Will the NHS recover? What happens if not?

[ilovemykids1]

As somebody with extreme health anxiety, seeing the collapse of the NHS is horrible and I get so scared of what's going to happen.

Do you think it can ever recover? How many years would this take? And if not, what would happen instead!?

I know of one hospital spending at least £1 million a year more on agency workers than it would cost to hire permanent staff. But the money from the agency workers comes from a fund where the cash is available, permanent staff is a different fund where no extra money is available. Madness. Extrapolate that across every hospital in the U.K.

Don't expect mental health care when you burnout.
Work 80 hours a week to keep a roof over your head.
Be forced to tolerate noisy, antisocial neighbours.
Have to live in an unsafe neighborhood.
Expect minor illnesses/injuries to worsen because you can't access initial help.
Don't expect any help into work if you're disabled.
Freeze in your own home because you cant afford heating.
Don't ever eat UPFs, even though they're cheap for poorer people and require less cooking.
Don't expect help if you're trapped in mouldy accommodation and get lung infections because of this.
Don't expect your ND kids to be able to access suitable education so they can work and contribute in the future.

And they wonder why everyone's sick.

But the workers are already paying constantly "small fees" - they're paying employees NIC, they're paying workplace pension contributions, they're paying student loan repayments, they're paying their own rent/mortgage, paying for prescriptions, etc etc - where does it end? There's only so much they'll take, and many have already decided to get off the hamster wheel by working part time and claiming tax credits/UC, or taking early retirement, or moving abroad, etc. You really can't keep squeezing the same minority group of people to pay for all the freebies for everyone else.

The alternative is to incentivise more people to work, to properly target the feckless who can, but can't be bothered to work, to deal with the time wasters in GP surgeries and A&E etc. Lots of alternatives rather than fleecing the people who are actually already contributing to the country.

The feckless will always find a way to get out of it I’m afraid. I agree with your post in many ways but no government will dare to tackle it, least if all labour. I don’t think it will ever happen sadly

Those who think that privatisation is the answer, think about how many MPs (and former MPs) have financial interests in private healthcare companies and therefore, set to gain from privatisation.

https://www.bmj.com/content/349/bmj.g6982

https://bylinetimes.com/2021/11/12/the-conservative-partys-private-healthcare-patrons/

https://www.opendemocracy.net/en/dark-money-investigations/private-health-firms-donate-to-conservative-party-amid-nhs-crisis/

I don’t think the NHS has been underfunded by accident. I think it’s entirely deliberate. Cui bono?

Perhaps we simply cannot afford the NHS in it's present form ?.

I agree !
The alternative scares me though ..
( paying more and so on)

We need a massive push around education covering personal responsibility, how to recognise and treat minor illnesses and promote healthy lifestyles.

If France, Germany, the Netherlands, Norway, Australia, Belgium, Sweden, Finland, Denmark, Luxembourg, Canada, New Zealand, Ireland and Finland can afford to spend more per capita on healthcare than we do, then we’re doing something wrong.

If we agree she needs to draw a salary and also that some people change careers or go in different directions, are you able to tell me why you think this? They seem to be well-established and active enough, when no one else seems to be doing anything. I would like to understand more, if you’re able.

I don't think it will "recover". I think it will continue to do some stuff really well but increasingly people will pay for healthcare privately and will begin to factor that into their finances.

I'm in Northern Ireland and it is REALLY fucked here. Years long waits for first appointments let alone treatment.

In NI too - things are genuinely quite scary here! We have private health insurance, if I’m honest I can’t really afford the premiums but it seems to be the only way to have timely access to care. I’d be devastated to have to give it up.

Worst waiting lists in Europe apparently!

I nearly died three months ago having a routine op in a private hospital. The NHS saved my life and then treated me for the resulting sepsis. The private hospital refused to call an ambulance to take me to the NHS hospital because they would have to pay for it.

Believe me, private treatment is not the wonderful care people think it is. The treatment and care I received from the NHS was head and shoulders above that of the private hospital. We really need to value it more.

What system(s) do they use to finance healthcare?

It is British born people over the age of 50 who account for the vast majority of NHS spending.

As it should be! They’ve paid for it over their working lives. Yes we have a portion of feckless homegrown that we have to bankroll. What we can’t afford is to bankroll the international feckless.

Which specific health conditions do you feel are overespresnted by the immigrant community ?

Well, what “immigrant community”? If all immigrants to the UK were American, Australian, Western European and Canadian along with their net contributor taxes, we actually would be a first world country with a state of the art health service. Unfortunately, this is not the case.

