Is the NHS now about treating 'shi t life syndrome'?

[mids2019]

https://www.theguardian.com/commentisfree/2025/jul/03/the-guardian-view-on-labours-nhs-plan-it-is-right-to-celebrate-medical-science-but-delivery-is-the-hard-part

A Guardian article but it seems like this push to reduce health inequality is making the NHS look like part of our benefits system. While I agree with good health for all is this strategy going to appeal to a middle class tax payer base who are a lot of their tax going to a struggling NHS with the money ultimately flowing from their pockets to more deprived areas? It seems like the poorer the area the more snazzier and funded your health service will be and I just wonder if ultimately this may too the balance towards a more health insurance based syatem?

Odd that, isn’t it?

Sorry but if you'r. ill people should be willing to drive to a large city hospital in their county (obviously parking and support for travel costs could be considered). In theory it sounds lovely having a local hospital but it is horrendously inefficient

Thats all fine and good if you have one illness needing sporadic appointments. My DD has complex needs at one point with 7 different specialists involved in her care. For a good while we had at least one appointment a week at our large city hospital - a 2 hour round trip - meaning every appointment was a half day, or full day, off school for her to attend, and a similar amount of time off work for me. In addition she had weekly appointments with CAMHS, another 90 minute round trip with an hours appointment so another half day off school and work. I ended up needing to go part time because I simply couldn’t keep taking 1/1.5 days off work every week.

We have a local health centre 5 minutes from the house, if any of those appointments could have happened locally it would have eased a huge amount of pressure, my DD wouldn’t have lost such a lot of time in school and I would have been able to work full time (thereby bringing in more tax and NI receipts).

I was fortunate to be able to drive to all of these appointments, if I didn’t have a car the public transport to get to the city hospital would have meant a full day travelling there and back. If you’re doing that every 6 weeks or so it’s not too bad but once or twice a week is a nightmare. She also wouldn’t have had much needed CAMHs support because there was no public transport option to get there.

More local provision is an investment in the health of the community, and the economy if it allows people to maintain their working life rather than ferrying themselves or loved ones to inaccessible central hospitals.

Surely though there needs to be more support for people to get to the larger centres where you do have the concentration of expertise and equipment. You can do something locally but not everything.

It is just a point that if you need a CT then I think travelling to a larger hospital is probably justified due to the expense of setting a CT in a local hospital and also attracting the expertise to with there.

In reality people are going to be served better at say a large city dental hospital than a local surgery as the skill and experience needed for certain procedures lies at the large hospital. We need to help people when we can to get to hospital but fracturing complex services doesn't necessarily lead to better outcomes even though a patient may see a reduced travelling time.

Right, but you agree local support for some issues is still good so the governments idea isn't inherently bad.
Was the support to get to larger centres you were thinking of improved public transport or some sort of travel voucher or a home to hospital taxi service? Because all of those are good ideas, but they all cost something. And the last two would be framed as additional money handed out to disabled benefits scroungers. Look at how PiP is talked about on here.

You can be as righteous as you want about the workshy that won’t help themselves, the evidence shows earlier interventions like health promotion make economic sense. Giving people vouchers and moving health services to areas they can’t easily access will just worsen inequality, increasing the tax burden and further squeezing the middle class.

The middle class aren’t static either, previously poor people walk amongst you. I grew up in a single income household on tax credits and now I’m a middle class homeowner. Im happy paying higher rate tax because I hope it helps other families like mine, getting a leg up is mainly about opportunity so if they need help for their whole lives so be it.

Not to mention the fact the people who are financially struggling frequently cancel appointments or neglect their health bevause they have to take time off work that they simply cannot afford: Making health care more accessible makes sense.

All of that is fine if you’re in travelling distance. My dad is 78, he had an issue with his eye that needed specialist examination. He had a 108 mile journey, including a ferry crossing and needed two overnight stays before and after his 45 minute appointment at the nearest city hospital. If there was an ophthalmologist with clinic hours nearer his home it would have saved him and his partner a huge amount of travel, distress and cost.

I think if you’re in travelling distance of a large city, that’s great, but we have huge rural communities with scant access to anything other than GP services.

also working in the NHS you can see some of the inefficiencies of having local community care in that you simply can't get the equipment (MRI, CT etc.) into local hospitals as well as staff with expertise (there simply aren't enough). So much time and money is wasted for instance with consultants driving around different regional clinics because patients want a shorter journey.
Summary:
The NHS is more important than its clients / customers.
They spend a lot of money on incredibly expensive equipment, otherwise known as the consultants' boys-toys.
Expecting consultants to put themselves out is 'wasted time and money', everybody else (the other 99% of the population) has to put themselves out because they are not important. It's not as if they keep the economy going or anything like that. (see above jellycat's comments about having to go part-time).

We used to have local hospitals. Then they decided to have specialist super-hospitals. Now they want to go back to local services. Typical Government: change from A to B then back to A again. So much wasted resource.

But of course it's reasonable for people who need care to 'put themselves out' travelling! Consultants are a scarce resource - can you imagine how much longer the waiting lists would be if they had to spend half their working time travelling rather than treating patients!

It's not about the NHS being more important than the patients. It's about treating as many patients as possible: as well - and quickly - as possible with limited resources.

And do you really think that the "incredibly expensive equipment" is bought for the consultants' entertainment rather than to treat patients? Really??

