Why doesn't anyone have a proper plan for the NHS?

Not all illnesses and accidents are the result of 'not taking proper care' of your own health. Victim blaming at its finest.

I agree with this. A large amount of public money goes to the NHS, this attracts a feeding frenzy from the sharks (aka middlemen) they smell blood and they want some so they insert themselves wherever they can to siphon off the profits.

I think that healthcare will always be a bottomless pit and there is the problem of perverse incentives- if health care is free for everyone where is the incentive to take proper care of your own health?

@DramaLlamaBangBang

This is why it needs to be done properly. We need to have a proper system not this piecemeal stealth nonsense.

Exactly this. And that's why the NHS will eventually collapse and we will end up with a US system. It's because the politicians (especially Labour) won't tell the truth about what needs to change that the NHS will limp on for a bit longer until collapse. Whilst Labour perpetuate the myth that all the NHS needs is more money, we'll never get the changes needed.

At least Wes Streeting is starting to test the water by saying change is needed as well as money. Let's hope he can actually make a start towards the changes needed and that he's not silenced and forced to backtrack by unions and other vested interests in maintaining the status quo.

Why don’t we stop paying so many middle men and start putting the money at grass roots level, where it is needed.

There is enough money, the problem is it going to all the wrong places and people at the top instead of into the actual hospitals!!!

Money is not the issue, it’s the way it’s being run that’s the issue.

Was it a clinic for chronic conditions? I'm assuming it wasn't for people who are seriously disabled and will be despite the amount of resources thrown at them.

And who is going to insure these people, how much is it going to cost them. You're naive if you think the government will improve people's incomes so they can pay premiums.

This is why it needs to be done properly. We need to have a proper system not this piecemeal stealth nonsense. NI pays for current pensions and healthcare. It's not an insurance system.

And healthcare isn't free. It's this misconception that leads to abuse of the service. We all pay for it through tax and national insurance. It's only free at the point of need. The only people who don't pay or haven't paid are children and vulnerable people who are unable to work. And that's as it should be.

I'd say it's closer to 75% than 7.5%. When you consider most GP surgeries and pharmacies are private businesses, then you have all the logistics which are mostly private businesses, in-house services such as cleaning and catering which are mostly private, most drugs and equipment will be brought from businesses, and of course all the new hospitals bought via PFI.

We already have that. It's called tax and NI. My DH is in his 70s and has been paying income tax for almost 60 years and is still paying.

No-one should have to pay twice if they don't want to. Otherwise you would have to allow opt out from the NHS and then who would fund the vulnerable - of any age - who need it most.

The ageism on this thread is terrible. Just because someone is older it doesn't mean that they require more healthcare than someone younger who is ill or vulnerable. We will all need to use it at some point. I'm lucky enough to currently be in good health and have not needed to see a doctor or have any treatment for several years. I don't grudge paying my share though as it is funding those people who need it now. That's how it works. Otherwise where does it end? If you're saying you only get out what you have contributed then that is effectively the end of the NHS.

We should always aim to care for those who need it.

I can't find the link, but I do recall reading that something like 75% of the NHS is already covered by private providers, and that was about 5 years ago

That would be 7.5% not 75% ............

Many NHS services are already expensively privatised anyway, look closely and you’ll see ‘proudly providing the NHS service’ everywhere.

Yes, its being done by stealth. Look closely at cars and vans with the big blue NHS logo... small writing somewhere underneath that reads 'working in partnership with'.

I can't find the link, but I do recall reading that something like 75% of the NHS is already covered by private providers, and that was about 5 years ago.

Yes because thats working so well for utilities, and transport, come to think of it 🤔

This ⬆. So many resources are being put into keeping failing elderly people alive with a poor quality of health that there seems to be little left in the pot to treat younger people with simple curable health issues.

The NHS needs to be taken away from politics. Both con and lab claim to prioritise and value it, but really both value votes above anything and nothing gets sorted.

it also needs some sort of insurance system. It should be free for the poorest 10% (or some system along those lines) and the rest need insurance.

it’s so broken and dangerous that it’s killing people every day

You are wrong. The two tier system you mention, works pretty much everywhere else in the world. The NHS has always been partially "privatized", right from conception, and is no more private now than it ever was. You cannot have a system where everything and everyone is paid by the state. The system would collapse.

DH was part of an NHS team along with cross party politicians and NHS folk who visited Netherlands. This is happening all the time. Recommendations are made. The NHS ten year plans, digital transformations, etc etc APPG's in longevity, mental health, etc etc, they run and put together reports continuously.

The issue is they never get implemented. It can be funds, it can be intransigence by local trusts, it can be because Tories will never be trusted with change because the NHS is sacrosanct, and staff, unions and a large section of the electorate, don't want to admit that anything new or different is actually better.

