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:

Yes our insurance costs $25k a year

Well.

"Yes our insurance cost 25k a year"...

Exactly.

I have no idea why that woman didn't get treatment - perhaps she couldn't afford to take a day off or had no childcare outside of working hours. I don't know. I do know she had an horrific injury and was working with it, and it was clearly untreated.

I know many people with chronic illnesses that live in America who have lost everything and have to make decisions between laying copays for appointments and medications or paying other bills.

It isnt inefficient compared to other healthcare systems, its very efficient

And every consultant I know is worked half to death as well, ridiculous hours, high stress. Keen to know where this nhs oasis is where consultants are swanning around earning lots and doing little. I suspect it is the 1960s.

I spent a day last week in a planning meeting for changes to maternity services. The service is going through a a scheme to satisfy the findings of theBetter Births project while having funding cut and trying to figure out what they can cut in order to meet the new criteria. I saw a room full of very passionate and dedicated professionals who desperately want to give their patients the best care but cannot. I don't need anyone to tell me how dire things are, or aren't. I see it through work constantly.

Bumwad.

The melanoma example is completely comparable.

You try ringing a GP in the UK and telling them you need an urgent appointment because you are worried about a mole. They will laugh you out of town.

Yes there are fast tracked appointments. You think she didn't want one? Her GP is so worried about budget he will barely fast track anyone. She had to cry before he'd refer her.

It sounds like you are blaming my sister for the fact she wasn't treated quickly for her cancer. She begged them, she cried, she refused to accept what they said. It's frankly insulting to imply it's somehow her fault she was left for months by which time her cancer was more advanced than it would have been.

It's insulting that you are ok with people being told by letter a month after their tests that they have cancer and in a way that means they have to google the medical name to find out.

It's comparable in every sense. It makes no odds if same day appointments are technically available if you can't actually get one.

Ttbb
Your experience of the Australian system is exactly what I recognise. I find it impossible to believe that the people suggesting the nhs is better have experienced both.

I honestly believe that most English people have only ever used the NHS or private care in the UK so have no idea what a decent health service should look like. It's not like the NHS.

TammySwansonToo

"Right so privatisation works better because of competition - more likely to have a better service at a fair price?

Give me a break. That's not how it goes.
Train system
Energy companies
Royal Mail
Moving property from government ownership and eventually into the hands of property investors

Those things aren't really working out so well in terms of service or cost, are they?"

I don't want to be rude- but I'm an older mother - late forties. Do you actually remember those things BEFORE they were privatised. The trains are bad now, but they were much worse then. We have newer trains and they work much better now, timetable is more frequent, everything is better, albeit far far from perfect. (and I apparently live on one of the worst lines in the country- Thameslink). I really can't understand why you'd think they were better when nationalised. They were truly dreadful.

Same with the post office. Hard to compare because obviously everything has changed so much and it's now about parcels not hand written letters, but I think the post office is vastly better in my area too. My local post office is within a small supermarket and is open till 11pm at least, 7 days a week.

Energy competition means that I change provider regularly and my energy is undoubtedly cheaper in real terms than it was pre-privatisation thanks to competition. As for the service- well, my lights have never gone off.

Council houses I'm with you. Should never have been sold off - that was a big mistake.

But overall, I think privatisation has been positive. The state is piss poor at running the health service, despite the amazing people working in it, and they were even worse at running everything else.

I don't want to be rude- but I'm an older mother - late forties. Do you actually remember those things BEFORE they were privatised. The trains are bad now, but they were much worse then.

Hello youngster! I remember. And I have to rely on memory. Can't afford them now.

Exactly! Yes I do remember them, and I remember travelling frequently across country to visit family without my mother having to take out a second mortgage to do so. Wouldn't be affordable now. Even if the service is better (I'm guessing you don't live in the First Great Western area for example) , they're out of reach for many. Is that what you want for healthcare? And as with the NHS now, slashing funding for things then pointing to its failings is the oldest trick in the book if you want to push privatisation through.

Have you actually paid attention to the costs involved in sending mail for example?

As for energy companies, you're saying that profit making companies can provide better service for less cost than being run as a not for profit? I can bullshit. That's not possible. Mismanagement is another issue entirely and one that can be overcome.

