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Politics

NHS should be a co-pay system.

213 replies

PeonyPatch · 23/02/2026 17:32

Who agrees? Other countries who use this model include France, Germany and the Netherlands and they are some of the highest ranked healthcare systems in the world. The NHS is no longer fit for purpose, and it hasn’t been for a long time. I am proud that we have a free at point of access system here but it’s no longer sustainable and has been mismanaged and inadequately funded for a very long time. The only way I think it could improve is by gradually making it co-pay - perhaps capping it like Germany does.

OP posts:
dwordle · 01/03/2026 10:59

Thisseasonsdiamante · 28/02/2026 11:04

I think a significant part of the problem for social democracies is how older age cohorts are treated. Elderly people with multiple health conditions, no real quality of life possible and yet multiple inpatient stints are being treated and treated and treated.

I cannot put into words how barbaric a family member’s end of life was due to these policies and one single outlier family member who wanted the person kept alive at all costs.

But the wards she was on when she was an inpatient were filled with other patients in similar circumstances. It is brutal and barbaric but it is happening is hospitals everywhere.

End of life is rarely nice, very few fall asleep and die. You can't blame the NHS for how horrible death is....the Liverpool path way was deemed barbaric also truth is other than putting you down it's rarely a quick thing

Thisseasonsdiamante · 28/02/2026 15:43

PeonyPatch · 28/02/2026 14:41

In what way was it barbaric exactly? That’s quite a strong word to use.

I have family members who use MN so I will not be detailing the family members trauma here but it was the very definition of barbaric. An A+E doctor has asked that this person go on palliative treatment because he had cared for her a lot previously as she had been in multiple times but he was over ruled by a consultant and one family member was never going to be on board with palliative care so very extreme measures were taken.

This patient was a 36kg adult less than half of her normal weight at this stage and they had multiple very long inpatient stays at the hospital. The A+E doctor was 100% correct she should have been put on palliative care at that point.

PeonyPatch · 28/02/2026 14:41

Thisseasonsdiamante · 28/02/2026 11:04

I think a significant part of the problem for social democracies is how older age cohorts are treated. Elderly people with multiple health conditions, no real quality of life possible and yet multiple inpatient stints are being treated and treated and treated.

I cannot put into words how barbaric a family member’s end of life was due to these policies and one single outlier family member who wanted the person kept alive at all costs.

But the wards she was on when she was an inpatient were filled with other patients in similar circumstances. It is brutal and barbaric but it is happening is hospitals everywhere.

In what way was it barbaric exactly? That’s quite a strong word to use.

OP posts:
PeonyPatch · 28/02/2026 14:40

sashh · 28/02/2026 10:50

Most hospitals have charitable fund. Pay aDD to your local one then.

Yeah, alright 🙄 Come back when you have something meaningful to contribute.

OP posts:
BIossomtoes · 28/02/2026 11:24

Imdunfer · 28/02/2026 11:07

You said the facilities could not have been provided without PFI. I don't believe that is correct and I explained why in my answer.

I don’t think I said that at all. I said that the PFI payments are covered by the income from the work it generates.

NorthXNorthWest · 28/02/2026 11:16

Farmerswork · 28/02/2026 10:59

The NHS used to work. It doesn't because of increased population caused by immigration. Immigrants need treatment and age. The indigenous population can take the roles. We have home trained medics who are desperately seeking work.

Individuals earning less than £35,000 are not net contributors, low wages caused by flooding the market with cheap labour. The main issue is those receiving a multitude of state benefits which is a massive drain on the economy.

In summary, stop immigration and reduce benefits. Return to a set up that worked.

The NHS used to work has little to do with migrants.

The UK has and aging population of which migrants are generally younger and healthier.

Government policy failure

The increase in long term illnesses cancer, diabetes, dementia and other conditions that would traditionally have killed people.

A lack of personal responsibility, although pplicy hasn't helped

Misinformation and waste in the nhs.

.

Imdunfer · 28/02/2026 11:07

BIossomtoes · 28/02/2026 10:22

In what way is it incorrect? The figures are there in the trust’s annual report every year.

You said the facilities could not have been provided without PFI. I don't believe that is correct and I explained why in my answer.

Thisseasonsdiamante · 28/02/2026 11:04

I think a significant part of the problem for social democracies is how older age cohorts are treated. Elderly people with multiple health conditions, no real quality of life possible and yet multiple inpatient stints are being treated and treated and treated.

