot of the NHS services, cut waste, allow a better referrals process that doesn’t involve GP gatekeepers, expand GP hours but pay them more to incentivise them and require all GPs to modernise with streamlined technology.

Then I would focus on public services to improve health and disincentivise unhealthy habits. Invest in development which is designed around walking and cycling, improve walking routes, widen pavements, improve cycling routes, set up bike buses and walking buses for schools, expand public fitness centres and pools. Invest in really healthy school and college meals and teach children about healthy eating by offering them delicious healthy food. Then tax sugar, tax ready meals, tax fast food, block fast food near schools and colleges, tax alcohol, ban cigarettes and ban vapes.

The public would hate me but I am not messing about!

Apparently there are medical students in this country who can't get jobs. Why the hell not? It's absolutely scandalous that young people who have worked their fingers to the bone to get to and through med school can't get jobs while we have such long waiting lists. I think it's similar for nurses.

@Leniriefenstahl use the PAs for that and get actual doctors back in GPs surgeries

We need our eyes firmly on the fact that the population is aging. Sort social care. I'd make it better paid to attract staff and yes, we'd have to pay for that in taxes.
Someone upthread mentioned specialist hospitals for the elderly. At first I thought yes. Then I realised this is tricky. What is elderly? Do we class it by age (in which case what is the threadhold age?) or by types of illness? Tricky. But in theory perhaps a good thing to look at. I know geriatric medicine is a Cinderella speciality. Let's elevate it. It might benefit all of us.
I'd also invest in public health and public health messaging. I don't know the best way of delivering this but let's dig down. We've had huge success in cutting smoking so can we pull similar levers for obesity?

It's my understanding that only Attendance Allowance or other disability benefits would stop. i guess this may affect pension credit amounts if they get severe disability premium though. Pension credit continues for a year.

Well i guess that is up to the government to sort out.

Where do we get the staff from to man these places ?

No, if an elderly person is in hospital for more than 28 days pension credit can be affected.
I agree with your comment about living in the country for a certain length of time though.

We need community, not geriatric, rehabilitation centres. Orthopedic problems take a long time to recover from and require lengthy stays and even longer periods of rehabilitation. Put them back into the community.

Oh yeah that’ll go down well with the Daily mail crowd.
@Thommasina what about those people on the cusp of paying much more or those with large outgoings like child care. I’d struggle to pay £200-300 insurance as well as NI which goes towards something different.

What about all the missed appointments that aren't the patients fault?

Several.posts including my own, give many examples where it's either not possible to cancel, cancellation message is not noted, appointment letter doesn't arrive etc etc.

What I can't understand (and I'm nearing retirement age myself so this isn't a younger person whinge), is why people who carry on working in the same job past state retirement age (66 at the moment), deferring their state pension, stop paying NI contributions?

According to a Which? survey, in 2018, 14000 people deferred their state pension when they reached retirement age. At that point they stopped paying NI contributions but, presumably, carried on working on the same salary.

Now I know that's probably a simplistic figure and some of those 14,000 may not have carried on working full time, may have relied on a company pension for a while. But, assuming 10,000 of them stayed in their current jobs and that the average salary of those people is £20K a year, that's nearly £600 per person in NI contributions gone. That's £6.0 million a year lost.

A friend has done this. The deferring has increasing her state pension and she's £600 plus a year better off because of the NI contribution stopping, but her outgoings didn't change when she hit 66 years old. They were the same the day after her birthday as they were the day before her birthday.

I totally agree with not paying increased taxes but this is a tax reduction without income being reduced - and I don't know why it's not been plugged with the money ring-fenced for the NHS.

I like the Danish? (sorry can't remember the country) system where you pay the equivalent of 20 to see a GP. That is capped at 100 a year. People on a low income don't pay.

£5 deposit for a GP appointment that either gets taken off the cost of your prescription or refunded after you attend

I'd get people to make a contribution towards food and heating whilst they are in hospital especially for long stays. Older people still get exactly the same amount of pension, pension credit etc and would need to have bought food and paid for heating if they were at home. Also think you should have lived here and paid into the system for a number of years to et free healthcare. I see a lot of people who have lived here for a couple of years then require costly treatment- this could be covered by some kind of health insurance until you have lived here for ten years.