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 .

@Babdoc I have to disagree about getting rid of the checklists (as a currently working anaesthetist) - have seen these checks prevent serious problems more than once (even when it's been the clever 'senior doctors' in theatre!).

I agree with wormzy -kick the. NHS into touch. It is well past it’s sell by date.
Has nobody read the GP thread yesterday, overwirke, on total burn out. And as for those saying get the conservatives out so it is funded properly-boy you have short memories -
www.theguardian.com/politics/2010/may/17/liam-byrne-note-successor
The coffers were left empty by the labour gov.

10 a gp visit will cost more in admin to collect.

The problem is flat rate payments of any sort immediately undermine the funadamental reason for the NHS.

We should increase taxes to fund it and pull the plugin Brexit which will decrease our tax take, especially from the financial industry.

Some people DO NOT HAVE a spare £200 flat fee, even paid monthly.
Some people with mental health issues don't get the help they need, hit crisis and call 999, or someone calls for them because they're worried. Those 'evil bad addicts frequently using the NHS' are actual human beings and it is an illness.

I think you’re a bit thick tbh OP

We need to stop putting the blame at the feet of the patient and put it on to those of the Government because that is where it lies. If they closed all the tax loopholes and stopped the likes of Amazon paying pathetically small amounts we wouldn’t be having this conversation. The NHS isn’t broken the morals of the politicians are.

As for not prescribing some drugs anymore that’s happened to me recently. I have a very painful disability and they’ve recently taken my painkilling patches away, as per the guidelines. I’ve run out now. I can barely function. I can’t sleep, I can’t eat (I’ve lost 3lbs thisweek and was only 8st2 to start with) I cry out every time I move. I don’t know how I am meant to carry on especially as my pain clinic services have been cut because my postcode doesn’t fit any more.

DS2 is an A&E nurse. When he did his placement there over the Winter I asked him about the drunks and he said he didn’t see that many. He said it was mainly elderly people.

I wish people would stop banging on about alcoholics and drug addicts not deserving NHS care. Of course they do. Have you ever looked into rehab services in this country? There’s hardly any.

Your check list will leave people dead on the pavement after being misdiagnosed as drunk.

People who can afford to should pay more NI.
Bring back the ward sisters.
Get in some IT bods who know what they're doing to overhaul the system.
Ditto managers.

You know that we already pay National Insurance and tax, right?

The coffers were left empty, so obviously the tories thought the best idea (via Andrew sodding lansley) was to waste what money there was on a massive, expensive and damaging overhaul of the system Go tories. Give us all a lesson in how to allow one utterly incompetent individual to completely screw over an entire health system. Google lansley reforms and CCG for more info. Turns out that GPs are actually not the best people to make decisions on funding in secondary care, who knew everyone in the NHS?

Anyway, crappy Lansley reforms aside, can I point out that the NHS already do deals with drug companies via NICE? Do you really think the NHS is paying the costs that the Americans do? We’re not (the NHS couldn’t remotely afford to). There is massive bargaining power in having an integrated health system.

I’ve seen news reports on why the nhs is struggling, & every time the doctors / nurses say one of the reasons is because we’re all living longer and many elderly people have quite complex medical needs, maybe 3 or 4 different things wrong with them.
What are your suggestions for this op?
Shoot everyone once they hit 70?

1. put more money in - higher tax ringfenced for health and social care. 2) integrate the funding for integrated care (complex internal accountancy stuff). 3) seriously rethink end of life - the nhs is entirely focussed on keeping people alive. Obviously this is mostly a good thing, but an awful lot of resource goes into keeping people with very poor quality of life alive as long as possible. Make Advance Decisions compulsory and normalise discussions about end of life options for those with chronic-terminal diagnoses (ie things like dementia and heart failure which people may live with for many years but ultimately will cause death).

Oh and pay managers in the nhs MORE, not less, so you get the best people applying for the jobs. (Obviously paying everyone more would be a very good thing: I speak as a household where our entire income is dependent on the NHS).

