To wonder if perhaps the answer is just to stop paying?

[Resurgam2016]

Listening to the radio the other day and there was a South African lady who was having kidney dialysis in the UK because she couldn't afford it in her home country. Apparently in SA they don't fund this treatment for the over 65's. There just isn't the money. She was a medical tourist but that is another issue entirely.

So what if we contemplated something similar to help 'save' the NHS? No treatment for life limiting conditions over, say 70 years. No treatment for conditions that are not life saving (so fertility treatment or breast rebuilding for example). Making people (or their relatives) pay for all but the medical care they receive (so food etc.). It's a horrible thought but maybe the answer?

FYI I have a chronic illness so might well be 'caught' under these new rules. I'm just wondering if it is 'acceptable' in SA why we don't debate it here.

Lengthy post. Sums up the problem as the word patient hardly figures.

We need to stop talking about reducing care as if that will solve it. Yes there are discussions needed but the biggest waste is at the top. I know because I work with them.

A chilling but highly accurate summary, coldfeet

They sound like parasites who are steadily killing the host ColdFeet

I'm not actually sure that they recognise their culpability.

They see themselves as part of the solution....the intelligent strategists planning sustainability for the NHS

I suspect many of them are also privately relived to have climbed the greasy pole far enough to not be one of the poor sods at the bottom.

Meanwhile social media argues about who should be denied healthcare. Infertile single mums, alcoholics, overweight, the elderly, the premature.

Barking mad.

ColdFeet - send that to Theresa May, please. Excellent, excellent work.

Would anyone listen? Everyone is so distracted by arguing about where we should cut services and who are to blame ....staff, managers (they blame the wrong ones, aiming too low), patients, inefficient IT... All of those factors need attention but it's like tipping a jug of water whilst plugging a pinhole in it and thinking that's where the water is going.

The problems I identify won't be heard with much enthusiasm because those people who would be high enough to direct change are the ones who will be threatened by directing cuts at their level. They are very capable of writing reports to demonstrate how important their roles are.

ColdFeet - you're probably right, but it's all so depressing....

I've done the probably unforgivable thing of not RTFT, but another poster highlight this from SmilingbutClueless:

"Free prescriptions also need to be looked at. No reason why OAPs should be exempt if they can afford to pay. And in terms of free prescriptions for medical conditions (which I also personally benefit from), it might be better to give free medication for the treatment of that condition but pay for everything else (maybe have a box for the doctor to tick when prescribing)."

This is something I feel strongly about but don't know what to do about it. DH and I are retired. We're comfortably off - no worries about paying bills, car, Sky, etc. We do have fairly standard older-person problems of high cholesterol/blood pressure, for which we get free prescriptions.

I'm on Ramipril and Amlodopine. I have no idea what they cost the NHS, and anyway the whole process is so automated that I don't even get a prescription, it goes straight to the pharmacy and it's dispensed free automatically because of my age.

There's no option, it seems, for me to contribute either in part or in full for my medical treatment.

We also get the OAP winter fuel allowance, which we don't need. I can understand that, however, because it's more cost effective to give that to everyone receiving a state pension rather than trying to put means-testing in place.

State-wide and age-related benefits systems are a monolith, and back in the past providing blanket care would have made sense given the sheer numbers of people involved and the limited (paper-based) systems available. But things could be done better now, with more sophisticated computer systems.

As an example: DH and I get separate letters informing us that the winter fuel allowance is going to be paid. Would it be so difficult for that letter to include an opt-out option?

I'm due a review with my GP soon. It would be a waste of his time (given how much pressure GPs are under these days) to ask if there's a way of paying, at least in part, for my medications. If there is a way, it's certainly not what most GPs would like to advertise as that could guilt-trip some patients, while being ignored by others.

Something does need to be done. Costs have spiralled to the point of being almost out of control. The last thing anyone wants is for the NHS and state pension systems to implode under the burden. It's an automatic opt-in system, but I think there should be an optional opt-out, at least in part. That would put the money back into the coffers for those who really need it.

The problems I identify won't be heard with much enthusiasm because those people who would be high enough to direct change are the ones who will be threatened by directing cuts at their level. They are very capable of writing reports to demonstrate how important their roles are

This ... just THIS ^^

You and I need to head to the pub to drown our sorrow over the demise of the NHS puzzled

ColdFeetinWinter That should be the definitive post for the problems with the NHS.