I cannot put into words how barbaric a family member’s end of life was due to these policies and one single outlier family member who wanted the person kept alive at all costs.

But the wards she was on when she was an inpatient were filled with other patients in similar circumstances. It is brutal and barbaric but it is happening is hospitals everywhere.

Farmerswork · 28/02/2026 10:59

The NHS used to work. It doesn't because of increased population caused by immigration. Immigrants need treatment and age. The indigenous population can take the roles. We have home trained medics who are desperately seeking work.

Individuals earning less than £35,000 are not net contributors, low wages caused by flooding the market with cheap labour. The main issue is those receiving a multitude of state benefits which is a massive drain on the economy.

In summary, stop immigration and reduce benefits. Return to a set up that worked.

NorthXNorthWest · 28/02/2026 10:56

sashh · 28/02/2026 10:50

Most hospitals have charitable fund. Pay aDD to your local one then.

100%

whereisitnow · 28/02/2026 10:55

No it should not. Free at the point of use.Lets fight to defend that against these shadowy thread starters from god knows where.

Chersfrozenface · 28/02/2026 10:54

sashh · 28/02/2026 10:50

Most hospitals have charitable fund. Pay aDD to your local one then.

Indeed. I've just checked. Our local health board has an official, registered charity that manages over 300 funds for equipment, research, treatment and patient care.

Needlenardlenoo · 28/02/2026 10:54

HappilyFreeNow · 28/02/2026 10:38

This!
Am astonished at the number of people wi just ‘give up’ and some that from the age of 40 itbud an inevitable decline so funny bother bc with nutrition or exercise and csee it as ‘normal’ to have multiple hospital appointments.

Health
1/3 behaviour
1/3 environment
1/3 genetics

At best people can influence a minority of their health outcomes. Much is down to luck.

sashh · 28/02/2026 10:50

PeonyPatch · 23/02/2026 17:44

I didn’t say it was - just feel it would take the pressure off. I think it's important to have good quality health care for those who can't afford it. But many of us could contribute in manageable ways and it might take the pressure of the creaking system that's unsustainable currently

Most hospitals have charitable fund. Pay aDD to your local one then.

Farmerswork · 28/02/2026 10:49

HappilyFreeNow · 28/02/2026 10:38

This!
Am astonished at the number of people wi just ‘give up’ and some that from the age of 40 itbud an inevitable decline so funny bother bc with nutrition or exercise and csee it as ‘normal’ to have multiple hospital appointments.

??

NorthXNorthWest · 28/02/2026 10:40

paolo2145 · 26/02/2026 16:53

Looking at top 20 countries for healthcare, no surprise to fin we are nowhere on the list. % rating healthcare

Taiwan (78.72)
South Korea (77.7)
Australia (74.11)
Canada (71.32)
Sweden (70.73)
Ireland (67.99)
Netherlands (65.38)
Germany (64.66)
Norway (64.63)
Israel (61.73)
Belgium (60.16)
Switzerland (59.6)
Japan (59.52)
Singapore (57.96)
United States (56.71)
Austria (54.86)
United Arab Emirates (52.3)
Czech Republic (52.25)
Finland (52.1)
Portugal (51.99)

I am a frequent visitor to Canada and they have great healthcare compared to us- Yes thy do contribute towards it but they really get a lot for their contribution.

Canadian residents pay for Medicare through their taxes, but the medical services are free at the point of use. On average an individual might pay around $5,000 per year which is about £2,800 or so.

I am not advocating we all pay that in UK but perhaps we could have something similar where the amount you contribute, depends on say your income. I know people will say that is the end of NHS, however, let's be honest it is no longer fit for purpose in its current state and something needs to be done to change things.

I understand the importance of having a healthcare system like the NHS that supports everyone, especially those facing conditions they cannot control, such as cancer or certain disabilities. I struggle with the idea that people should contribute more purely because they earn more. In many cases, how healthy someone is as an able-bodied person can be influenced by personal choices and lifestyle. While not every condition is preventable, some healthcare costs diwn to individual responsibility. It seems reasonable to question whether contribution should be based on income, rather than also reflecting personal accountability. We have enough taxes which reward lack of personal responsibility whilst pubishing productivity.

