How Can We Save the NHS ?

[LuluJakey1]

Just that. I am interested- having been discussing this with DH, SIL and BIL tonight (we get a bit wild here on Saturday nights)- in what your thought are on how we save and protect our wonderful NHS so it remains 'free at the point of delivery' to all citizens and continues to provide high quality, cutting edge health care as well as more mundane but very necessary healthcare.
This is what we came up with as ideas on the basis that it will inevitably cost us all more and should if we want to protect it. We (DH and I) do, we don't want to see it privatised and us all having to have health insurance and ending up like America.

1. Remove some common items which can be bought cheaper at the chemist without a prescription from being available on prescription eg calpol, paracetemol, asprin, E45 and various creams etc. There would be a list.
2. Every person over the age of 18 to pay a yearly one off NHS flat rate charge of £200. No exceptions. Deducted at sources - wages or benefits or pension. Anyone under 18 to pay £100 (parental responsinility to 18)

On the basis of some stats we found from the National Data Office online, there are 15.6 million under the age of 18 and 52 million over the age of 18 . If we work those figures that would raise almost £12000million every year. OR We all pay an NHS monthly contribution based on our family size and income eg 1% of salary per family member and 2% for any family with an income of more than 100,000 but everyone pays, no exceptions. OR We pay £10 for each visit to a GP and £100 for each hospital stay, flat rate, prescriptions on top.

1. No one working in an NHS hospital or as a GP should earn more than £150,000 a year - this is to stop the ridiculous salaries of NHS Trust Executives.
2. Deals must be done with drugs companies so the NHS is not ripped off by them charging extremely high prices for life saving medication.

5 Plastic surgery, vasectomy, sterelisation, breast enhancement (apart from following cancer) , breast reduction (apart from in cases where it affects health) in fact any surgery done for cosmetic purposes or want rather than a health necessity should not be available on the NHS.

1. Smokers and alcoholics and drug addicts should not be treated for illnesses related to their addictions.
2. Anyone who calls out an ambulance for unnecessary reasons should be charged for that ambulance or at least fined.
3. Drunks should not be treated in A and E.
4. Drunks should not be picked up by ambulances.

Now I know these are provocative. We did not all agree on them but they were suggestions. They were not instead of National Insurance- that would continue.

Interested in your ideas .

Too many people using it who don't have a right to

Reading your post reminded me of a fictional episode of ER where by a Mum brings her severely asthmatic daughter in. She is discharged with new medication which the mum said was fine but actually had no intention of getting it, not because she didn’t want to but she simply couldn’t afford it and as a result her daughter nearly died.

I’m guessinf everyone in that discussion is healthy and have ok paying jobs.

I want the drunks not treated when I first think of them too but then some are just 14, it’s not better they die from choking on vomit or alcohol poisoning and god helps those with conditions which make them appear drunk even though they aren’t.

I think wastage needs cutting down, a huge cash boost into social services and community support so there isn’t bed blocking going on, those patients won’t be exposed to hospital bugs longer than needed etc It will never happen but I would like to see companies like Virgin donate back all the money they make from the NHS, even if it was just for a year. Some how get staff back in the nhs and protect the wonderful ones have from burning out.
STOP PRIVATISING

Get the Tories out so it's decently funded. Integrate health and social care, the social care element at present must be costing the NHS a fortune with some elderly people languishing in hospital. The whole social care system needs a good shakeup. Privatising care homes and home care has not worked. It was bad 20 years ago when I looked after my Dad and needed some home care for him, which was not only inadequate and haphazard, but also him cost a fortune. (Obviously still cheaper than him being in some care home though).

It's also very worrying reading threads on her from over-worked and very stressed medical professionals. How wrong that they should be working in such a stressful and unsafe way. With Brexit as well, without the pool of foreign nurses and doctors, I really fear for the NHS.

How to save the NHS

• Employ staff permanently rather than using expensive agency staff
• Get better deals on medication from the manufacturersq
• Have a database on all users so that instantly staff know if someone is pregnant/allergic to things/have mental health issues/current medication so that if they turn up at a different hospital to normal they can be given the right treatment
• Properly fund social care so that those who need it can leave hospital
• Properly fund mental health care so that those who need it can get it at an early stage and then (mostly) wont then need to he hospitalised later.
• Have easier access to sterilisation/vacectomies on the NHS which will help save money long term on maternity care
• Text everyone a day before their appointment with the Location and time (to stop people missing appointments)
• Help streamline the service. If a HV thinks that a child needs a referral, why can't they do it (and copy in your GP) rather than making you go to your GP for it?
• Have more walk in centres (not just open 9-5) so that those who can't get GP appointments don't end up in A&E

People who don’t want to discuss ways to save it are hiding their head in the sand. Unless something is done it’s not sustainable in its current form.

I don’t have the answers unfortunately. But people are going to have to be charged in some form imo.

Good idea for a thread OP.

It's not a binary choice between "our NHS" and the US system. People always trot out that as the only alternative- it isn't. Many countries have effective, safe systems that deliver outcomes as good and better than ours with a funding model that is a mix of state and self-pay.