As for the mole claims above, last weekend I discovered a mole on my breast was looking suspect. I called the GP practice at 8:30am on Monday and was in having it checked before lunch.

The reality is, and what I'm reading here, is that very few people on MN actually really know what the experience of medical care is here. You get what you pay for. The NHS is underfunded and badly managed.

I don't think anybody is saying the NHS isn't underfunded and in some cases may be badly managed, but paying $25k a year, PLUS $6k per person deductible, simply isn't possible for the majority of people in the US or UK. That's about £19k plus the deductible.

With regard to free clinics, what kind of treatment and ongoing care are those patients getting?

I'm not really sure how anyone can disagree that consumer competition improves service and drives down cost.

The US model is disastrous because the AMA, insurance companies, big pharma etc are all more or less acting as lawmakers. Congress can't say boo without their approval.

I was gobsmacked when I reached the 40% tax bracket to see my national insurance payment fall to 2%. Tax up 20%, NI down 10% - meant my deductions only went up by 10%. Should be a 5% contribution at least.

Lots of people disagree that consumer competition works in models like healthcare, utilities, railways. In fact, most entire countries disagree. Where is the consumer choice right now with rail? How much cheaper and more efficient is our electric now it is owned by other countries monopolies instead of ours? How are we doing on private rental compared to state council houses? Get a cheaper better deal on those?
It was never about consumer choice. It was about selling off assets cheaply to rich.people

How does utilising profit making companies drive down cost? Especially living in a country where we can see CLEARLY that this is not true of privatised services.

You do know that many of our rail lines are run by European countries, running vastly cheaper systems, subsidised by the profits from our extortionate services?
www.google.co.uk/amp/s/amp.theguardian.com/money/datablog/2017/jan/06/tracking-the-cost-uk-and-european-commuter-rail-fares-compared-in-data

"Tammyswansontwo" "As for the mole claims above, last weekend I discovered a mole on my breast was looking suspect. I called the GP practice at 8:30am on Monday and was in having it checked before lunch."

That's great, you're lucky. Try living where my mother lives in Dorset. It's four weeks for an appointment. They release them periodically. If you ring up and the ones released are all gone they say ring back NEXT WEEK when some more will be released. Because it's a four week wait for a regular one it's nigh on impossible to get an emergency appointment unless you are literally at death's door. We make her weekly appointments and cancel those she doesn't need because as an elderly person no way she can wait four weeks when she's unwell.

It's fine to have an "I'm all right jack" attitude because you can get a same day appointmen, but all over the UK people can't see their GPs for weeks and just because that's not how it is where you are doesn't make anything about the claims false.

Actually I do live in Dorset, in a big town, not a rural area.

I used to live in the next town over and getting appointments there was a nightmare, and things have been significantly better since I moved practices.

I absolutely do not have an "I'm alright jack" attitude. I've experienced decades of worsening treatment at the hands of a funding-starved NHS. That doesn't mean we need to privatise it more - if anything to me it means the opposite. The government have dramatically cut payments to the GPs per patient while demanding improvements in service. They know it's not possible, so that when things fall apart people will not fight the privatisation they're pushing.

(BTw, if by some chance your mum lives in Poole, please let me know - I can recommend a wonderful practice to her. Honestly, I would have moved years ago if I'd known I could have had such better care. My practice is definitely not typical. The Echo released a practice league table recently - my new one is in the top five, my old one right at the bottom.)

Thank you - I wish I could take you up on that offer. She lives in a village but her doctor's practice is in Blandford. It's a nightmare, but it wouldn't be practical to get her to Poole sadly.

That's a real shame. I do have occasional GP contact in my job, I will ask around and see if anyone knows of any decent practices. It definitely depends on the number of residents in their catchment area it seems.

Thank you, I would love her to change. I have asked her to change before but apparently there is only one other practice there and she's been told it's no better. Whichever one she goes to it has to be not too far from her as she goes to the doctors etc by taxi ( she can no longer drive).

I really feel for her - spent six years in the same situation, although it wasn't quite as bad at the beginning.

Have they started doing online bookings yet? For a while I found that was a good way of getting appointments but had to stalk it and I'm guessing you may have to do that for her.