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?

It's impossible to know whether an NHS-style system is better or worse than a German, Swiss or French system, until we give it the same amount of funding they give theirs.

For a very small percentage increase in funding, we could have a vastly improved service, because each tiny shortfall causes many times itself on other costs.

Very simple example: person has condition X. Person is

a) seen in 3 days by adequately-funded GP service, it's fixed, they get better

or

b) can't be seen for three weeks, they've deteriorated, more expensive treatment is required

or

c) can't be seen for three weeks, goes for expensive A&E appointment instead

Simple example 2:

Person has complex severe condition that ten years ago would've merited inpatient treatment. There aren't enough beds being funded for that person to be treated as an inpatient any more - those beds are used for only the most extreme cases. Instead, our patient is taken on by the community team. Their condition takes a lot of staff time - three people who would've been under the community team are now discharged to GP care instead. GP can't provide the specialist care that would help them recover, or at least lead worthwhile lives. They go on being ill, costing money, and taking up large amounts of GP time which doesn't help nearly as much as a shorter amount of time with the community team would. Now there are many, many fewer GP appointments available, GPs know if they refer anyone who isn't seriously ill they'll just get sent straight back, and lots of people with a mild version of the condition struggle to get an appointment at all. (This is what we have in mental health services right now.)

Another example:

A patient can't get a timely referral. They remain iller than they should be. They can't work, and have to go on benefits.

The knock-on effects and costs of under-funding the NHS by even a very tiny amount puts enormous extra pressure on benefits, social services, other parts of the NHS, etc.

pausing a number of posters have already provided descriptions here which are sufficient for the level of this thread but feel free to do your own research. I am not a business analyst, nor am I a healthcare expert but have had experience of other systems and know there is a better alternative. Yes, it may cost more, either through taxation or top up payments, but it'll be less expensive than putting more into a system which will still continue to provide substandard care. Maybe then we will be able to fund things like preventative medicine, appropriate healthcare for children and old people (i.e. paediatric GPs, Geriatric specialists etc.).

I think as well, a large part of it has to come from encouraging people to live healthier lifestyles - which is sort of what stevie is saying with her "preventative medicine".

Our food industry needs overhauled, we need better family education for looking after and preventing health problems in the home. We really need to look at why smoking and alcohol are so acceptable, and why the high taxes on these products have not really made a significant dent in changing this.

We need to help children become more resilient both by improving access to mental health services for children (immediate access), but also by changing the way children are viewed by society - we need to start giving them the tools to build their own resilience rather than putting them in a box and using that box to define what that child can achieve etc.

I work for the NHS and without sounding too bias, which I will. Even though it has its fuck ups, badly run by clip board divas who are mainly accountants and have never worked in healthcare on a ward etc. The NHS is one of the best services this country has to offer . The whole service needs scrapping and starting again, I personally wouldn't know where to begin because there are too many gaps in funding etc.
I have health issues that I wouldn't be able to afford if I went private. The operation my daughter had to save her leg, I couldn't pay for. The NHS did brilliant , she had excellent care at 2 NHS hospitals and has 2 legs!

Mountain I mean things like annual Pap smears. Mammograms for younger women. That's what I mean by preventative medicine. I agree that public education is intrinsic but that's not an NHS responsibility necessarily.

I will also add, on the icu I work we have admissions from the private hospitals because they don't have emergency care. They won't get money back . We may of lost out on the £6k ( or there abouts) hip job . But these poor people had to mix with the commoners 🙄

I'm baffled why people think that a not for profit service is more expensive than one that has to make a profit for shareholders.
Or that it has to somehow be run less effectively.

Totally agree with this. The idea of a private, health insurance system based on the US model is not one that I would welcome. I would personally rather see our system fixed and if I have to pay more tax so that we all have access to healthcare regardless of circumstances then so be it. I am not against the idea of some additional charges within the NHS but I am proud of our healthcare system for all its faults.

Pausing - I think there are two reasons why the NHS is in the mess it's in: no one has all the answers, and no-one is really prepared to think about it because it is publicly unacceptable. That's the point Stevie77 was making.

