to care more about whether something works than whether it is politically correct?

[ICBINEG]

A general political musing...

It seems at the moment that there are lots of 'policies' aimed more at sounding good than at actually delivering good...

like stopping people not entitled to NHS treatment from getting it...

Sounds great. Costs vastly more than it saves...

Is it worth so much to us to say 'that's not fair' that we would rather spend our money on making it 'fair' than treating entitled patients?

Also benefits cheats. So a very very few people cheat...but it would cost more than you get back to chase them. Do we really want the system to be fairer or would we like more police on the streets?

We want to reduce the deficit (well some people do anyway...I am personally not overly fussed) so does it make more sense to take a little more from the multinational corporations or to cut back benefits (again) and scrape in the pennies? Actually I don't know the answer to this one...but I would decide on the basis of the bottom line income wise...not on whether I considered people on benefits to be work shy or multinationals to be greedy...(I don't).

So is it bonkers to care primarily about what actually works? And not so much on feelings/policies/looking tough on crime etc?

[Iamsparklyknickers]

Forms are only as good as the information people put on them.

Once somebody is in a place to have a form I would say you're probably already past the point of effectiveness - much like LondonMans quote illustrates.

How much would you be prepared to invest at every point of public service to be able to have the investigative power and resources to scrutinise and question every form submitted.

[Booboostoo]

I am with you OP. None of these policies have anything to do with actual justice or with saving money. They are all about politicians looking good and getting elected. 'Foreigners coming over here and using up our tax money' is an easy slogan that's not going to alienate anyone who can vote for you.

[Iamsparklyknickers]

Just to make it clear - are we really saying that in the case of the maternity unit identities we'd turf out a woman in labour (whose already cost a pretty penny by that point) because it's become apparent she's not who she says she is.

Do we actually want our nurses, midwives and doctors to be responsible for and capable of that?

[ShellyBoobs]

That seems to be quite basic - teach receptionists and GP management how to deal with foreigners requiring treatment in UK. Our German insurance would have reimbursed the NHS, but they didn't even apply for it

There is a fundamental flaw in this seemingly obvious 'fix', unfortunately. Once the practice, or the trust in the case of hospitals, etc, has established that the patient isn't entitled to free treatment, they become responsible for obtaining the payment. If they can't get the money, they can't claim the fee they earned for the treatment from the NHS.

The solution, for the service provider, is to not declare that the NHS is owed money from the patient of their insurer, in case they can't get it off them.

Bonkers.

[MmeLindor]

I think we have to differentiate between those coming into the country to take advantage, presenting at A&E as an emergency because they know they will be seen, and the other scenarios in that Spectator piece, where people have been registered here and are now no longer living in the country.

The first is difficult to prevent, because no hospital should send a woman in labour away. The second much easier to prevent by making patients attend GP surgery once a year, rather than just phoning for repeat prescriptions.

And the question again is, how to do this without it costing more than we are saving.

[MmeLindor]

Shelly
So does each GP practice or NHS trust have to communicate individually with the foreign health insurers?

[ShellyBoobs]

I don't know, Mme.

I just saw some documentary type tv programme which discussed the issue. I'll see if I can find more info.

[NMercury]

Ten seconds after the implementation suggestion of any policy where the identification of country of origin of those seeking health care was required then I would imagine the Liberal party and numerous of the chattering masses would be up in arms about it being racist and divisive.
To go back to the common sense part, I could imagine that the triage nurse would be told to actively check those she / he thought foreign. Queue headlines of racial profiling - even though it might make common sense that those speaking poor English and not looking as if they were citizens of these isles might, actually be foreigners (and before anyone screams racist at me - I can usually pick out those of Slavic descent in my local Tescos, and not just due to their hovering around the Polska items).

[Iamsparklyknickers]

I think it's more of an issue to ask our medical and support staff to act as immigration officers never mind the training and equipment used by actual border staff to spot forgeries in paperwork and interrogate a story.