Lose the idea that the NHS is some pinnacle of wonderfulness. It is not the envy of the world.

Social care and health have the same budget pot in Northern Ireland. It's still a mess - highest/longest waiting lists in the UK.

At a macro level, I think there are two main challenges to the NHS that have never been properly addressed:

1. Using it as social care (e.g. bed blocking). The NHS is a medical service, social services should either be properly funded at a local level, or a National Social Service should be founded and funded via taxation. Of course, at a micro level, individual patient's needs should be delivered by both services in a collaborative manner.

1. Mental health care has always been the poor relation, fund it properly and help patients who keep presenting with physical problems (including drink and drug related) caused by an underlining mental problem.

Moving to a US model would be financially disastrous, 50% of the money spent goes on admin, legal and insurance costs. A mixed system, like in Germany or France could well work.

Why is the NHS in a mess?

There are far too many people putting their money into off shore tax havens. Big businesses avoiding paying the tax they owe.
I do think that those of us on PAYE are bearing the brunt of funding public services, but I don't know how you make greedy, selfish people pay their taxes.
The French health care system seems to me to be well organised and efficient.
The American system is awful and I do wish it wasn't held up as the only example of an alternative to the NHS.
CCGs have a lot to answer for in terms of inefficiency and waste.
I worked in the NHS for long enough to see the same stupid ideas come round again and again, when they hadn't worked the first time.
Government never listens to the people who actually look after the patients.
This governnment has no intention of making the NHS work.

Point 5 is disgraceful! Having a vasectomy is not cosmetic reasons! Would you rather I have 20 children and live on benefits?!? How will that help the country?
Or imagine having breasts so big they hurt your back? Of course it should be free to get them reduced!

Over screening and over diagnosis is a problem. Things are picked up that would never go on to be life threatening/shortening e.g. tiny prostate cancers. That then cause more harm than good being treated.

Lots of ineffective nhs work going on.

toolazy stop being so pompous and ridiculous. You know you wouldn't have to have 20 children- you could always say no to sex. You sound like someone who reads the Daily Mail with all of your exclamation marks, categorising things as 'disgraceful' and over the top exaggerating of imagined, potential consequences.

Most vasectomies now are done privately. Most breast reductions are turned down and not allowed on the NHS- although it seems to be a bit if a lottery as to where and why. The numbers of vasectomies, female sterelisation, brest reductions, varicose vein treatments have reduced dramatically in the last 5 years on the NHS as NICE commissioning groups just say no to the requests.

There are already olans to stop a whole series of very common operations, and look how many affect women.

news.sky.com/story/nhs-plans-to-cut-back-on-unnecessary-and-risky-operations-to-save-money-11421544

The NHS is finished imo.
Too many people, too many ‘negligence’ claims, just unsustainable.

You know you wouldn't have to have 20 children- you could always say no to sex

OP, did I really read that correctly?

Even if that wasn't a ridiculously intrusive thing to suggest, you do know people won't just stop having sex, don't you?

So by default, even if it was acceptable to expect people to 'just stop having sex', people will continue to do so and more pregnancy possibilities are there as a result.

More pregnancy, more children. More children, more funding from the government (obviously not everyone, but those who'll need to support to support their children).

This is part implemented and will be in all regions by the end of the year.
www.thesun.co.uk/news/5932438/full-list-medicines-no-longer-free-nhs-prescriptions/

I agree with that apart from 6 and 8. I think repeat offenders who call out ambulances for unnecessary reasons should be charged. I think drunks who are hospitalised should be charged. But I've no idea how we'd charge them. I also like the idea of paying a flat rate of £200 a year. And £150,000 is a massive salary.

You think the sun is better than Daily fail? You have finished your own thread!

Point 5 is disgraceful! Having a vasectomy is not cosmetic reasons! Would you rather I have 20 children and live on benefits?!? How will that help the country?
This was the ridiculous statement toolazy made. It is plain silly to suggest if her partner had to pay for a vasectomy she would end up with 20 children, living on benefits. A) Most vasectomies are privately paid for now B) There are less than a dozen women across the country who have 20 children. C) Most of us use contraception very successfully. We don't end up with 20 children born as contraception failed. Vasectomy privatisation does not equate to 'If he can't have a vasectomy we will end up with 20 children and living on benefits'.
DH was told we would have to pay. We will pay. He has not made up his mind 100% yet he wants to have it. We won't be having 20 children if he doesn't.

Might be The Sun but it is the content that is important, not the slant. There is already a programme being implemented of common drugs which can no longer prescribed by the NHS.
We will see more and more of this because NHS funding has to be pad for, it is not a magic, neverending pot of money.

My questions are what ideas do we have to find the huge some required and what is actually palatable to us as a society?

How to save the NHS? Why?

Do away with it entirely and replace it with a system similar to that in place in several countries in Europe. Germany, for example, has an excellent health care system, which is partly state-funded for those who are unable to afford compulsory insurance and which is also funded through employer-based insurance schemes.