Maybe Labour can push something through. Watch the unions fight tooth and nail for status quo though, all they want is increased wages. Look at the railways...... Change and improvements are not readily accepted.

So what treatments do people suggest the NHS stop providing if you say we can't provide everything.

@taxguru It’s long overdue that the retired should pay NI. Haven’t the Cons said they went rid of NI? It should just be general taxation on income- for all. Many pensioners have far better incomes than young families. We actually got tax relief on our mortgage! We’ve had the best of the nhs. We’ve actually had the best of everything. Tax relief on medical insurance would be a good start. Looking at Australia would also be beneficial. After all they poach all these doctors who don’t like it here. So how come their system is so great? Or are they mostly fit and healthy without an aging population? Germany is surely a decent role model too. Definitely not USA but people always mention USA without ever looking at state insurance schemes . We are so poorly informed and killing off all decent healthcare.

Everything will be privatised, the MP's mates and families and donators will all make fortunes, while the government, i.e. the rest of us, pay poorer peoples monthly insurance premiums. There will also be a two tier system with expensive premiums that cover everything, and the cheaper ones that are worse than useless.

Also, just wait for it to become mandatory to have insurance, like car insurance, once the MP's/elite/their cronies move into insurance companies.

Some people really should be careful what they wish for.

How do you define "rich"? Is it income based or asset based? What about people with "hidden" income or assets, i.e. those engaged in the black economy, tax evasion, benefit fraud, selling stolen/duty free goods, not charging VAT, etc?

I would define 'rich' in terms of income plus assets.
There will always be people who evade payments, or who engage in fraud, but you can't base a whole system on the minority who try evasion.

What happens when the rich don't want to pay, especially if they already make their own arrangements via private healthcare, they may just beggar off abroad instead

They would have to pay - like income tax, non payment isn't an option. We all pay for state education through our taxes, even those who choose to go private - healthcare would work in the same way.

Going abroad isn't that easy to do for most people.

Perhaps a better option would be to actually encourage "rich" people to use private healthcare, so they wouldn't cost the NHS anything, maybe via tax relief on private healthcare costs, in the same way there's tax relief on private pension costs?? I.e. carrot rather than stick

Doesn't this already happen? Some posters have already said they went private when NHS treatment wasn't forthcoming or wasn't effective.

Its too politically sensitive.

The NHS tries its best to deliver far more than it can for far less than it gets.

It has a hugely increasing burden from increasing population - despite decreasing birth rates and old people burden it too.

It likely would need to cut back its "free" services and utilise an insurance system for all but the most essential, emergency services, which the media and left would brand as killing the poor or switching off nannas life support machine - so no party will touch it.
The only solution in reality is probably to let it collapse and then rebuild it as reform is too difficult.

@AnnaKristie

Why can't we pay for the NHS on a means tested percentage basis, with rich people paying a higher percentage, down to some people paying nothing?

How do you define "rich"? Is it income based or asset based? What about people with "hidden" income or assets, i.e. those engaged in the black economy, tax evasion, benefit fraud, selling stolen/duty free goods, not charging VAT, etc?

What about those who currently manipulate/hide their income to avoid paying child maintenance - they're already evading tax, so they'd also benefit from getting free NHS treatment that others who are honest and declare their income would have to pay for.

What happens when the rich don't want to pay, especially if they already make their own arrangements via private healthcare, they may just beggar off abroad instead.

It's a nice idea to say "rich people should pay", but it's just not going to work in the real world.

Perhaps a better option would be to actually encourage "rich" people to use private healthcare, so they wouldn't cost the NHS anything, maybe via tax relief on private healthcare costs, in the same way there's tax relief on private pension costs?? I.e. carrot rather than stick.

Why can't we pay for the NHS on a means tested percentage basis, with rich people paying a higher percentage, down to some people paying nothing?

It would be complicated to instigate, and would need reviewing annually, as people's incomes can fluctuate.

It can't continue to be free, and we need to avoid going down the American route - health insurance there is extortionate, and I hate the idea of treating people on the basis of their ability to pay.

We need to get rid of middle managers and go back to the good old Hattie Jacques days of matrons.

If we're to keep the NHS at all, it needs to be free to charge "extras" so that it can actually start to raise funds for itself.

We already have it (or had it) with opticians, dentists etc. You could "choose" the NHS glasses or filling, or you could pay "private" for a better option.

Why can't that be extended to other NHS services. I.e. a basic hearing aid for people with hearing impairments (as currently), with an option to pay extra for an all singing, all dancing hearing aid (as would be provided by a private audiologist). The difference being that the NHS could actually charge more and make a profit, that profit staying in the NHS rather than lining the pockets of the private audiologist.

I just don't see why people have such a problem with that kind of thing. People seem to want the NHS to provide the top of the range hearing aid for free, and there's just no money in the pot to do that, and never will be, so everyone suffers the downgraded service.