Practically speaking I don't think your average £12k pa GP receptionist is going to want to confront a fraudster anymore than an A&E consultant wants to while they're trying to patch up an artery.

[Iamsparklyknickers]

[MmeLindor]

Yes, I agree Sparkly. I was just thinking that it is unfair to delegate this responsibility and hassle to the poor receptionists.

The only way to do it, is to have a requirement that to access healthcare, patients must have a card - In Germany, it is issued by health insurance, and has name and address on the electronic chip, and photo on the card - see here

When you go to the GP, the receptionist puts the card into the reader and can see if you are insured. Not sure what they do if you don't have insurance, but having this system would prevent some fraud.

It won't be cheap to implement though, and that is where we are back to the OP's question.

[canyou]

many moons ago I ended up in a UK Hosp I gave them my holiday health insurance policy etc they never processed the claim for a week stay a&e and ambulance. Fast forward two yrs my Aunt was in IRL and visited a&e after a fall, 3 weeks home she was incensed to receive paper work from NHS asking her to confirm treatment etc from an Irish Hosp. The Irish Hosp Had billed her local trust from the details sh had given them. She could not understand why it was not free like in the UK where it is not free you just pay in before you need it

[ICBINEG]

hmmm I am a negligent OP...

this became all about the NHs...which it isn't...it is about all the ridiculous policy driven initiatives....

This morning labour were banging on about identifying themselves to the public...with policy.

How about someone saying we aren't for or against anything in particular we policy wise and just sticking to trying to achieve the things that everyone genuinely does agree on...

like...erm...

equal opportunity for kids....
education regardless of income
health care regardless of income....
teenagers that know the difference between porn and real sex....

and will vow to do these things in the most efficient way possible, regardless of what that might entail.

[rainrainandmorerain]

To go back to your op, OP -

I feel this way about prisons. They don't work as a deterrent. They are very expensive. They can actually generate more crime (you put a young/minor criminal in prison, they make contacts and learn more crime - it's like crime school).

But any politician can score points by demanding criminals are 'locked up'. Even if you tell people prison doesn't work in terms of reducing crime or preventing re-offending, they still want to see criminals in prison because of some notion of punishment.

So what you get are people who like the idea of someone being punished even if it means MORE victims in the long run.

The things to do tend to work (interventions to stop reoffending), or work better than prison, are seen as not desirable because they are not nasty enough. Go figure.

[ICBINEG]

fantastic example!

I will add that to the list...

[edam]

YY, that is very true about prisons.

Same with transport. Cheap, frequent public transport is a great investment. It pays for itself over and over again, in boosting the economy, reducing congestion and accidents, encouraging employment, helping people get out and about which is good for the economy and for health (esp. for the elderly and vulnerable, being able to get around and see people keeps them well). Taking traffic off the road saves lives and reduces costs to the emergency services. All this is proven - the experiment has been done.

Yet have governments listened? No, they've pushed up both subsidies to private rail companies AND ticket prices for passengers, so we have the most expensive rail in Europe, while bus services are being cut. Bad for taxpayers, bad for passengers, bad for the public, the economy, the emergency services... Ridiculous.

I don't think stupid policies penalising people on benefits do anything to reduce prejudice against people on benefits, btw, - quite the reverse. The government is deliberately stoking resentment, using entirely false figures (had to apologise to the ONS over this) and then pretending they have a great solution to a very minor problem.

It's a pathetic attempt to make the government look good. It's also hugely expensive - Universal Credit is shaping up to be yet another massively failing big government IT project (Blair, Brown and Cameron have all fallen into this trap). It will be bad for the taxpayer and miserable for anyone caught up in it... but who cares as long as the government gets to show off, briefly?

[cumfy]

These are politicians, remember.

If they had any interest in, or could do anything useful they would have chosen medicine, engineering or science as a career.

Expecting politicians to do anything sensible is akin to hoping water will run uphill.

The poor darlings just want to get re-elected.