to ask Conservative voters what they think will happen to the NHS

[MyBeautifulSquid]

if they stay in after the GE?

Not gonna lie...I am a Labour voter. Not wanting a bunfight or trying to goad anyone ...I genuinely respect everyone's right to vote whatever way they think fit. However I am genuinely terrified of the prospect of losing the NHS ....like most people I am an ordinary earner just about getting by day to day, I cannot afford private healthcare, and doubt I ever will. I have friends in America...I have seen how the US system works.

My Facebook is a bit of a lefty echo chamber and lots are very active so I am constantly being bombarded with doom and gloom articles etc basically saying we will lose the NHS if Labour don't win.

Anyway like I say really don't want a fight, I am genuinely interested and do want to hear from the "other side" what they think.

The well respected European systems are more expensive than ours. The us system costs twice what ours does with little difference in outcomes and most of the money going to insurers and drug companies. If we want European standards, we have to fund it to the same level, either centrally though taxes or through some sort of copayment. All systems are looking to the future and worried about what ageing populations means for the cost of healthcare. There isn't a magic bullet!

Who provides the services is not that important - there are excellent NHS providers and excellent private providers and vice versa. The NHS isn't brilliant at procurement though so doesn't always get it right. And again where ideology and politics gets in the mix of those decisions it's even worse...

Imo we need to get rid of the commissioning and internal competition model. The NHS spends huge amounts of time and money pushing bits of money between different commissioning bodies and providers and arguing about who pays what. There are literally thousands of people employed in this practice it would be easier and cheaper to have annual provider budgets instead of commissioner budgets.

"It can't be beaten on the big, life saving/life changing issues, but doesn't work so well on the niggly stuff that would improve your life immeasurably if it could be sorted out quickly"

I seem to remember the UK lags behind much of Europe and US on cancer length of survival rates - I know there are difficulties in comparing like with like, but I'm not sure that it is 'unbeaten' on that.

(Though, survival rates I find conceptually difficult anyway - if you discover a cancer earlier then to some extent the patient will seem to survive longer even if the eventual outcome is the same as if it was discovered later. I have never worked out how the comparative stats allow for that.)

Very true Twinkie

Privatisation as long as PATIENTS get better treatments and outcomes I'm ok with that.

How can privatisation improve outcomes?

I've worked for the NHS and private hospitals, patients did not get better outcomes with private, in some cases they got worse treatment, tests that were strictly not necessary or told to come back for a check up that was not needed.

Angelicinnocent

Totally agree with you there. If I was in charge all NHS staff would spend a week working on a ward every other year (obviously with caveats for disability/ill health). Management should be promoted from the ranks not brought in after an MBA.

The NHS model was devised at a time when the population was smaller and treatments far fewer. The NHS is basically a bottomless pit which no amount of realistic taxation will fill. There are some great healthcare systems round the world (with the US possibly the worst in the. Developed word imo). We need to encourage the widening of private services which health insurance will pay for to relieve pressure on the NHS. Remove some of the non essential services from the NHS to make it more into a life saving service. Some of the saved cash can go into elderly care. Gp appointments should have say a £25 charge with a fine for non attendance. In the 1940s no one could have imagined the world we now live in so to continue of operate the same model is foolish to say the least

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

According to this, France spends 11pc of GDP on health and the UK spends 9pc.

All other western European countries plus Japan etc spend more of their G D P on health.

So it seems likely we need to spend more.

The question is then should that be through taxation and spend on the NHS in a similar way to now? Or through encouraging more private spending on health either directly (cash copayments to visit a GP) or via taking out insurance?

If we go with the latter, are we comfortable with the idea that the richer will get considerably better health outcomes than the poor?
Because people will only spend more of their own money if the NHS is not providing a good enough service. If it was great, no one would feel the need to pay privately.

So when people say, there should be co payments or richer people shouldn't burden the NHS with their health issues, there has to be an acceptance that this means a two tier health system where those who can pay, pay those copayments and get a GP appointment today or see a private doctor whenever they choose. But those who can't pay, either don't see anyone or wait a long time or in horrible basic wards with no privacy or can't access certain treatments. Maybe we say people who cannot copay can only have cancer treatments that cost less than £5,000? Or only if they have more than a 80pc chance of success? Are we all comfortable with that?