There is very little general practice; instead, people tend to go to specialist doctors depending on what is wrong with them. You pay a small fee for seeing a doctor every quarter - this cuts down on time wasters.

It's not perfect (what system is?) but far superior to the NHS in preventative care and far more efficient.

The problem is, so many people only ever see the NHS or the US system, both of which are extremes at opposite ends. There are much better systems in between.

'sum' not 'some' Grr.

I have a sneaky feeling the OP does not have masses of insight into what it is we actually get up to in the NHS. Medicine is not as black and white as presented here. At the risk of having wasted time rising to the bait, to address points 6, 8 & 9 of the daft suggestions...

Would you fancy being the doctor/nurse telling the alcoholic, ex-service man/woman, who suffered life changing injuries serving the country (and been denied reconstructive surgery because that's cosmetic!) that you're just going to let them vomit their entire blood volume because it's an 'illness related to their addiction'? Or the retired teacher, who dedicated his entire working life to educating our little darlings but who smoked in his thirties & forties (because that's what everyone did back then) that you're not going to bother treating his bladder cancer because it's an 'illness related to his (former) addiction'? What about the East European immigrant who's been trafficked for sex work and is being kept quiet with drugs?...would they be worthy enough for medical treatment should they present to ED? Or about the 70 year old lady, who likes a sherry (or 3) but is otherwise respectable, who comes in for her hip replacement and a couple of days post-op develops delirium due to the lack of sherry - presumably you'd leave her to wander the ward assaulting the staff/other patients & risking breaking her shiny and expensive new hip because it's an 'illness related to her addiction'? Would you feel comfortable explaining to the parents of a teenager who's overdone it on a big night out & been brought in by a taxi that their mates waited an hour for because an ambulance wouldn't pick them up (because in this brave new world they don't pick up drunk people), that you didn't attempt to resuscitate them after they inhaled a stomach full of beer and kebab because it was alcohol induced? Or is it just the homeless scumbags with questionable hygiene, who rob old ladies to support their addictions and don't pay taxes that you're in favour of leaving on the streets to fend for themselves?

While we're on the subject of moral judgements about who deserves treatment (because by rationing treatment for people with 'self-inflicted' medical problems that is what you're suggesting)... just to be clear, lets consider the cyclists/horse-riders/skiiers/footballers/rugby players/kite-surfers...you get the gist... who present to ED with injuries related to their chosen hobby. Presumably as it's all self-inflicted you'd be ok with not treating them too, or do they sound middle-class enough to get through the doors to the operating theatre?

Running the NHS and practising medicine is a little be more complex than the Daily Mail makes out. The answer to 'saving the NHS' is not going to be found in ridiculous blunderbuss rules from people who don't actually understand the service or the complexities of medicine. I don't have the answers to the very real crisis in the NHS, but do have enough insight to see why absurd ideas like the above just won't work.

The quickest and simplest way to save money in the NHS would be to sack every second manager or administrator. There is currently more than one manager per bed in the NHS. The admin cost of the NHS was 4% when I started as a junior doctor. It’s now over 12% and rising.
Second, cut the ridiculous amount of paperwork. Nurses have to fill in 27 pages of crap for the simplest admission. Senior doctors in operating theatres waste time having to repeat checklists that were already carried out five minutes earlier in the anaesthetic room.
You can’t even insert a cannula without filling out an A4 document.
When I started working, I anaesthetised 24 patients a day. By the time I retired, that had dropped to 4. Due to a combination of excessive bureaucracy ( up to five repetitions of the same damn checklist, by the ward nurse, the HA collecting the patient, the theatre reception, the anaesthetist and the theatre nurse) and delays due to dirty equipment (centralised TSSU, sterile trays chucked on and off lorries, tearing their sterile drapes in transit, waiting 30 mins for replacement trays by taxi), and the slowness of modern surgeons whose training hours were restricted to 48 a week, meaning they never gain enough experience to operate at speed. Add to that the shortage of post op ITU beds (or even any beds at all in winter), due to ward closures and money being diverted to pay for office staff and “bed managers” instead of clinical staff and actual beds.
Finally, stop wasting money collecting statistics and imposing pointless targets - it just means the managers spend even more money to massage the numbers and pretend they’re performing ok when they’re not. Ban outside “efficiency consultants” who charge millions and only save pennies.
Ok, rant over!

I agree with pp that you need to lose the arrogance that the NHS is the finest system in the world and the envy of all developed nations. It's so arrogant and so false. Take a look at other industrialised nations and see how they do it. The arrogance of people saying just vote the Tories out and somehow Labour will fill the NHS with unlimited cash is just such bollocks.

The NHS is stuffed because Brits consider themselves to be entitled to whatever treatment they like and whatever they need when and how they need it. No obligation to contribute at all. It's so passive and demanding. There's always a reason why you should receive whatever treatment you desire, but without the consequential acknowledgment that you should actually pay towards said treatment.

Take your blinkers off UK, you are not the envy of the developed world.