NHS should be a co-pay system.

They do in a lot of countries yes, but my point more being we need higher wages and higher contributions from businesses to be able to fund into healthcare.

But look at the outrage at the recent NI increase.

I look at the NI i pay each month. That's my contribution.

Look at what most people pay though? it’s nowhere near enough for the healthcare & state pension costs particularly with an ageing population.

I would be open to it, if it came with some of the other elements, such as being easier to choose a doctor, not restricted to postcode and being able in some cases to go directly to a specialist

Absolutely not. It would be yet another way of working people subsidising everyone else. The people who take up most of the resource would not be paying anything.

in switzerland you pay around 300 quid per month for healthcare. you can choose different co pay amounts (from 0 to max 2500 per year). completely private, amazing hospitals, no wait lists. but here the salaries (and quality of life) are insane, unlike in the uk. so it might be true that the uk simply cannot afford a good healthcare system

DH was booked in for a CT scan. His haematologist knew he couldn't tolerate the dye/marker and said she'd put it on the referral for the CT scan. When he turned up for the scan, the guy running it told him he'd first put in the dye/marker, so DH pointed out it was a scan with NO dye/market, but the guy wouldn't do it without as that didn't agree with his "day sheet", so DH had no choice but to go away as the guy refused to try to contract the oncology dept to get the referral order changed. He then got a "did not attend" letter - not only that but at the next appointment, the haematologist asked why he hadn't attended! That despite him phoning the oncology dept immediately he got home after the aborted scan to tell them what had happened and to ask for a new referral - clearly whoever he spoke to hadn't bothered doing it nor noting it on his records!

I simply don't trust the NHS statistics - same happened with waiting list data which likewise we know had been fiddled for our respective parents who had to wait a hell of a lot longer for urgent cancer referrals/treatments by being moved between hospital/consultant lists!

I look at the NI i pay each month. That's my contribution.
I'm late 50s so too old to be able to afford private health care cover.
I have in the last year paid privately for an MRI on my back., £400, and for private physio due to a long wait.
Part of my pension planning is to have £20k put aside to cover health care, eg knee/hip replacement.

This is bizarre. All European healthcare systems are in difficulties and all European healthcare professionals are under significant pressure. Study after study shows that. It’s a fantasy that everywhere else is doing better.

There are Europe wide shortages of healthcare workers, everywhere has an ageing population. There are far more expensive treatments available than there were 50 years ago and far more expensive ways to diagnose illnesses.

There isn’t a single country where people are satisfied with treatment and waiting times and the expectations are always increasing.

The co-pay system in Germany is hardly worth mentioning, it's €5 for prescriptions, €10 a day for hospital stay, and 10% of the cost for physio, occupation therapy etc. The total amount you have to pay is so low that most people on benefits or low income are quickly exempt, it's a tiny % of household income.

What a lot of people don't know abroad is that state insurance funds in Germany often reimburse you for dental hygienist appointments, I get €50 back twice a year, just upload the bills to the app. Some funds also have a bonus programme where you "earn" money for getting vaccinations, going to the gym, 35+ checks, health courses that are also paid by the insurance.

I get so frustrated as there are areas of the NHS where the care just isn’t good enough. For example, the NHS generally doesn’t want to pay for surveillance for people at high risk of a primary cancer returning as metastatic. The rationale for this is that there is an absence of clinical trials showing survival benefit and there are risks of picking up incidental findings. But there have been leaps in recent years in the efficacy of drugs available to treat metastatic cancer, and many oncologists who keep up with the latest developments will say that early detection, and therefore a lower disease burden, is crucial to maximising the benefits of treatment for metastases. It’s often too late by the time you go to your GP because your spine has broken due to bone mets, or you’ve turned yellow because of liver mets.

I think we need to be more honest about the shortcomings of what the NHS offers, and what the options are for people who want better care than that offering. For some stuff it’s not currently easy to go private, as the pathways and integration with the NHS provision aren’t there.

