To think a privatised health service would be an improvement?

[WhiteStars]

At the moment we all have to be grateful for the overstretched and often inefficient service we receive. I had a 9am appointment today with a nurse practitioner. At that time in the morning she was already running 25 mins late on her appointments- how?!

She also couldn't use her computer system so I had to then wait for a doctor to come and issue the standard repeat prescription (I couldn't get this over the phone as needed a blood pressure check). The doctor then issued the wrong medication and only corrected it when I noticed she had done the wrong thing on the screen.

All very minor but not a great service at all really. We all know how over stretched the service is and everyone says it's at breaking point. Why is everyone so against paying for health insurance and getting a better service or going private?

It's not uncommon to hear of people waiting weeks to get an appointment and not being able to book in advance. The government would save an inordinate amount of money that could be ploughed into schools whilst subsidising some health services but with people paying an annual health insurance fee. We already pay for prescriptions in England. I would rather have a better private service than the NHS as it is now- on it's last legs and not really fit for purpose any more. AIBU?

Have used the nhs a lot recently - never kept waiting, most if the time I have been seen before appointment time. I don't think you have enough data with one late appointment to extrapolate.

Seems very efficient to me. Operated on within a week of finding I have cancer. And that was with Christmas in the middle! Not sure how more efficient you'd like! It was only three weeks ago I was umming and ah ing about a lump...

YABVU - if you understood the way the system works here in the USA, you would not want it. It is incredibly expensive (even with employer-based insurance), bureaucratic and stressful. If you can't get employer insurance then insurance through the Obamacare exchanges can be expensive and basically useless, depending on where you live. My sister-in-law is paying $200 a month after subsidies but her excess is $7000. That is a fortune for her. Our excess is $3500, but last year when I had an in-patient surgery procedure, it turned out that my anaesthesiologist (whose name I was told the day before the procedure) didn't accept my insurance so I had to pay an extra $1500. There was no way of me finding this out in advance. It is a nightmare.

Healthcare is expensive in general - I believe the USA spends double what the UK does on health care per capita. Government spending per capita on healthcare is more in the USA than in the UK, even though only a limited range of people are covered.

The NHS isn't perfect, but it runs on less money per capita (we are 17th on spending for OECD countries) than almost any of the systems in northern Europe. I'm sure there is room for organizational change (or perhaps we should elect politicians who promise not to keep on making expensive and pointless changes), but you can't ignore the funding differences: en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

I think my point was that in a private system I imagine less attention would be paid to finding the right meds with the most tolerable side effects in spite of cost.

Fair point.

I think the NHS at the moment can only manage to treat people if they are going to die soon without treatment.

This is simply absolute horseshit. Thousands of people are treated every day on the NHS for things that are not life-threatening, or even serious.

I saw an old lady begging for her ears to be syringed as she couldn't hear. The GP receptionist simply told her there were no appointments and the old lady had to just go away. Thats the sort of thing I think clinics could be used for.

First of all, most doctors will tell you that you shouldn't have your ears syringed unless you've been using drops to soften the wax for about a week first (otherwise the syringing can damage the ear drum) so even if they'd had an appointment available that day, they wouldn't have been able to syringe her ears.

Secondly, if by 'clinics' you mean private clinics that do those kind of minor, non-urgent procedures for a fee, those already exist.

My DP has an ear problem that means he has to get his ears syringed about once a year; sometimes he gets it done by the nurse at the NHS GP's surgery and sometimes he pays to get it done at a clinic. Either way he usually has to spend at least a week being deaf as a post while he administers the drops required to soften the wax first.

In short I think under a fully private system mental health services would be fucked. It's already underfunded as it is.

I never got the whole privatisation argument in any sphere. So you take a business that is a bit shit, but which is owned by us, joe public, and you sell it to private individuals. The business then has to pay out dividends to the shareholders in addition to the costs it was bearing previously, so if it has to either radically cut costs or increase its income, i.e. the amount it charges us - either way, we the consumers are very unlikely to benefit. See rail services, utilities etc etc. We have some choice but competition hasn't really driven down costs in the way it was supposed to.

When we are talking about the wellbeing and lives of people, I genuinely cannot see how privatisation can improve the delivery of services. Privatised healthcare only gets to be 'efficient' by not handling all the tricky and expensive bits of healthcare.

I had a 9am appointment today with a nurse practitioner. At that time in the morning she was already running 25 mins late on her appointments- how?!

My nurse practitioner colleague starts her morning clinic at 0730. She has a patient booked every 10 minutes. By 0900 she could have seen 9 patients. If each patient took 3 minutes longer than their allocated time she would have been running nearly half an hour late by 0900. Some patients can be seen quicker, but not many. Some take 5 minutes to get into the consulting room and take their coat off before you've even started to take a history, assess them and action the findings. Oh and then record it accurately, completely and contemporaneously on the computer.

Add in computer issues, queries from colleagues, problematic consultations, the need to arrange admission to hospital (waiting on the phone for the on call bleep holder to call you back...) if you can't see why HCPs run late you need an MRI to check if you have a brain IMO.

Just give the doctors and nurses more time for appointments I hear you cry! Yes, then your chance of getting an appointment becomes even slimmer and your 3 week wait for a routine appointment stretches to 5 or 6 weeks.