Thank you for those comments. I'm passionate about delivering a good NHS. I'm distressed at the waste and also the hypocrisy of expensive wages being spent causing that waste whilst blaming the lowest paid and hardest working.

ColdFeet - sounds a bit like some charities I know, too... Indeed, many organisations. Management Consultants and their ilk hv a lot to answer for.

There's plenty of money to fund the NHS; The issue has never been a lack of money, just a government who refuse to allocate it correctly.

I for one would be entirely opposed to paying any more tax, why should the people continue to fund the lifestyles of the privileged? We shouldn't - It's insane for anyone to even suggest that the burden of additional funding should fall on the shoulders of the average workers.

The money is there but the British state would rather spend it on frivolous things that benefit very few, people are very naive if they genuinely believe that there's no money to sustain (and improve) the health service.

ANYBODY in need of sincere medical care should receive it regardless of their age!

Applause for ColdFeetinWinter. A perfect summary of what is wrong. It unfortunately is the same for pretty much any governmental body.

They will religiously audit the books for the fine detail such as (for expenses) matching a night in a hotel to the staff grade, but completely fail to spot colossal waste, because it is just ‘part of the system’.

They never stand back and look at the big picture, for example, Staff Nurse £25,000 (coal face) and Change Manager £75,000 (no idea where the coal face even is).

Walking from the wards to the HR department is like returning from ice-laden Narnia to a feasting banquet hall.

I'd be happy to pay more tax to prop up the NHS. In an ageing and growing population there is no alternative.

We ought to celebrate the huge advances in medicine allowing us to live longer. Making our ageing population an excuse for years (and years and years) of mismanagement - across all governments, is a disgrace.

And where the fuck is Jeremy Hunt these days.... the Hospital series shown on the BBC has been damning and and again, not a squeak from JH.

Ha! He's ON! And yes...within one minute, he's banging on about "the ageing population".

When the financial crash came, our Govt. decided that the way to drag us out of the resulting austerity was to make cuts on the most vulnerable. Mental health services, social care etc. And here we are. Buggerall in the pot, no care home beds, local councils providing the absolute minimum per head per patient for home/social care. George Osborne should be ashamed of himself. But no, it's our OWN fault for living too long.

You and I need to head to the pub to drown our sorrow over the demise of the NHS puzzled

Just name the place and time

I perhaps ought to mention that my experience is with local authorities whereas yours is with the NHS, but it's clear that we both recognise the mindsets only too well - and it's those mindsets which will fight against change at all costs, in defence of their own wastrel positions

And that is why I keep saying that "more money" isn't necessarily the answer

"I hope they all become little old ladies. Because the alternative is worse."
That's a matter of opinion.
There's not much worse for all concerned than dementia.

I meant that either you get old, or you die. (sorry, I think it's a Woody Allen joke ...)

And I've seen elderly family members with dementia, but you know, I've also seen them fight valiantly and gloriously to stay alive. Who are we to judge quality of life from the outside?

But my comment on MN ageism still stands. What worries me particularly is the arrogance of young mothers, who seem to think that elderly women, in particular, have passed their use-by date and should just STFU. I see it in many of the MiL threads.

As I say, I genuinely hope that all the young complainers have a chance to grow old.

The complete refusal to recognise that money spent on staff who actually give face to face care to patients is cheaper than all the money wasted on strategies to manage the issues caused by not enough money spent on staff who actually are face to face with patients.

coldfeet that rings great clanging bells with what I've seen in other organisations (inc private sector).

It pisses me off when I see yet another restructuring being cheered and praised for "cutting management", "cutting admin staff".

When what they're actually doing is cutting the firefighter tier (and below!) and dumping the jobs done by those people onto the coal face people.

Your idea is beyond stupid and am sure my 79 year old grandma who has had cancer treatment would've really loved that idea or better yet my 90 year old nan who sadly died in January am sure she would've loved being refused any treatment or maybe even my parents who both have chronic illnesses or all the people with dementia in the nursing home that I work in. See how many people your stupid idea would effect.