Is this a completely bonkers U-turn by the NHS?

[HappySecret]

My faster is well and truly flabbered. Can this be in any way reasonable? Justifiable?

From today's Times:

Did the Tories have a mandate to do this?

Loosely related to this , what would help with the pressures on hospitals at Xmas is if surgeries issued repeat prescriptions early Ours wont. Many times ive sat in a chemist on 23 Dec or Christmas Eve getting DHs script and if something is missing it could mean a trip to hospital over Christmas ...........already one of the busiest times. Something that could easily be avoided. I get sick of the patient blaming around this issue when there is a refusal to do this simple thing.

Btw I fully agree that we could have some system in place such as the ones in Europe.
The major issue IMO is that the government is NOT trying to develop such a system but is running the NHS down to the ground.
What you can see developing is a fully private system
Have you seen for example adverts for ‘appointment with a GP within a hour/at a time that suits you’? This is full on private care (in some way worse than the US).

And even worse is that it doesn’t seem to have ANY plan of how the health care service should look like. Just empty talks about how we can’t afford it, even though other countries can.
At least with a plan clearly established, there could be a discussion on what to do for the best.
Instead everyone is just fire fighting (like the trust on that article)

I agree that we need a different system. The Australian system (where I lived half my life) is about halfway between the UK and US systems. It works much, much better than the NHS. There's still a public system and healthcare is still free if you're poor/elderly but there's much more private too and they are fully integrated.

So if you go to a private hospital the govt pays the doctor what they would have been paid on medicare (the nhs equiv) and your insurance pays food, hospital bills etc.

If you earn over a certain amount it's compulsory to have insurance or you pay and extra % tax.

The whole system just works so much better than here- far fewer waiting lists, better care, doctors that have time.

Do the Tories have a mandate?
Well yes an dno. Yes because they have been going in about it for a whole 5 years and then got re elected. Twice. So sureky people knew what they were giving their approval for.

And no because no one has ever said what is the plan for the NHS. They just keep going on about the fact there isn’t any money and they can’t do better. Which IMO is a lie. They are choosing to spend that money somewhere else (or not collect taxes form those who should pay etc....)

*if something is missing or the pharmacy doesnt have all the items.

The healthcare system in France is part state funded (if you qualify) and part private insurance which is not very expensive. Short wait for A&E where we are. State of art hospitals. Able to get appointments at GP quickly.

But the taxes here are much, much higher, and the whole economy is balanced differently.

You couldn't just transpose this model into the UK, for sure.

emergency surgery on Christmas day - try getting an NHS consultant to do that

I must have imagined those four transplants we did last Christmas then.

The continental system looks great, because France and Germany are spending 2-3 times what we spend. When people say the NHS is efficient, they mean it gets pretty good outcomes proportional to its funding.

Having experienced both, I’d be happy with either system. Don’t imagine you can get continental style service on NHS budgets. I work with a lot of Spanish and Italian doctors, and when they first arrive they are horrified by the lack of money, and the things the NHS is expected to sort out that are the family’s responsibility in their countries.

that are the WOMENS responsibility in their countries, half my family is Italian Sashkin so i know what they are really getting at.

I have several autoimmune diseases. I saw my consultant in September and he told me categorically and without a doubt that I need my right knee replaced and my left on will need doing eventually as well. He then chose to inform me that I will be waiting for 7-8 years minimum as the local NHS now has a policy to not offer knee/hip joint replacement until a patient is 45 at the very minimum. I am 37. He was very embarrassed about this and apologised profusely. He said he will apply to see if he can get me a revision surgery to try and patch it up a little but as I have already got massive joint space loss and bone erosion it will be like closing the door after the horse has bolted. my knee is like a crunchy bowl of porridge and has zero stability at all! In the mean time my injections and treatment cost a bloody fortune and I am totally reliant on benefits as some days I can barely move.

An american style system would see me totally written off. My current treatment plan costs the NHS about 4-6k a month depending on which medication/physio I am on etc and if I was in America I couldn't get the same level of insurance and would be stuck on low level chemo for life or until my liver died an early death. We need to fight tooth and nail for the NHS and force in a government that will restore it as a free point of access service for Brittish nationals.

I don't want to say too much and give my job away, but those who are praising foreign systems really don't appreciate they're almost as fragile as our own. Demography, technology and public demand are growing far faster than finding across most of northern Europe, Japan and Australia.

US healthcare now costs almost 20% of GDP (more than double ours); Australian healthcare inflation is racing far ahead of funding (Aussie doctors are regularly earning $2m+ per year), Italy's ssystem has faced swingeing cuts, and the likes of Belgium are struggling to cope with a much older population than our own.