She's generally considered to be grifting, it's all about sale of merchandise and nothing really actually accomplished. No clarity on where money for previous campaigns has been spent.

It is British born people over the age of 50 who account for the vast majority of NHS spending

Well duh! they are the sandwich generation. Working full time, caring for their children and caring for elderly parents. So of course they are going to get ill from the stress and runnng themselves ragged. Not really too much to ask to expect NHS treatment when they have saved the NHS and social care £££ re caring is it???!!!

@OzCalling i have similar concerns about my mum but if she fell and broke her hip etc I wouldn't consider it safe to move her, much less put her in a wheelchair and somehow transfer her in and out of that into the taxi. So if it happens then I imagine she would be on the floor for hours. <shudders>

I think they mainly use hybrid systems, but that’s not the point. My point is that until we fund the NHS to the same level as say, France, we’re comparing apples and oranges. The insurance system gets the credit for the better healthcare outcomes, when it’s more likely to be the money itself that makes the difference.

Arguably, the most cost-efficient healthcare system in the world belongs to Cuba. It’s run on a pittance, but has much better health outcomes than could normally be expected from such a low budget. And it’s free at the point of use to all Cuban residents.

I don't think the NHS will recover, I work in middle management and have a very close relative currently being treated in an NHS hospital.

They sat outside in an ambulance for hours whilst having a brain haemorrhage.

However, the way we live our lives has changed. Granny can no longer come home to live with their children and be cared for because everybody is run ragged with working full time, maintaining a house and their own children. Granny might live until she is in her late 90's and she may have confusion and multiple falls. Nursing homes won't take granny if she is not fully self funding - not achievable for the average person as some nursing homes charge 2k a week. It's a sorry state of affairs and I am feeling it in all directions, professionally and personally right now. I don't know the answer.

I’m a physio so we’re trained in moving and handling fracture patients. It’s not ideal (and wouldn’t be appropriate in some situations, ie if a spinal injury was possible) but personally I’d much prefer mum to be in hospital quicker via an unconventional method rather than languishing on the floor in pain for hours on end

The issues within the NHS are obviously very complex and will vary from region to region.

However, I think one aspect that is nationwide is that the NHS isn’t used appropriately.

We have people turning up at A&E for a sore head, people with prescribed paracetamol every month, GP appointments taken up by people who have a cold or have pulled a muscle. It’s no wonder that people feel they can’t get an appointment.

So I think it’s time we charged. A flat fee for a GP appointment, a flat fee for a walk-in A&E presentation (of course anmbuance-worthy emergencies such as car accidents, stroke etc should be exempt). There should be no circumventing the cost by calling an ambulance for a minor issue instead; the paramedics will triage on site and fees will apply if you want taken to hospital.

Watch how quickly the queues dwindle when it’s costing them.

We also need to be mindful of non UK citizens using the services. People on holiday etc should be paying. That’s what travel insurance is for.

Alternatively, it’s time to privatise it. What good is the current public owned model doing? Imagine a system where you can see a GP the same day, have scans within 48 hours, surgeries done immediately.

The system needs a huge overhaul.

have you heard of the 80/20 rule? It is easy to get that first 80% right (the uk does vaccinations well and efficiently, childhood screenings, managing long term conditions, etc.) but the last 20% becomes increasingly expensive to deliver. The problem with the uk is that we are trying to deliver 100% on the same budget as 80%. Getting to 100% funding for everyone is not an extra 20%, but an extra 200% of money, so treble your NHS allocated tax.

Also it isn’t just about money in the system. In those hybrid systems, some people will get the 80% level of cover, while a smaller portion of the population will get the 100% because they pay over the odds. On average it will be higher than the uk, but that is because some people get a LOT more than others rather than a bit more going to everyone. You have to accept some inequity. The uk system has plenty of inequity, but we pretend it isn’t there and don’t use it to help improve the system more broadly.

https://www.npr.org/sections/health-shots/2024/03/13/1238269753/maternal-mortality-overestimate-deaths-births-health-disparities

The US rate is higher because we count differently from every other country. If a woman dies who had been pregnant within 12 months of her death, it is counted as maternal mortality. If we counted like the rest of the world our maternal mortality rate would be 10 per 100,000, just like the UK.

We also count infant mortality differently, which increases our numbers, fwiw.

State run health care in other countries has evolved to cope with aging populations, larger populations, treating more complex health conditions and so on because their governments make far more investment in the service and their populations won’t put up with poor service they pay for via taxation.
There was always too much sentimentality attached to the NHS which helped to mask the financial drain that started with Thatcher.