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 .

Don’t see London as best place it isn’t a centre of medical expertise now is it?

I'm loving the notion of travelling to centres of excellence (feel the irony). Do has to go to our nearest hospital every 4 weeks for cancer treatment/monitoring, and has done for the past 2 years. On public transport it would take him eight days, yes, eight days, to get there and back for this one appointment, a one way journey of around 40 miles.
Anyone who thinks travelling is a good idea must live in a town and near a station or a frequent bus service. Really narrow idea for many people, and so impractical.

The U.K. is a relatively small country , somehow americans, Australians make it over huge distances.

Completely agree Fuzzy.

Patients are treated in single organ sylo’s. The majority of patients are over the ages of 75, and therefore have a degree of frailty. This means they need multi disciplinary care that supports them to getting home as soon as possible, that’s not going to happen if they are miles away from where they live and their families.

Stop imagination .
It has been reported that most child births in London are to women who where born overseas.

But the US and Australia have completely systems relating to social care

We need to stop seeing the NHS as a system on its own. It needs to be fully integrated into social care, third sector parties and NPOs. Farming people out to hospitals for treatment miles away from their homes goes against this. Trust me!

Read the future hospitals guidance. Gives great detail of what is a sustainable solution for acute care

OP how do you suppose everyone over 18 pays £200 a year?

There are so many hidden vulnerable people out there who couldn't afford that bill. People using food banks, people with mental health conditions, pensioners who are poor, people who can't afford to put the heating on during the coldest spells (me.)

People will go back to tying to self treat and end up very poorly because they don't have access to the NHS without a fee. You have a stab wound? Oh well you can either pay x amount to go to hospital or I can treat it with this TCP and a warm flannel (have seen it happen) and the stab wound ends up infected and much worse.

My brother has a tooth which is going black around the top of it but he cannot afford to go the dentist and he isn't entitled to NHS free dental care. It's getting worse but he has to wait until he has the money.

People who suffer with problems to do with alcohol also have underlying problems. They don't just pick up a bottle and think Ooo I know i'm just going to drink myself stupid..

There are so many ifs and buts and no ones health problems are clear cut. We are living in tough times where people are already struggling with basic bills (rent, gas, electric, council tax) let alone adding another which will make things so much worse.

@Vicky. Stopping imagination would be boring wouldn't it? Did you mean something else?

Thinks read my last few posts. I am saying, if we accept that there are people who will never be able to contribute then we must accept that the rest of us, who can pay, will pay more to pay for them. The money has to come from us- that is where the government gets its money - taxes of one kind or another. If it comes from businesses they will put their prices up abd pass it on to customers. Yet, very clearly, people do nit want to pay higher taxes for those who can not pay. Nor do they want to pay for the systems suggested earlier on by an English person currently living in America where they are paying £125.00 per month per person in the family in insurance with an annual £6000 excess per person, or, as in Belgium, to hand over a debit card every time they go to the GP or hospital.

So what is the answer?

The U.K. is a relatively small country , somehow americans, Australians make it over huge distances.

The UK is smaller than most US states. The US is the same size a Europe

And petrol is cheaper, train and bus travel is cheaper, flying is cheaper and you have better roads.

Petrol $2.79 a US Gallon
Flying is slightly cheaper (no taxes)
Roads in the south are better, in the north much worse

If you have to pay to see a GP, what do you think will happen to those who can’t afford that £10? They will get very very sick. Then they can’t afford to go to A & E. Ahh well, shouldn’t be poor, should they?

Fuck off.

custardismyhamster

From my experience in the US. Americans are very health conscious, and have a wide home medical knowledge and a massive home first aid kit.

You visit the doctor when you need to, not when you want to

Nothing will happen until the population demands it. Any gov increasing taxes to pay for it, or limiting access to certain expensive treatments ( I can see the guardian headlines now) , or resulting in shutting too many care homes will be immediately voted out of office. Look at the ‘dementia’ tax at last election. Somehow everyone is in denial that they will need it, their money is to go to their DCs not the gov.
A string of unwarranted deaths, probably of young people, due to staff shortage etc and then people will accept that something must be done —and grudgingly put hands in their pockets—

Well you’re definitely a Tory, Jesus...

For starters obesity costs the NHS far more than smokers and drinkers do. It’s actually the second most common cause of cancer behind smoking in this country now too. So would you like to extend the list of untreateables to the obese? You’d exclude a lot of people that way, hopefully we’ll return to a Dickensian country where they die on the streets.

Not many people can afford £100 every time they happen to get sick. The idea of the NHS is that it is free at the point of use, not pay £100 for the privilege of a hospital stay . Do you really want families deciding not to take their child to the hospital for a broken bone or meningitis because they don’t get paid till next week?

Finally, I implore you to watch the Michael Moore documentary Sicko. It might open your mind to why the NHS is so vital.

Outpinked Nope, have been a member if the Labour Party since I was 18 and able to jo8n. Never voted anything else. I have watched Sicko. You have not read the thread. Am being provocative. I am happy to pay more taxes to protect the NHS. I don't want it privatised or for any kind of pay as you go or health insurance. But something has to change- standards are falling, the social care system is atrocious, people can not get access to the treatment they need in some areas, there are huge staff shortages and waiting lists are up significantly. Most people are not prepared to pay extra and even on this thread have said they do not want to pay more taxes to cover provision for the people who can not pay.

So what are your solutions?