What a load of tosh OP!
My example...A person has cancer. They can no longer work and are reliant on benefits. Their partner has to give up work to look after them (thus saving the system a shed load of money) and is reliant on £64 a week of carers allowance. They are now living below the poverty line. So...they have to pay £400 flat rate annually, £10 for each GP visit and £100 for each in patient stay??

What do you think they should give up to fund this? Food? Already buying the cheapest stuff. Heating? They don't heat the house - can't afford it. The car? There's no public transport here, even in immunosuppression allowed the use of buses and trains so it's essential for the frequent hospital visits. Holidays? They are a dim and distant memory from many years ago.

It's easy to make demands on other people when you aren't walking in their shoes.

(You may have gathered that your post has made me really rather angry, since the example I gave is my own situation)

This thread is a great example of how hard it is to do anything about changes to or funding of public services.
Get amazon to pay more taxes-that’s easy, or why don’t we all buy online from the shops and take amazon out of the loop?
Get rich people to pay more taxes, how to stop them moving their wealth abroad if you do that?
Get people to agree to have their life ended if they get severe dementia ets , well the doctors won’t do that so whose job will that be.
Get a Labour gov to put in more funding, god why did no one think of putting in more funding - great solution.

I think that more people having decent morals and respect for the NHS would help a fair bit. Alot of people waste NHS resources. Heading straight to A&E for something they should go to the GP for, calling ambulances instead of getting a taxi, getting medicine for free on prescription that they could afford to pay for themselves, the list goes on.
Yes there is alot that the government needs to do to save the NHS but we as a society need to do our bit too and stop being so entitled and piss taking.

Well it needs more money so we have have to pay considerably more

Is the NHS to cover all medical procedures

The NHS culture the management, the meetings, the eye watering amounts of money wasted

I think the NHS is a sinking ship we need to look at other countries who run successful healthcare systems may not be perfect but it isn’t crumbling as the NHS is

I agree an annual fee would be a good idea, means tested might work.

Scotland and Wales to pay for prescriptions, not just England.

People with chronic illnesses to pay for prescriptions where not related to their chronic illnesses.

End to health tourism - it's inflammatory to say it, but every penny counts.

Pay cap on trust ceo salaries. None of them should be earning more than the PM.

Better deals from drug manufacturers.

Ending waste of drugs and other medical sundries.

Better communication between both community and hospital care providers and different departments within hospitals.

Health records need a massive overhaul to improve efficiency, this relies on an overhaul of IT systems which will cost a fortune and so will never happen.

Large corporate companies to pay the tax they owe instead of squirrelling it away.

Get rid of the Tories and cancel Brexit for starters.

Then, stop wasting money.

The system is fundamentally flawed. The U.K. is one of very few countries (I think the only other might be Denmark?) with fully socialised medicine. Everywhere else, people pay something - even in the socialist utopias of Greece and Spain.

Firstly, all health provision needs to be integrated to fix solutions at lowest cost - for example, elderly people often can’t be discharged from hospital even when they are well enough, because there isn’t sufficient care at home. So they don’t need to be in hospital at vast expense, but because of the lack of £50 a day for someone to pop in and help them dress or make a cup of tea, they have to stay in. Overall cost is much cheaper to support them at home, but because they are separate budgets held by different authorities (but all public money)the cost gets pushed to the NHS.

Secondly, we need to have insurance for non life threatening illnesses - hip replacements, cataracts etc. Most European countries have this and its managed through mutuals, so not extortionate - maybe £10 a month per person.

I think the free prescriptions for over 60s will be changed anyway, and actually agree with this. Perhaps make it state pension age. Slowly and gradually just because people are living longer.
Prescriptions cost £8.80. Make doctors appointments the same price. I work at a pharmacy, and a lot of the pharmacists think this is the way to go. We have patients that book doctors appointments, I think just to have a chat with someone. Very sad but also a lot of the time they don’t need to be there.