Is that ok? I don't think it is (and I say that as someone who does have private health insurance as a work benefit so arguably already benefiting from the unofficial two tier system)

I also am not sure about the argument that the NHS shouldn't provide non essential healthcare. If I break my arm, it probably won't kill me but it would be less painful and more likely to mean I can work productively if it is treated properly by a doctor.
I had terrible skin which again, wasn't going to kill me but was pretty miserable and an NHS dermatologist fixed it. This is probably non essential but I wouldn't want to stand by and watch other people suffering with it and not being able to access healthcare that can fix it easily
What is non essential? And don't say "boob jobs like that one that woman in the paper got". Probably is non essential but is such a tiny amount of money as to be irrelevant. If we want to save money, we have to cut big bits of spending

Also the other uncomfortable truth is that old people are very expensive in terms of healthcare but they also vote. So no politician will make rich old people pay copayments or take out private insurance even if they are sitting in million pound houses. The burden will be borne by the young.

I don't want to have a system where poorer people receive significantly worse care than me, just because I have an above average income. That doesn't feel right to me. I would rather pay more tax and share it out among everyone than spend more on health insurance just for me.

It seems people want their cake and eat it which is not to pay much in tax but also that Jane from round the corner who is just lovely and has two nice kids should get that expensive new breast cancer treatment plus a nice wig to help her spirits and also that baby who was in the papers should get that super expensive treatment that has a very low chance of success but he is cute and his mum looks really nice. And also I don't want to wait very long when I take Johnny to A&E after he breaks his wrist at hockey practice and I want to see the GP this week to talk about my options re HRT and for my mum to have fabulous care in a quiet, maybe private room, when she trips and falls over again.
And that this can all be paid for through not giving slappers free boob jobs, making admin staff file more efficiently and cutting the number of managers....

Ok, that was long.

TL:DR we have to spend more money on health. Can be tax or private spending. depends on whether you are ok with a very much two tier system

What scatteroflight said. It needs to be looked at dispassionately.

It's not even fulfilling its basic, bottom line remit at the moment for my very elderly relative who paid in for 40 years.

I think they'll start charging non UK citizens and actually chasing them and their home country for payment, like they should but currently fail to do.

It should be like the US where if you don't have a valid insurance/ID/documentation (or in our case NHS registration) then you're denied service unless in an absolute emergency.

And they also need to weed out the shitty admin staff who wouldn't last 2 shifts in any decent customer service roll/call centre environment. So god knows why they're front line of the NHS.

Until recently, I was having routine appointments each month for five years. I'd make the next appointment on an as seen basis and receive a text and email reminder.

But somehow they felt the need to send me postal notifications as well such a waste of money and time!

I'm very grateful to the NHS though for the care I have received though. I also vote Tory.

Dump the pen pushers and bring back Matron. That's the only way the NHS will survive. Too many useless people being paid for nothing at the moment

What MojoMoon said.

I think in the not too distant future the free-at-point-of-use NHS will only exist for emergencies and acute life-threatening conditions. For chronic conditions or for more run of the mill stuff you will be expected to pay. If you can't pay you'll either go without or you'll get a really bargain basement "free" option.

People won't agree to pay enough tax to properly fund the health service, so they only way to get sufficient funding is to take it directly out of people's pockets by making them pay.

Well, I'm not a conservative, so I don't know if my opinion counts, but I am utterly baffled by labours rhetoric about being the saviours of the nhs....as far as i am concerned PFI is what will sink the NHS, long before obesity, diabetes or the ageing population.

The scale of debt unleashed by these agreements on the NHS is boggling, almost impossible to get your mind around. It would have been cheaper to pay for entire new hospitals with Wonga loans.

I don't know who to vote for, tempted to spoil my vote to be honest, but I'm absolutely clear that the NHS is NOT safe with a labour government and it makes me so, so cross this 'labour are the saviours of the nhs' nonsense.

I'm a hospital governor. Having worked in the public and private sector I thought I'd seen it all. How wrong I was, the NHS is a world on its own! Archaic, ridiculous funding models, too many layers and too many politics. The trust I work for is currently having to apply to run its own community services because the CCG in its wisdom has decided to separate community from acute despite the fact the trust performs exceptionally well. I have sat in hours of meetings regarding this and I am just a governor. I dread to think how many hours of the board this takes up. CCG's are a pain in the arse quite frankly and I know it would be someone else if it wasn't them but there are too many individuals on a power trip, contracting things out to their friends.

Budgets should be set and providers left to get on with it. If there are performance issues these should be regulated but too much time is spent reapplying and tendering to provide what they have always provided.

As an aside whoever takes us forward has difficult choices and there is a lot of areas that waste could be reduced from (non clinical) but pretending this is a Tory issue is very much misled, we are reminded at every Meeting I attend of the exorbitant PFI costs which are a labour legacy.