I completely agree. The cost to the economy and the net impact on GDP is never calculated in relation to difficult to access health services.

18 months ago my mother (88 now) needed a TAVI to replace a heart valve due to acute aortic stenosis (poorer outcomes than stage 4 cancer without surgery). A TAVI is fabulous, cutting edge, minimally invasive surgery that requires a large team. Absolutely fabulous. She and step were glad to attend a couple of appointments 80 miles away at King's College Hospital. A consultation was a return train fare. However, for the procedure itself they had to be in London the night before and step needed the hotel room for a further night to be on hand. Train tickets £60, hotel room £350 for two nights. It wasn't a problem and they were happy to travel.

What was a problem was that the first op was cancelled with less than 24 hours notice. Cost of train tickets and one hotel night sunk. The second op was cancelled on the morning it was scheduled to take place, cost of train tickets and two hotel nights on that occasion. The third time, it went ahead. The two cancelled ops extrapolated to about £500. For the second I wasted a day of annual leave and a tank of petrol. Notwithstanding the upset and anxiety caused. The upset was the biggest issue for mother, for her the money is neither here nor there.

It's unacceptable to mess people in their 80s around in such way and what do people who don't have £500 sloshing in the bank do? Nobody seemed to care.

Uh huh. The NI rise didn’t affect them at all, did it?

And I'm sure they don't have any capital assets which are now subject to the increased CGT (which flies in the face of the unbelievably high inflation we 've seen in the last few years, btw. Inflation being the reason cgt is rightly lower than income tax)

The increase to the 2nd property stamp duty penalty won't affect them either, apparently.

I think people have drunk so much kool aid about 'the rich' not paying enough, that they won't even realise that our ever-decreading standard of living is linked to the fact that not only is Britain losing the most millionaires in the world right now, but in fact in 2025 we'll have the largest exodus of millionaires that any country has experienced over the last decade.

Yay us. Let's see how that affects the next few budgets.

https://www.theguardian.com/business/2025/jul/09/thames-water-paid-out-millions-in-bonuses-using-3bn-emergency-loan-documents-reveal

For anyone who may think that ill people are the problem....
Well, which kind of "life is shite syndrome"do the bonuses paid to a failing company with our tax money do these guys claim?
Because it is because of issues like this that so many people do not get that treatment, that surgery, that diagnostic, that help... when they need it. This is the problem.

£2.5 million spent on retention bonuses which aren't well deserved, given Thames Water's failings. But irecognising that t's in nobody's interests for the company to become completely unable to function.

£303.3 billion spent on welfare each year.

The problem really isn't Thames Water.

But there are more Thame Water companies, plus you are not counting the loan they got, from the tax payer. Go and have a look to how much we spent on keeping Thames Water going, plus rescuing the banks in 2008 and so on.
You are blind.

I'm not blind. You're not understanding how numbers work.

For every £8 wasted on those bonuses, £1 million was spent on welfare.

It's a complete irrelevance.

Thames Water is s water company. It's badly run: but they were badly run when state-owned too. We'd be spending money on keeping them going anyway.

And the loan we had to pay to a private company. The loan! Add it together.
You are still blind. But because you want to be.
Keep blaming ill people. Just wait till is your turn....

Thames Water got a 3 billion loan. Plus the money they take from their customers. Yet failed to provide proper services and put a good chunk of that money into bonuses!
This is one company. There are others. But.. but .. but...
Always some silly explanation of why others do not deserve something. So we still have enough money to pay to Thames Water and company. You know... because they are "good" to society... and they "contribute"... lots, don't they?

How much did the taxpayer fork out to bail out yhd banks agsin? I know it was obscene.

Also, regarding benefits - it’s true that it’s set to raise by around 20 billion by next parliament, but the vast majority of that isn’t going toward working aged people…but all most can bleat on about is ‘universal credit’.

Exactly.
Never anything to do with the huge corporations, the financial institutions with zero morals, the politicians and the rich beyond healthy levels.
All the fault of my disabled neighbour. That is it. Sponging. And they are not really sick. They are entitled people. End of reasoning.

The bank bailouts were a loan, which have almost entirely been repayed.

Someone on here complained that despite that, it tied up UK government resources.

But who do you think would have suffered the most of the UK economy had collapsed? Rich people who have their own resources to weather the storm? Or people with insecure jobs, no personal resources, and who already rely on government hand-outs: which would have collapsed?

A loan to stop that seems to me to have been in everyone's interests.

If you drive up health outcomes in poorer areas then you decrease the economic burden on society.

Unfortunately this kind of economic analysis just doesn't win votes.

I am in favour of health hubs - increasing visibility of public health in the community.

Starmer should have done a one off windfall tax. There was an article in the Economist when he came in saying that Labour missed opportunies to do more and this was one of the missed policies.

I find it morally appalling that individuals and companies who made their profits- extracted their wealth from the toil of hard working British people are doing all they can to avoid tax and leave.

However we just have to get on with it. Moaning isn't going to help.

I find it morally appalling that individuals and companies who made their profits- extracted their wealth from the toil of hard working British people created value which benefitted all British people through their own hard work are doing all they can to avoid tax and leave feel that they need to leave in order to avoid a punitive tax regime.

Fixed it for you.

I agree, it's immoral and destructive to the UK's future. Labour - with their destructive policies - are a disaster.

It isn't economic analysis though, is it?

It's just ideology-driven wishful thinking.