I am not thick thank you These are not all my views. They are suggestions that came out of a discussion between 4 intelligent, well-educated professionals (one who works in the NHS as a therapist), admittedly after a couple of glasses of wine. I did say they were u refined and blunt force and provocative. But very few people here have come up with a single idea to better fund and more carefully control the spending of the NHS.
I totally agree about managers and paperwork - BIL said exactly the same.
Just voting Labour, as I keep saying, will not resolve the problem- it will cost billions every year whoever does it and the money has to come from somewhere - either cutbacks and less services or higher taxes of some kind.
I would happily pay more NI for the NHS or higher taxes. Many wouldn't. Labour would probably put up contributions to fund the services, the Tories prefer to cut the services and privatise to allow profit to be made by their pals.
BIL- who has worked abroad - says the money that is made by private healthcare insurance providers is unbelieveable. Every single dressing, syringe, tablet, stitch, temperature check, meal, drink, is charged for. The best Drs and hospitals charge more so insurance providers don't use them for anyone who doesn't pay top level rates. Anyone with lower levels of insurance is not able to access particular drugs or treatment eg only basic chemotherapies, not the latest or most expensive which are charged more because they work better so people want them and there is more profit. So anyone poor is not able to access the best treatment.
Is that really what we want?
It isn't what I want. I want the best quality healthcare available to everyone who needs it as a public service, free at the point of delivery. But it has to be paid for somehow.
Perhaps if we were starting now we would build a very different system - we don't seem to know what that would be.

The biggest positive changes would be:

1. Remove the internal market mechanism - get rid of the complex commissioning and contracting model and revert to direct funding of the healthcare providing organisations. Spend the money saved on these layers of bureaucracy on improving the hospital estate (shocking number of hospital buildings are in a dilapidated state) and on actual care provision.

1. Scrap the current organisational structure of NHS Trusts with separate identities and remits. Revert to the old structure of Health Authorities, a single entity responsible for acute, community and mental health care in an area. Then you might actually see some integrated joined up health care initiatives than work.

Anyone on this thread petitioning for privatised healthcare needs shaking.

People will have a massive wake up when they are charged in line with what other well developed countries pay for healthcare. We get away with paying relative peanuts in the U.K. people who don’t work, the elderly or are on low incomes do very well out of the current system.

As someone who has worked in the NHS through conservative, conservative, labour, coalition and back to conservative governments I can tell you it ran best under labour. PFI excepted which was a major balls up.

People should be very concerned to read there are 40,000 nurse vacancies and 10,000 doctor vacancies, and all the recent threads on here from HCPs experiencing burnout.

We need to rethink the purpose and funding of this. And ensure we properly tax everyone, including business to fund it. I would write it into law to remove it from political control and make it independent of the whims of populism / political parties.

OR We pay £10 for each visit to a GP and £100 for each hospital stay, flat rate, prescriptions on top.

Regressive taxation is not the way to go. Those with complex health conditions will pay more than healthy people. The former are far more likely to be on low or fixed incomes and could not manage such a burden, so they start avoiding vital appointments. As a result their health gets worse and they need in patient care, but they can't afford it. You can see what the outcome could be there.

It's an awful idea.

It should be run by a cross party group sonit can't be used to score political points. Unfortunately Labour just won't agree to this depite the Tories asking them.

Ref: www.google.com/amp/s/www.independent.co.uk/news/uk/politics/labour-nhs-social-care-funding-government-shadow-health-secretary-jon-ashworth-jeremy-hunt-liberal-a8204141.html%3famp

And I am aware that this has been requested by the Tories on a number of occasions.

Add a £2 NHS levy on to tax and get it named on payslips so people know where it's going.

No cosmetic surgery unless reconstructive. 3 strike £20 fines for missing appointments.

Relaxation of visiting hours to encourage family care of patient (assisting to the loo etc) - might need some thinking through this one.