100% about the comms too. I was booked in as part of the same diagnostic process to 2 separate appointments 40 minutes apart. But in 2 different hospitals in towns 15 miles apart. I rang the team and they told me to just turn up at one hospital and get it done all at one.

I was sceptical - so I rang again when the hard copy letters still showed 2 appts- and the senior person told me that it was entirely impossible for me to do that and then took 40 minutes to sort out a proper appointment for each procedure.

Thin end of the wedge. It'll be 'Oh its just a £10 charge' to get us used to the principle. and it would mushroom. See also student loans...

They would need to sort the systems first.

I sent phone and email records to a rheumatology department last year to prove that I had made three attempts to alert them that I didn't need the apointment, after they sent me a snottogram for failing to turn up.

I am still recorded on the NHS app as a no show.

Exactly.

9 EU states spend more public money per head on health than the UK. Germany spends a whopping 55% more.

And in France, the system I'm most familiar with, the state only covers 70% to 80% of your health costs, you usually pay for a mutuelle (complementary health insurance) policy, at anywhere between 30 and 150 euros per person per month last time I looked. Anything not covered by your policy, you'll have to pay the 20% or 30% yourself.

£10 charge for any NHS appt you booked but don't attend.

Regardless of income or being in receipt of benefits.

People might take it more seriously then and the hundreds of thousands of DNAs in the NHS each month would add to the pot.

There will be no political will to implement this without a hard left wing government like Corbyn.

Instead the NHS will get worse and more and more people will go private to avoid waiting 12 months for simple procedures.

Nail on the head there. Like the idea of paying for GP appointments. Half the population would be exempt, so it's just another tax on workers, who are already taxed more than enough.

I’d rather see a tax increase than co pay. The rich would be fine, so would the people on benefits because it’d be free for them. The people who would be squeezed would be people who work and are over the threshold for benefits but are still not earning a living wage. The ever shrinking middle class would be squeezed too. We need NHS reform, but not this way.

No

Because everyone on benefits would get it for free anyway which is half the country.

The tier system in this country is awful and it does absolutely no one any good.

Yup, waste, inefficiency and duplication are rife. My DH has cancer and when first diagnosed had loads of test, i.e. full skeletal x-ray, MRI scans, CT scans, and bone marrow testing. The first haematologist referred him to a specialist in a town an hour away, and at the first consultation with the specialist, he had no test results at all - just a 2 paragraph referral letter with no data on it besides the diagnosis, so a complete waste of the appointment and then the consultant said he'd arrange for his own tests, i.e. full skeletal x-ray, MRI scan, CT scan, bone marrow testing as it was "easier" just to order them again than chase the first hospital to send the results! Utterly bonkers!

I pressed go to soon! They do in a lot of countries yes, but my point more being we need higher wages and higher contributions from businesses to be able to fund into healthcare. We can’t just lift one element from models that operate better and ignore the rest of the social construct. We have a cost of living crisis and taking more money from those who are squeezed pushes more below the poverty line than we have already - I’m not sure we have a solution but it doesn’t feel like spending more when we’re already taxed

Just like the UK then. My MIL spent 48 hours on a trolley in an A&E corridor before finally being admitted to a ward where she died because she'd not had any treatment during those 48 hours.

I know my UK student abroad in the Netherlands pays into their health system and pays to see a doctor? In fact, to get her student visa she had to prove she had sufficient funds to support herself even if she couldn’t find a job (students can work part time on a student visa) and part of that figure included costs for healthcare.

European models tax more not less.

Most European systems have a process whereby if you are a student or unemployed you don't actually pay to see a doctor. So there isn't a situation where you are put off seeing a doctor because you think you won't be able to afford it.

I think my reservation about that would be that it's always people who were just above the poverty line who get hit really hard by costs which people below the poverty line get for free. There's this whole pretense that if you aren't on certain benefits you do have enough money to do basic stuff like by school dinners etc but it's not true.

No system is perfect. But I think the taboo around discussing better ways of financing and running the NHS is really not helpful in delivering a good service. I hope people will continue to calmly discuss this usually there's massive Hysteria if you even suggest that there might be a better way of doing things.