I should have added to my list of clichés that people need to stop spouting is that making foreigners pay and bringing back matron would equal the additional 2pc of GDP needed to bring us in line with health spending in other comparable countries.

It really, really won't. We have to PAY for it. It will be a lot of money. We can do this via the tax system (progressive) or via private spending (regressive).

That would be a useful referendum to make everyone take part in.

Maybe we can start now. Do you want to pay £500 extra in tax a year or spend £500 on private health insurance? But when you are old or if you develop pre existing conditions you pay £5000 a year on health insurance.

Rules
You are not allowed to be upset when your gran gets crappy care and not offered more than pain relief if she hasn't taken out insurance. She hasn't paid for it so she gets the bare minimum.
If you go for the tax, you can't whinge that the fat woman from the shop should just stop eating rather than spending your taxes on her self inflicted problems. You have to accept it gets spent on everyone, including people you don't like.

Vote now! Tax or health insurance?

Labour had been putting scare stories round about Conservative plans for the NHS in every election I can remember (I started voting in 1974). It is still with us. Perhaps one party or the other might one day make it a truly National Health Service and not a group of individual trusts that seem to have major duplications at higher management levels and no real contact between trusts. But the idea that the Conservatives will "abolish" the NHS is nonsense.

Labour, in 2008 struck a naive pay deal that meant Consultant Doctors and Gp's were no longer forced to work outside normal hours, particularly Consultants at weekends and overnight. Their basic pay rose by 30 percent to over 100K (2008 rates)
People get ill at weekends and after 4pm, this wasn't realised by Mr Brown.
This is why we now have a second rate Nhs, with only Junior Doctors outside of Mon - Fri 9 till 4, working 80hr weeks, chasing the dream of one day being a Consultant on 9-4.
The system is broken.

Utter bollocks user you clearly know nothing about the 2008 pay deal.

The NHS runs for the convenience of the drs and the admin makers. Private care runs for the benefit of the customers.

No it is run for the benefit of shareholders/to make a profit.

Wait until you start using your insurance more as you age and the premiums soar.

And check your bill carefully and ask why aspirin cost £20 and an ECG cost £150.

Sashh most managers are brought in from the ranks, our unit had a manager who came in as a qualified nurse god knows how many moons ago. She was great on clinical matters but had fuck all idea of how to manage people or work to deadlines. High level clinicians were also on certain boards which were unnecessary on the whole but took them away from the clinical role they were employed to do therefore lengthening the stays of patients. And don't get me started on the consultants saying they'd retire if they had to work out of the 9-5 hours they were used to meaning Mondays and Tuesdays were often spent firefighting the crises that happened over the weekends.

@user1471545174 It's not even fulfilling its basic, bottom line remit at the moment for my very elderly relative who paid in for 40 years.

• But healthcare isn't doled out on the basis of contribution, that's the whole point of it, like NI. We all pay in a little bit and we'll all take more or less of the whole service as we need. I've been paying for ambulances for my entire working life and have never used one. Does that mean I can call one to take me home after a boozy night out now, because I haven't used my quota

@pennypickle Dump the pen pushers and bring back Matron.

• Should I tell this to the Matron of the ward I have recently spent a lot of time in, visiting someone? Or did you just say that without checking if Matrons do exist in the NHS today?

@user1471439240 This is why we now have a second rate Nhs, with only Junior Doctors outside of Mon - Fri 9 till 4, working 80hr weeks, chasing the dream of one day being a Consultant on 9-4.

• Apparently nobody had told this to the team of three consultants/senior medical staff that were doing their daily rounds as usual on my friend's ward, right across the Easter Weekend (Fri-Mon and Easter Sunday included)

Mother You have previously said where you live, and as for Tervuren not being salubrious....I don't think there is any part of the 3080 post code that is not 'naice'.

It doesn't matter what they do in Ireland, we were talking about Belgium. If you look at the europe-cities website, it says that those on low incomes do not have to pay health contributions, and are exempt from making payments to see the GP.

I taught in Plymouth and Cornwall in secondary from 2000-06. There was no money. We were using old textbooks, because the new editions were too expensive; we as teachers bought all the resources for our classrooms, and I bought some of the textbooks for my A level students. If we wanted to go on subject specific CPD we had to pay ourselves. That wasn't under a Tory government, and it didn't improve over that time. I was lucky, I got a classroom; some colleagues taught in huts that had water seeping in and there was no money to replace them.