We could pay more tax and keep everything else the same. We could ration healthcare (wait - we already do that through NICE) or raise thresholds for access, and increase waiting times.

We could change the funding system to an insurance model (which - yay! - depoliticises it) and then start to tinker with co-pays to reduce demand, or perhaps even adjust premiums downwards for people who don't smoke, have regular check-ups, and aren't lard-arses, and upwards for everyone else. This could be social insurance or private, or even a mix.

We could privatise the provision system or parts of it, so that managers are incentivised to make sensible decisions. I could write books on the things NHS managers get away with because there are no consequences.

Or we could get the state out of the business of providing services altogether and leave everyone to themselves. I personally don't think that's right for UK health, but it's the first thing I'd do with pensions, Stevie, come the revolution!

YABU. Naive and silly, too.

We spend less on healthcare than most other European countries. You want better healthcare? You have to be prepared to be taxed more.

There are many problems with the NHS. When it was designed in the 1940's as a free at the point of delivery service it could not have been anticipated at the time the number of chronic long term
Health conditions that people are now living with. Furthermore it has become a victim of its own success with life expectancy increasing but with all the attendant problems this brings. Long term health conditions linked to obesity alone are costing the NHS billions. No one wants to acknowledge this and look at ways to to stop theses conditions arising in the first place. That would take investment elsewhere and in reducing poverty and inequality, theses are not popular vote winners. Middle England want a Free health service but they are not prepared to pay higher taxes to prevent socio economic problems which ultimately drain this service. The NHS cannot be looked at in a vacuum. It has to be looked at alongside lifestyle changes and social care in a holistic fashion. Only then can you begin to get a modern free service which is fit for purpose. Also small things like people visiting Gp's for things which resolve themselves in a few days should be targeted. Quite often many minor ailments get better on their own or with an over the counter treatment from the pharmacist. Small changes can make a big difference.

Absolutely, Sock.

And vice versa.

There has been an active cut to the health and social care budget. Not a failure to keep up with inflation, but an actual cut.

Social care, which keeps people as well as possible and out of hospital, used to be the responsibility of local councils. Central govt funding to local councils was slashed, so their social care spend had to be cut. (No choice, but it's at one remove so central govt pretend their hands are clean.)

The cuts to social care have knocked on to the NHS with avoidable admissions and bed-blocking.

Since the Health and Social Care Act, some (most?) of the job of social care has been moved from councils to the NHS but the money hasn't.

Central govt puffed itself up with big announcement that it was increasing spending to the NHS, but IIUC, the amount of money added to the NHS budget for the additional job of social care is less than that the councils had for the job even after the cuts. It's certainly less than they were spending before the cuts.

So net, this is a cut to the NHS.

Now giving more of the responsibility for social care to the NHS could work well. There was always a conflict of interest when councils saved their own money by costing the NHS lots. And there's room for more co-ordinated care. BUT ONLY IF ALL THIS IS FUNDED.

What's actually happened is a sleight of hand, where the Tories claimed to have given more money to the NHS while effectively making a cut.

This also highlights how tricky it is to do cross-country comparisons of healthcare spend - because the social care end of things varies hugely and isn't always accounted for.

I live in the US and receive healthcare insurance via my husbands company. its a large multi national with thousands of employees so is in a good negotiating position with regards to cost of packages. However it still costs us $400 per month for insurance. On top of this, we have to pay out of pocket for $1500 worth of services (except some preventative stuff - annual GP checkup & OBGYN checkup) before insurance will pay for anything. Plus i have to pay $30 every time I go to see a doctor. I had to have an injection in my back near my spine. About 50% of the injection cost was covered so I paid around $350 all in. However, the anesthetic that I needed in order to have the op wasn't covered under insurance as the company deemed it "unnecessary". My doctors view was that he preferred not to stick a large needle into my back 1 inch from my spine whilst I was awake, so I paid for this out of pocket. That was another $500. Luckily I can afford this but I dread to think what I would do if I couldn't. Is the NHS perfect? No. But at its worst, its 1000% better than the other options.

