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.

OK @pleasantpheasant so tax aside on the assumption that the size of the NHS money pot will not change significantly what should we consider?

Jeremy is that you?

Resurgam-if the pot isn't getting any bigger then what money is available still needs to be better spent.

I don't know how as I'm not in the medical profession but it's not being spent correctly at the moment is it?

My ds has to wait 5 months for an operation right now. An operation he needs because his everyday life and education is being affected-(obviously as his mum) it needs doing now

The UK spends 9.1% of its GDP on healthcare. $3935 per capita.
EU average is 10.0 % of GDP on healthcare. $3613 per capita
The US spends 17.1 % of GDP on healthcare. $9403 per capita.

data.worldbank.org/indicator/SH.XPD.TOTL.ZS

So yeah, what many PP said. It's not that the UK can't afford it, it's that we're choosing not to.

@vintageperfumista I wasn't just suggesting discussing (elderly) age cut offs but cut offs in every area.

Hmm yep, let's say that anyone who is over 70yo and therefore not a working person anymore is someone who has no value anymore and let them die.
Oh and do that for chronic illnesses too so that would include cancer.

No treatment for things that aren't life saving so no preventive actions let's say on diet for diabetes oops, that's already the case anyway

You do realise that sort of rules would just put a large part of the population on death row don't you??

Do we have a 'National' Health Service or not? The key word is National. This implies without strings.

I did also read something somewhere, comparing European funding with that of the UK and I remember thinking that we were quite low on the list. Here's an article to be going with anyway: www.theguardian.com/society/2016/jan/20/nhs-funding-falling-behind-european-neighbours-kings-fund-research

Buggrit - 65? I'm 62 and don't get my state pension till I'm 66. Seems a bit harsh to be on the scrap heap even before I'm a drain on the state.

And actually I agree with the pp who said means testing on lifestyle choices too.

I don't see why someone who chooses to overeat gets money spent on them before my dcs treatment for example (I agree I'm bias)

People need to remember o look past current politics and realise that the NHS it totally affordable but is being starved of cash in order for us to be primed for an American style private insurance provided by UNUM.

Our great/grandparents set the NHS up with not much more than a wing and a prayer, while the country was on its knees post war. We have ten times more than they did and yet we are allowing it to fail. The answer is to force our MPs into driving funding for the NHS back up to what it should be. At the same time we need to promote the hell out fresh , UK grown foods (even government subsidise them) to reduce obesity. Tax junk food to its limit, increase healthy food classes in school and out of hours sports provision to give kids a fighting chance at being healthy.

It wont happen though. Its horrifying how much of the NHS has been sold off and privatised when it belongs to the people. Give it 5 years and I bet people are moaning about how much they have to pay for their private health care copay.

My 3 year old is full of joy and life and you would never know anything is wrong with her if you met her but she is classed as life limited. She has severe heart problems and the open heart surgeries she has are 'palliative' surgeries. So they are buying us precious years that will hopefully see her into young adulthood (but we have no idea). Should she be denied treatment? Because ultimately her life can't be 'saved' just prolonged?

And elderly people have paid in all their lives! How can they then be denied treatment? And the suggestion of family providing everything else like food etc- what about people with no family?

Very very grim.

Every area? What do you mean? Prosthetic limbs? Hearing aids? Hip replacement?

Again, horrific idea.

yeah, what many PP said. It's not that the UK can't afford it, it's that we're choosing not to.

And thats because we now need the money to do Brexit (that will cost a hell,of a lot of money, money to have the right people to negotiate, public servants to rehash all the laws, then negotiate new FTA and all the rest of it)
Hence the fact this government has already said it was reducing the amount spent per person on the NHS. When the situation is already described as a humanitarian crisis.

I would be in favour of stopping treatment that prolongs life in some cases and has an objective of making the patient comfortable and pain free as they die.

Hadenoughoftumble best wishes to you all

I completely disagree with an arbitrary upper age limit, unless it is so high to be effectively meaningless. As others have said, a 70-year old could carry on for another 20-30 years, still potentially contributing to society through working, volunteering, providing childcare, paying tax...

I agree that we should look at what treatment the NHS offers. NICE is one way of doing this but their decisions seem to be unpopular. I'd personally stop fertility treatment as no-one needs a baby (and I am speaking as someone who can't conceive naturally, before anyone jumps on me for that), and there are many options for private treatment. The more 'cosmetic' procedures I'm less sure about. Would you really deny breast reconstruction to someone who has undergone a mastectomy? Or plastic surgery to someone with extensive facial scarring?

Tbh what I am finding even mor scary is that you came on here thinking this could be a good idea in the first place.
It means that, as a population, we have been primed very well to accept that there will be no NHS and that's OK :(:(

Who decides which cases diamonds ?

The patient. Obviously, prior to their decline.

My dad is 95 and still pays tax on his private pension he saved up for, worked for 45 years and spent nearly 6 years in WW2. Pays full rent and bills ( a lot of which are also taxed), he doesnt receive benefits.
Do you think that now, because he doesnt pay NI, he shouldnt receive any help or an op if he needs one and because he is over 80, when he has lived here all his life and paid his way, never drunk or smoked and still can still walk around to the shops and so on?
I can see that happening in the future, but its wrong.

Thank you pleasant she's doing well at the moment

I don't agree on means testing, no.

Yes, people don't look after themselves sometimes but the reasons for this are sometimes complex and we would be better getting to the root cause than closing the door on people. For example, there is a strong link with obesity and poverty, drug and alcohol abuse with mental illness. If we close the door on people, we will still have people with the above problems walking around and they will be even sicker.

The idea of the Welfare State was to rid ourselves of the Workhouse culture and have a healthier nation. By and large, it has worked.

I would be in favour of stopping treatment that prolongs life in some cases and has an objective of making the patient comfortable and pain free as they die.

How do we do this though? Who decides and how?

I am absolutely not pro any sort of Logans Run style world. I just think its important to discuss what is acceptable and unacceptable (so fertility treatment for young couple vs new leg for life long smoker for example) given that in some places (and my example was SA) some very unacceptable ideas seem to be accepted.

We should move from a residence based system - where you receive treatment whether you have contributed or not - to a compulsory insurance system which is means tested. This would make no difference to most UK residents, certainly not to the poor, but would boost the amount of money available to the NHS while eliminating health tourism. No insurance card. No treatment other than emergency treatment.

We should insist that wealthy retired people, and those whose income is from property and investments, pay into the system. They currently pay tax but no NI. Why should pensioners with high incomes and those living from unearned income not have to pay?

And speaking of South Africans it would mean that those UK citizens who have spent their entire working lives in SA and then return to UK after retirement, would have to contribute in accordance with their means. Why should they be entitled to free health care when they have not contributed a penny towards the system?

I agree with Tinkly - and extra penny on the income tax to be spent WHOLLY on the health service wouldn't be too onerous and would provide a good amount of cash

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).