HappilyFreeNow · 28/02/2026 10:38

NorthXNorthWest · 28/02/2026 10:31

More emphasis needs placed on people
taking more ownership for their health from childhood to the grave. The waste that is strangling the NHS should not only be considered from.the perspective of money being spent by the government or mismanaged resources.

This!
Am astonished at the number of people wi just ‘give up’ and some that from the age of 40 itbud an inevitable decline so funny bother bc with nutrition or exercise and csee it as ‘normal’ to have multiple hospital appointments.

NorthXNorthWest · 28/02/2026 10:31

More emphasis needs placed on people
taking more ownership for their health from childhood to the grave. The waste that is strangling the NHS should not only be considered from.the perspective of money being spent by the government or mismanaged resources.

damsela · 28/02/2026 10:31

@paolo2145 Could I ask where you got those stats for healthcare please? There are some surprising statistics there (to me!) Thanks.

NorthXNorthWest · 28/02/2026 10:23

Odditea · 23/02/2026 17:34

Disagree. The reason it’s on its knees is not because it’s not co-pay.

Edited

This

BIossomtoes · 28/02/2026 10:22

Imdunfer · 28/02/2026 10:20

I don't think this is correct. The PFI deals are only an alternative way to borrow money rather than do it through the Treasury. Anything that was bought with PFI money could have been bought by raising National Debt but governments preferred not to do it that way at the time.

In what way is it incorrect? The figures are there in the trust’s annual report every year.

dwordle · 28/02/2026 10:21

Imdunfer · 28/02/2026 10:15

France doesn't have a better healthcare system than the UK and they pay huge amounts in tax to fund it. They don't have the same cancer care provision...no where near.

And yet they have some of the best survival rates in Europe, quite a lot better than the UK.

Have you seen the numbers being treated for cancer in the UK, I think you'll find that the system is being overwhelmed. Cancer treatment often lasts years...if not a lifetime. Surgery, chemotherapy and then hormonal suppression drugs etc. ...you are never truly cured....in remission yes....cure is something doctors rarely use for cancer.

Imdunfer · 28/02/2026 10:20

BIossomtoes · 28/02/2026 10:15

It means that the volume of income generating work is equivalent to or greater than the PFI payments. In my local trust the volume and range of provision wouldn’t be possible without the PFI provision so your assessment falls at the first fence.

Your last paragraph is entirely correct.

I don't think this is correct. The PFI deals are only an alternative way to borrow money rather than do it through the Treasury. Anything that was bought with PFI money could have been bought by raising National Debt but governments preferred not to do it that way at the time.

dwordle · 28/02/2026 10:16

It still needs to be funded, the NHS is massively underfunded. I'm a higher rate tax payer but I can still recognise a system that offers exceptional value.

The innovation medicine term phrased relies in previous posts relies on being able to pay for it. Germany is a good example of this and one particular clinic offers state of the art kidney cancer treatment....the cost is 1.4 million euros per patient. No insurance scheme is going to fund that and in comparison the NHS is adopting it, albeit slowly, at no cost to the patient. In the real world which seems to be void from many posts, is it's the NHS that is a world leader in researching such treatments.

If people want better healthcare tell your MP you want to pay 30% tax like in France. The thing about British people is that that can't seem to relate how much healthcare actually costs and how much it costs them. If you are earning less than 35k you won't be contributing towards anything....you are a net burden to the state, if that's not an argument for tax increases to fund things then I'm lost. So if people want better healthcare changing the funding model will do nothing because the money isn't there to pay for it.

Imdunfer · 28/02/2026 10:15

dwordle · 28/02/2026 09:17

What a bizarre reply, so you would rather have no healthcare than a system that provides universal free healthcare that is ranked in the top 5 in the world.

America has millions of people who can't afford it, and you say it comes free with employment....this only applies to certain jobs. Something like 10 percent of Americans have absolutely no healthcare provision, another 20 percent have inadequate provision.

France doesn't have a better healthcare system than the UK and they pay huge amounts in tax to fund it. They don't have the same cancer care provision...no where near.

Having lived all over the world, the best places have been Australia and Saudi....but again you have to pay into a compulsory scheme and it's not cheap.

France doesn't have a better healthcare system than the UK and they pay huge amounts in tax to fund it. They don't have the same cancer care provision...no where near.

And yet they have some of the best survival rates in Europe, quite a lot better than the UK.