To worry about the NHS if Reform get into power?

I don’t now how anyone could realistically favour the US system. Apart from the ethics of it it is massively inefficient - it actually costs the US Government more per capita in public spending than the NHS.

Most European countries have some kind of hybrid system, where treatment (at least out-patient and GP visits) is not free at the point of use, or at least where the patient does actually see the bill even if they don't pay it. There is then some arrangement whereby one or more insurance schemes either reimburse you, or pay the bill directly. Sometimes this comes with modest co-payments. Spain is a bit of an exception — its system is very close to the NHS.

To take France as an example: A visit to the GP costs (in most places) €30, a price which is regulated by the state system. The system reimburses 70% of that, minus €2 which is considered to be your "skin in the game", so €19. Most people have top-up insurance via their employer that will reimburse the other €9. (It's actually illegal for an insurer to pay that last €2 back to you — the idea is that people with time on their hands need to be discouraged from visiting 10 GPs until they find one who can be bullied into giving them antibiotics for a cold.) But if you have a very low income and/or chronic conditions then you can get 100% reimbursement. And for major things like hospitalisation, where 30% would still be quite a lot, the system covers pretty much everything. Your top-up insurance might pay for a better room but that's about it.

In some countries there is a mixture of private and public hospitals, in others it's all private but the government regulates prices. Even in Switzerland, which likes its capitalism red in tooth and claw, medicine is private but the government guarantees that everybody, regardless of pre-existing conditions and disabilities, can get insurance at an affordable price.

So if you want examples of systems that I either have experience of or know of people who live there and are happy: France, Germany, Switzerland, Netherlands. Of course, all of those systems have issues, but is none of those countries (or Spain) is health as prominent a political topic as it is in the UK.

Now, how you would go about getting to that situation starting with the NHS model is an interesting (and hard) question. Overnight you would have to put in place billing systems and insurance rules, which would add many billions in overhead themselves, and hope that that would somehow allow people and the state, between them, to spend more (% of GDP) on healthcare, which is the real problem of the NHS. (It reminds me a bit of Universal Basic Income, which may or may not be a good idea, but if it was ever introduced it would be incredibly hard to remove it.)

I'm not sure the purpose of your question. Damned it we do have the NHS and damned if we don't. At least a privatised system would get rid of the perpetual scroungers.

The NHS and private is already heavily intertwined.
A lot of private health care goes through the NHS as they have the best diagnostic equipment and operating facilities. All the staff in theatre will be NHS, paid at enhanced rates. Then the patient will as soon as possible, be transferred to private facilities to recover.
Reverse is, NHS will send some elective surgery to private hospitals.

My concern is Farage may favour an American system, when it's the French and some Scandi countries who do it a lot better. In health care league tables, the UK comes way higher than the US.

It’s a genuine pleasure to do my job. I’ve nursed from being 18 years old. I’m fiercely proud of the NHS and feel incredibly lucky to see the miracles of modern medicine and true kindness of human beings every single day, not just from medical professionals, but patient to patient, relative to relative.

It would be a tragedy if the intended role of the NHS changed.

Most people in this country can’t afford the astronomical healthcare bills, even the insurance is extortionate and doesn’t cover everything. If you’ve got existing health conditions, you’re buggered. Could you afford it?

Well the NHS is pretty much broken now. Cant really get much worse.Patient safety is a big issue at present. I’d be frightened to be a hospital patient as I couldn’t trust the care I’d be given.

Please explain - I am genuinely interested in how health care is equal amongst everyone in their system.

So you would rather a failing system that sees endless money pumped into and no return on investment. The ideology of Bevan is no longer sustainable and hasn't been in donkeys' years.

Same question to you. Have you an example of a successful current working hybrid? Genuinely interested if you do.

Singapore, for one.

Yes, but given that Farage is up Old Donald’s rectum and is taking many of his ideological positions from him, and given that Trump has mentioned interest in the NHS previously on one or two occasions after Brexit, it doesn’t take a genius to work out what the ultimate goal is as far as reform are concerned, does it? However much he protests, we know he’s got the American health care system in mind for this country, and that’s exactly what would happen eventually.

So you're not much of a follower of politics but you know enough to start this goady thread. Right.

Have you an example of a successful current working hybrid? Genuinely interested if you do.

I find it unbelievable that some people see a struggling health service and say time to ‘get rid’ . Have they considered the alternative? It really frustrates me that people seem willing to sacrifice this and that our children will never get the benefit. They will be working 60 hour weeks to afford private healthcare.

Thank you for what you do 😊

One of the HCAs caring for my husband told us that the trust (Blackpool Teaching Hospitals, Lancashire) has to save £50m every financial year.
How is that possible?

But the opposite of the NHS is not an American healthcare model. There are numerous, and excellent, alternatives across the globe.

Why does this debate only concentrate on the current model and the American model, like it was one option or the other. There is, surely, a happy medium to be had?

The NHS is not fit for purpose.
I wish someone could find a solution.

I can understand that frustration is causing people to protest vote, but I think it is really important for people to know that the privatisation of the nhs in some form is one of the cornerstones of Reform’s policies. Do we want to end up like America, where people can’t afford to have the medical care they need or end up deeply in debt? How is that a good working model?

I agree with this. My DH had a terrible accident last year, it was abit bumpy to begin with but once in resus the care he received was nothing short of outstanding. I felt very proud to be part of such an amazing organisation at that time.

That said, I’m not sure what will be left if all the planned cuts go ahead this year. Our trust is aiming to save £60 million in 12 months. This will, without doubt, be detrimental to patients, and ultimately they are why we turn up every shift 😢

oh I agree, @Labraradabrador . It took 3 emergency admissions with waits of 18, 32 and 54 hours in A&E, twice with sepsis, to finally reach diagnosis. Which was inhumane and almost unbearable for us both,
But, when he was finally admitted, his treatment was outstanding and life saving.

I don’t know what the answer is. The pathway was diabolical but in the end, his life was saved by expert surgeons (both immigrants).

You’re definitely right to worry, but it’s struggling now and the whole system needs a massive overhaul. I’m not against private sector involvement providing that the basic principle of free at the point of demand is maintained. Sadly no politician of any party is willing to go there; the NHS is like a religion, and the model can’t be questioned.

So Farage has suggested another model, one which explores alternatives to which has been failing for years. One which has seen money thrown at it and wasted on ridiculous job titles and fat cats creaming. Yet you worry about what Reform propose!

Just because it sometimes works doesn’t mean it is functional.