The NHS isn't perfect. It's a very very long way from perfect but its all we've got right now, and not for much longer.

Why do people talk like there are two systems in the world. Uk or USA.

WHat about a European system?

The alternative to the UK system isn't just the US system as a few on this thread have stated and demonstrated. It's not just a choice between bad and worse. There are a number of hybrid systems worldwide, that are a million times better than how the NHS works. If you ask anyone who's used such a system they'll tell you.

But people in this country always end up in hysterics (example, this thread) when even the notion of discussing this is brought up. It is such a sacred cow that no politician and/party will ever be brave enough to say the truth - a fully funded, free access system cannot cope with ageing population, increasingly expensive medical and care costs and no mechanisms to stop access of those not entitled. It was a fine idea post-war but the world and medicine has changed greatly since.

We cannot save the NHS by ploughing more money into it, the way the system is set up is fundamentally flawed. The public needs to grow up and be willing to consider other ways of keeping the NHS.

Stevie77 - excellent post. Are we allowed to say the same about the state pension system, and any other public service sacred cows?

The OP has vanished.

I give this thread 4 hours to appear in the Daily Heil

Hi from the U.S.

All of that happens here, and you have to pay for it. Wait times are horrific, health care is only for the wealthy. Six weeks to see a psychiatrist. Four to see an orthopaedic specialist. Weeks to see a GP. And all of these options ONLY available to you on insurance if the office TAKES your insurance -- they don't all participate with all providers, or even all plans offered in a provider! So I can go to a doctor and find out they take Horizon but not Horizon's OMNIA plan and be stuck with the full cost.

The lowest cost health insurance plan for my family is about $1200 per month. My parents, who are nearing retirement age, pay $2400 a month and it has gone up every year for the last 15 years.

Some employers do subsidise health care for employees, which brings things down to a more manageable level if you qualify. And then you are stuck in a job because your health cover is tied to it leave the job, and your coverage ends. Even if you're lucky enough to be walking into a new job, you'll be uncovered during the new employer's probation period and paying for COBRA (during which my family's $1200 per month cover now costs us $3600 per month, as the employer subsidy is gone.)

I miss the NHS.

The nurse was probably doing house calls before 9am.

If the whole system goes private then you will be seeing the same people as you were seeing before anyway.

We have full coverage private insurance and the cost is phenomenal - it's through the roof at over 1000 per month (thankfully DPs employer pays it). I still use the NHS for 90% of my healthcare needs. Private insurance doesn't necessarily mean better health care, particularly in emergency situations.

Certainly wouldn't be an improvement for people unable to afford the use of a private health service .

The nurse may have had a difficult smear test, done an STI screen on a woman who was recently raped, been doing a health check on someone who was recently bereaved.

I by the way, bloody love our practice nurses. They are the best.

The "better" hybrid systems you refer to, Stevie, generally have more spent on them per capita than the NHS.

So which is it?

You want to spend more?

Or we cannot plough more money into healthcare?

Of course it is in the private providers interest to promote tests, and do additional procedures.

"They gave me a full checkup..." Translates as they made me pay for an ECG which isn't needed and won't alter my care and a blood test, again which no one needs to know!
The punter is none the wiser...but poorer...but somehow feels more cared for, reassured that more tests are done (even if they aren't needed)

I work, I also have a chronic illness that requires lots of treatment. I would not be able to afford to pay for private health insurance. All private health insurance has co pays. These add up. My family in the US have the same genetic illness and all are dying younger than our family here, because they can not afford the preventative healthcare that we get here.
Also they pay more for their healthcare.

a fully funded, free access system cannot cope with ageing population, increasingly expensive medical and care costs

And can you spell out EXACTLY what you mean here?

Because I was thinking just yesterday of starting a thread to ask what EXACTLY do some people mean when they say "the NHS cannot continue in its current form."

Do you mean, there's a magically more efficient way to spend existing funding, that gives everyone the same level of healthcare as now. (If so, please say what and describe how it's more efficient.)

Do you mean, let's have higher taxes, and continue to give everyone the same level of healthcare as now?

Do you mean, let's not give everyone the same level of healthcare? (If so, please say from whom you are proposing withdrawing healthcare. It would help if you would also say whether this includes your own family, and how you would expect to acquire for good care for your family.)

Or some other option I haven't listed? Please be explicit about it.

If we genuinely do want a "proper debate" about healthcare in the NHS, these are questions that need to be answered.

Don't get me started on pensions, Otherpeoplesteens! That's for a whole other thread, but an individual's pension pot should move with them wherever they work. Instead we have a system where workers have a number of small pots, by different providers, that never manage to grow any significant capital therefore will fail them at old age. No wonder they want us to work till we die!

pausingflatly they do, but not the proportions that would be required to "save" the NHS.

I like countless other posters assume this thread was started by someone in Jeremy hunts office.

Computer problems happen in the private sector too.

Sorry, that would have been better phrased, "please say from whom you are proposing withdrawing some healthcare, and specify what."

The private sector doesn't necessarily automatically run things better than anyone else.

Plus the private sector often seems to need injections of cash by the government which means it's still very costly for the consumer both in terms of point of purchase AND taxation.

Double uppercut for us again.

I thinking the banks, railways etc.