The reality is that you get what you pay for. We do not pay enough for first-world healthcare, and something has to give.

It makes no difference to the likes of me if the NHS is abolished; I can afford whatever supersedes it. It will, however, mean much worse outcomes for the poorest and most vulnerable in our society, and it will categorically be more expensive than what we currently have.

I work with a lot of Spanish and Italian doctors, and when they first arrive they are horrified by the lack of money, and the things the NHS is expected to sort out that are the family’s responsibility in their countries.

I didn't know much about the NHS before I got on MN a couple of months ago, and I've been surprised both by the rationing/long waits and some procedures that have been standard in the US for many years still aren't used by the NHS despite clear advantages, like minimally invasive vasectomies

www.mumsnet.com/Talk/relationships/3050233-Selfish-attitude-to-vasectomy

I didn't understand why men were complaining of high rates of post operative pain until I looked into it and saw that the rate for such problems was 5 to 10 times higher in the UK because the NHS hasn't adopted minimally invasive techniques yet.

The US spends a lot more per capita on healthcare than most places, and the reasons for that are complex (yes, there is a lot of waste and quite a bit is driven by lifestyle diseases) but the upsides are that there's no wait for elective procedures and new treatments become available relatively quickly.

Anyone who can look at the American system and think its ok or comparable to the NHS has their head in the sand. People die because they have the wrong type of insurance.

To all of you who wish continental european treatment: have you lived in it for longer periods of time? i have (Germany, Netherlands, Switzerland). i'm so thankful for the NHS!
Treatment is so much better, not to mention that you don't have to constantly chase your insurance for hundreds or thousands of euros.
You don't have to think whether you can afford to go to the GP this month (for example CHF 120 minimum, not covered by insurance in Switzerland), there are very clearly 2 classes of patients (Germany, private vs normal), endless waiting times (netherlands)

What saddens me is the 'I'm alright Jack' attitude of many people towards the NHS. In terms of maximum benefit for minimum cost, it's almost unbeatable. It just so happens that it's underfunded.

Rather like attitudes to the general 'austerity' agenda, it's often the people who think they won't be affected will actually be hit the hardest. Not only is our healthcare less than half the cost of that of the US, but outcomes are better. Despite our shitty lifestyles here (and the fact that we're a considerably poorer country, per capita), life expectancy is higher and infant mortality rates are lower than the US.

Square that!

People die because they have the wrong type of insurance.

That might have been true before the ACA but now all insurance has to provide the same minimal essential benefits, including employer provided insurance.

www.healthlawguideforbusiness.org/aca-compliant-plans

Insurance systems cost MUCH more!

That might have been true before the ACA but now all insurance has to provide the same minimal essential benefits, including employer provided insurance.

Ah yes. The ACA that Trump was elected to get rid of.

Medicare reduced bankruptcy, but it didnt abolish it. People in the US still die because they have the wrong insurance.

www.independent.co.uk/news/world/americas/conan-soranno-couldnt-afford-private-healthcare-los-angeles-photographer-vomited-blood-a7916191.html

The average American has $1,766 in overdue medical debt
www.advisory.com/daily-briefing/2014/12/15/the-average-american-has-1766-in-overdue-medical-debt

60% of personal bankruptcies are due to medical bills, and most of them have insurance
www.huffingtonpost.com/simple-thrifty-living/top-10-reasons-people-go-_b_6887642.html

''each time they have an item, an episode of care, it costs two or three or five times more than it should do, by international standards."
www.investopedia.com/articles/personal-finance/072116/us-healthcare-costs-compared-other-countries.asp

There is no benefit to taxpayers or consumers to the US system over the NHS.

Yura I have lived in Europe and I would give a hell of a lot to be able to have system like .they have in France compared to the NHS.
Have you been ill recently and actually needed the NHS?

Because I’ve seen friends not been told they probably had cancer (so no treatment/biopsy despite a scan that was clearky showing something wrong) and then weeks delay to actually get I. With the treatment.
We’ve had a baby in the news this week who died because he didn’t receive his treatment in time because surgery had been cancelled numerous times.
It’s near impossible to see a GP so I’ve seen people not going to get some medical advice because it was too hard work.
And that’s wo the fact that care is often patchy.

I’ve seen never seen anything like this in France. Not in Germany.

The very difficult thing about the NHS is how much it varies area by area. I suspect that may be the case in the systems of other countries too. It makes comparisons and generalisations based on individual cases very very unreliable.
Someone I know who lives in Spain finds their local public health care system awful and has private insurance on top, but in other areas she says it is much better.

even with a continental style health care - (not for profit insurance etc etc) how many British family afford the insurance considering the debt levels in this country?