And there are parts of the NHS that have already been privatised, and have failed drastically. Such as the previous centre of excellence in Nottingham that dealt with dermatology. The centre has went from one that was a recognised centre of excellence, to one that has to send patients elsewhere because it can not see them and not meet their needs.
Catering services which have often been privatised for decades are also an area that has been a disaster in many hospitals. And catering is a damn sight easier to provide than medical care.
The reality is the private sector want the easy patients to treat. The fit 30 year old who needs elective surgery. They don't want the 90 year old with dementia, multiple health problems, who is having constant treatment.

And there is a false idea that because healthcare is free at the point of delivery here, we do not take care of our health. In the US that is not the case. And yet they have more obese people than us. Life is far more complicated than many of these so called simple ideas portray.

YABVU. I live in the USA and the healthcare for profit system here is a massive convoluted clusterfuck. It is nothing like BUPA, not even close. You have pharmaceutical companies, insurance companies and hospitals all competing for the privilege of who can take the most figurative arms and legs from the patients.
I'm a fairly intelligent and literate person but trying to work out even the barest outlines of what my workplace insurance covers me for is beyond me. There is very little they can do apparently that doesn't involve a massive co-pay or deductible or paying extra because they insist on this drug and the hospital ( in the pocket of the drug company) wants to prescribe the other drug or bring in an out of network practitioner to put on a bandaid which will be itemized on the final bill as costing $300.

My DH changed jobs and therefore his insurance was changed, new job offers slightly better coverage in some areas but less in others. He has sleep apnoea so uses a cpap machine issued by previous insurance, new insurance doesn't cover it so when previous insurance demanded it back, oh yes they did, we had to buy our own. It's a fucking nightmare.

Paying for medical services privately is not illegal in this country. We pay less per head for the NHS than Americans do for Medicare and Medicaid which the majority cannot access. So if you want it private, go ahead. But if you think it's impossible for a private clinic to be running late, you may be in for a bit of a shock...

Speak to anyone who pays for private medical insurance in America and they will tell you that we are so lucky to have the NHS. Private does not always mean better it means that companies are in it to make a profit. Who wants that?

Honestly OP, read patients online talking about attending the private dermatology centre in Nottingham and comparing it to attending the NHS centre of excellence dermatology centre before it was privatised.
And I am surprised after we have had various private firms make a mess out of delivering public services, that anyone can still think privatisation is a magic bullet. G4 providing security at the Olympic Games and Southern Rail are two that spring to mind as enormous fuck ups of gigantic proportion.

You supposedly want proper discussion of what future healthcare system the UK should have.

But when I ask you to give details of what you want, you say Ask someone else?

Mm.

OK, well putting together what you've said, with random "other people on the thread" as you've referred me to unspecific posters, do I correctly divine that you mean both that:

• you want to pay more for your healthcare, and
• you want different people to receive different levels of healthcare (according to money, not according to need)?

I'd rather you told me what you meant, though.

(And no, no one on this thread has described how any system is more cost-effective - although they've described systems which spend more per capita. Doesn't mean a more cost-effective system doesn't exist, but I haven't seen one detailed on this thread. I'm interested in the method by which such a system would achieve greater cost-effectiveness, so this detail matters - especially given the inherent inefficiency of admin and billing between multiple fragmented organisations.)

It's funding rather than the NHS itself that's the problem, isn't it? I don't live in the UK at the minute and one of the few things that puts me off returning is the underfunded health system. I like being able to call into the GP on the way home from the morning school run and get an after school appointment. I like having a private room in hospital. I like rapid referrals and easy access to specialists. The UK doesn't have this stuff because the people running the government don't think it's worth it. I disagree.

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

THIS

Dear Jeremy and the Daily Fail.
We may bicker among ourselves, but we ALL loathe you.

Actual LOL at the thought of reduced waiting times for appts. Yeah, I wanna live in that fantasy parallel universe of private health care.

I have a pre existing condition. How would someone like me get insurance?