To wonder how long it will be before the NHS ceases to exist?

[DuchessofNorks]

3 years? 5 years? How long will it be before those deemed "rich" enough will have to pay through the nose for health insurance?

Grovel

Nope, more a Private Eye person myself!

We do already pay for prescriptions, appointments and everything else in the NHS, through our taxes.

The NHS is manifestly no longer fit for purpose. we are limping along with a tired old antiquated system that we keep tinkering with and it still doesn't work. how many people pitch up at casualty and are not UK tax payers? why are we treating them? how many people make lifestyle choices like drugs, drink and obesity and we treat them. even fertility treatment. why do we pay for this. what I am saying isn't popular with lots of people I know but really we have to look at the whole system afresh. we need it to target UK citizens only with illnesses. Not be there to deal for the umpteenth time with the Saturday night drunk or pay for someones tattoo removal. more importantly our hospitals don't treat the sick any more, they are mainly old peoples homes holding on to old people that they cant send home or into family or other care. someone needs to get a piece of paper and start again. stop tinkering with it, its bust. start again with a system that meets current needs.

personally I would make anyone with a sporting injury pay full whack - they are just abusing the system.

The NHS is cheap compared to most comparable healthcare systems in Europe. Charging patients means putting in place a bureaucracy to collect, process and chase payments. This requires employing large numbers of clerks, accounts assistants, IT professionals etc etc.

That said, I do think that the debate in the UK has become very poisoned and polarized. The French system provides excellent care from a system that requires all but the least affluent to contribute to the cost of their treatment (those pesky socialists eh!), and where both the private and the mutual sector play a large role.

One of the problems with the privatization model in the UK is that is it often a byword for enriching the friends-of-Dave. It doesn't have to be like that - there is a third way.

However, no improvement will be possible without spending more. French and German healthcare spending is about 20-25% higher than in the UK, and this explains much of the difference in quality of service.

Incidentally re sports injuries, the french system does not cover these. Anyone practicising competitive sport in a club is required to take out a licence which includes insurance to cover the cost of healthcare in the event of an accident. The system can and will recover costs from insurers.

threegoingonthirty I was probably a bit snappy about that - sorry. I just felt that perhaps the phrase "she can't be bothered" with contraception, in explanation of why someone required another termination, had more than a hint of judgment/potential misunderstanding about it. But I don't know your patients, so shouldn't have snapped.
(I was also probably reminded of a FB friend of mine who is a GP and bitches rather publicly about people coming to her with mental health issues. Which is not what you were doing at all).

However, I think that saying "The NHS will cease to exist because of the ridiculous demands the public put on it" massively overplays the part of suboptimal NHS use and underplays higher level managerial factors.

Side note: In the US, the safety net is Medicaid. This is the free government provided health coverage for those (very specific requirements) who are unable due to age (children or very elderly infirm) or a permanent, debilitating condition or illness and who do not have adequate income or assets to provide private insurance and aren't covered under an employer or family plan. Not an expert on this subject may have not stated exactly but you get the idea or comparing to NHS. There's also Medicare in place (some parts optional/billed and not 100%) for any person 65 and older. A very extreme example: I worked with a young lady (about 10 years ago) whose father received a heart transplant on Medicaid. I should also mention that, of course, all people must be provided transport, emergency room care, and hospitalization in the case of an accident or potentially dangerous illness or injury. (The billing, unless on Medicaid, of course, is another matter and can be massive. Hospitals involved must "eat" these emergency unpaid costs most of the time.) There are also public health departments for free inoculations, certain tests, etc. The rest of US health care is a balance between private insurance and its costs and deductibles/percent covered and employer-provided insurance plans with the same issues or combinations, with all the accompanying problems everyone has heard about. But no one is left just to suffer and die, as you have been led to believe! Care in the US is costly for those who are expected to be able to pay, but it is or has been "patient" driven. Too early to tell whether the ACA has really improved anything or the costs.

Forgot to mention that nursing home care, when necessary, can also be paid by Medicaid. The choices of nursing homes, of course, are very limited, but again care is provided at no up front cost to the patient. If the patient owns his/her personal house/residence at the time of death, the cumulative moneys paid out by Medicaid may be subtracted and claimed by government/Medicaid from the estate before the estate is settled.

The NHS is unsustainable in it's present form - zero cost = infinite demand. Whatever party is in power, there will have to be changes and that inevitably will involve some payment by patients. at leasy the Conservatives are prepared to challenge and change the NHS, even if they haven't got it right, it's a start. Better that than to pretend everything in the NHS is perfect and then let scandals like Stafford happen.

I think anyone admitted to hospital because they have fallen down drunk should be charged. If you hurt yourself because you take part in a dangerous sport such as climbing, racing cars etc, you should take out insurance and pay. Why should the truly vulnerable suffer because money is being wasted on self inflicted injuries and illnesses?

My dh works for the nhs in our local trust, his department is really under pressure.

In his office there are a handful of middle managers that have worked their way up to a high pay band over the years, who do literally nothing. They waste time by going to meetings (that they arrange) flapping about and generally trying to make themselves useful.
If they were employed in the private sector they would be let go because they are just not needed.
If the nhs streamlined and got rid of some admin roles that are not needed anymore, they would save so much money. But they never seem to be let go, instead they move nurses onto lower pay bands. While useless managers in admin keep their band 7 pay because they have been there for years.