Wellness clinics and or Gp surgeries in big supermarkets ..walk in while you shop , easy parking , most have excellent pharmacists on hand too . A decent i.t record sytem so you have your notes on your phone or email so non duplicating the same bloody questions every visit . A dedicated National Health Lottery with multiple single millionaire prizes as an additional source of funding, with £1 tickets and minimal management fees unlike the dubious health lottery currently advertised .
Abolish internal market if it still exists, an astonishing waste if resources .

What on Earth is a wellness clinic?

Prevention and general check ups ..take up.a huge amount of time with no shows at gp surgeries esp for things like diabetes ..just a suggestion to catch people at a convenient place and time to scare the shit out of them about the content of their shopping trollies

" I am saying, if we accept that there are people who will never be able to contribute then we must accept that the rest of us, who can pay, will pay more to pay for them"

And if you cant see this wouldnt be used as another stick to beat poor people with you are either naive or deliberately ignoring the elephant in the room.

Imagine the AIBU

"Aibu my neighbour wouldnt smoke/overeat/drink if she had to pay the NHS tax like i do"

The quickest and simplest way to save money in the NHS would be to sack every second manager or administrator

Babdoc - sorry but that is ridiculous! Without Administrators or Secretarial Staff running around after the Consultants all day everyday the work wouldn't be able to function at the level it is already.
I did my training at a University Hospital and I can safely say, I have never been as busy and flat out in my life! Those Administrators are constantly behind the scenes and get no more admiration for the amounts that they do - Yes its not Brain Surgery but its still doing the jobs that other won't be seen doing in their lifetime, who's going to process your pay packs?
As for the Paperwork, Most Hospitals now are using computerized systems to input and note everything instead of having Patient Records flying around.
I don't think that you can cut the NHS anymore than it already has been! There are different money pots for different things - that's why its seems ridiculous to be in the different specialties. For example at my local hospital where I have worked for the past 7 years, we have a major budget for training in the Levy that we have to spend by the working year and have only spent something like 0.5% in 8months recruiting over 200 apprentices this year alone.
So in my own opinion, its always going to buggle me that the NHS is in so much sticky issues with finance when some departments have so much but they can't transfer this across.

With working within the NHS, there are clearly some major points that aren't working efficiently, however the NHS is there for a reason and it's only there to help people and put them back together. The Employee's work their absolute butts off to do the job that they do and its easy to criticize.

I mentioned Universal Credit on page 1 complete with a link about the problems OP and you went right back to patient blaming.

Helena That is typical of this government - welfare is not their priority. Useful, fair, workable systems are not their priority. Cutting benefits is.

"However, for every honest person who worries about ticking the right box, there will be many who just tick. The chances of being caught are tiny. The numbers sampled and checked are tiny and the chances of being in that sample are tiny. Many think it is worth the risk. The government think presecription fraud is a significant issue but the resources required to deal with it are not available and not likely to be- the systems do not work in any knitted together way. Let's say I tick one of the many boxes. First they have to trcak me down, then somehow check I have what I said I had - medical exemption, job seekers, maternity exemption ,my age, etc etc. How do they do that when their systems do not speak to each other?"

they had no trouble finding me when i ticked the wrong box by mistake while DH was recovering from a heart attack.

Also many of the right wing press kept banging on about how easy it was for those on Incapacity Benefit with their free presciptions So maybe some took that at face value. the old IB did NOT entitle people to free prescriptions. Ten years ago DH and i were living on £40 a week after paying rent and council tax and other bills. That £40 had to include frivolous things like food and hospital parking.

And prescriptions had to come out of that as well DH was and is now on a lot of medication. He was fucking pleased to turn 60 a couple of years later That birthday was a blessed relief for both of us.

As for presciption fraud the forms and rules for those on UC arent clear They havent caught up. This is not the fault of the patient You could have someone who is very ill and having to stand in Boots worrying about this as well while filling in the back of a script.

And it may well affect you OP in ways you havent thought of. If UC claimants are too scared to fill in a prescription that could well include for things like head lice treatment for their children.

Which means that other children in their class could keep getting reinfected with it. Including possibly yours!

So what's your solution then Helena? I think the OP is getting an unfairly hard time here. She's been clear that these are not her proposals but ideas to get debate started. The only real consensus from this thread is that more money is needed. But it has to come from somewhere and every suggestion has been shot down.

Helena K. I won't say it and that means it isn't true. Shall we just pretend then? Let's pretend that in our society we should only pay for ourselves. We should only pay taxes based on what we use and we have no responsibility to look after the needs of those people who can't do that- that will include the poor, the sick, the elderly, the disabled. Let them look after themselves.

Because pretending means we condone everything the Tories do. It means reducing public services to the bone - and believe me there is a lot more cutting that could be done yet. It won't affect those of us who send our children to private schools, have private healthcare, live in homes we own outright and have decent savings to fall back on but it will affect the people whose children go to the local state school, who use the local hospital, who live in social housing or old people's care homes and have no savings and no job. Living in a selfish society means everyone taking responsibility only for themselves and their family only. That route would mean we would end up with no NHS but a system where we all pay £125 a month for every member of our family in medical insurance and then the first £6000 of treatment in every year. Those who can't pay that will get the lowest level of public care possible with no treatment options.

If we don't want that we need to be prepared to speak up and say if you earn more, you contribute more for the greater good. There is no point in hoping no one will notice if we don't say it. We should be honest about it and make it a moral imperative, not a choice. It should be drilled into the values of our country that those who have more contribute more to improve public services for everyone. We have become a selfish nation with the wealthy getting more wealthy and the poor having an even poorer quality of life.

The test of how civilised a society is should be how well it looks after its most vulnerable members. We are doing an increasingly poor job with healthcare, social care and education. They do need money pouring into them.