To ask you to educate me about politics and the NHS?

[Februaryblooms]

Having a chat with a friend of mine about healthcare and how fortunate we are to have the NHS (I've recently received alot of care during a hospital stay)

He's passionate about politics whereas i am admittedly very uninformed and not educated on the subject whatsoever which I aim to change.

He's having a rant about the government wanting to privatise the NHS and saying I'm lucky because if that had already happened then I wouldn't have received the urgent and life saving treatment I received, because I'm not somebody who can afford private health care, and I would have in effect been left to die

If the NHS did become privatised, what would happen to the sick and disabled living on the breadline or in poverty, can they really be refused treatment because they don't have the money to pay privately?

Is all of this a possibility or is he just scaremongering?

Look at dental care here. Plenty of people don't have an NHS dentist and therefore can't afford dental treatment.

Medical insurance in the UK doesn't cover chronic conditions (I have two) so I will have to rely on the NHS for treatment for the rest of my life.
There's also no private A&E.

This is absolutely rubbish scaremongering. The NHS will always be free in those situations. This isn't American and neither should we be compared to it.

The NHS has elements of privatisation eg laundry services, portering, cleaning, ambulance services.

My local trust was broken up and the three hospitals (all failing) were distributed to three neighbouring trusts. EG Trust A provides all the district nurses and mental health care for the three trusts, Trust B deals with all the autopsies and planned operations, Trust C has the Acute (A&E) unit and elderly care wards. So all three trusts buy each others services. This would also be called 'privatisation' by some politicians.

Nursing homes are now also largely privatised rather than state owned. People like to slag off Branson but Virgin Care is a not for profit organisation and his homes are largely well run.

In short the NHS is fucked over for two reasons - Labour - yes Labour and its poxy PFI - our local trust spends over 50% of its central government income on paying PFI interest. Whose idea was that, ah yes Tony fucking Blair. Ditto education.

The second reason is chronic incompetence, endless meetings with no purpose and of course 'procurement' which explains why I waited 6 months for a printer to be shipped from Germany at a cost of £600 when I could have nipped down to PC World and got an identical model for £100. The procurement contracts have now changed so I cant order cartridges for it - I have to order a new printer. You couldn't legislate for this level of utter incompetence.

I do less than an hours work a day and get paid very well for it. I only stay for a half decent pension and flexi working

We have private healthcare through work but it would probably be a couple of hundred pounds per month for the family if we didn’t.

Ok MN people are very quick to dismiss private healthcare and extol the virtues of the NHS. In my quite extensive experience private health care is generally like night and day compared to the NHS, the care is on another level with no waiting lists, immediate and more regular scans and monitoring and time to spend with patients.
It’s medicine how medicine should be and physio etc is definitely not shorter, they actually treat you rather than giving a sheet of exercises.

I would also dispute that if there’s a problem you get moved back to the NHS. Many NHS hospitals have private wings and intensive care beds and yes on occasion you may be moved back to the NHS but it’s quite rare.

The doctors are the same as those on the NHS but you get continuity of care, you can choose your doctor and you don’t see a succession of registrars etc who know nothing about your case and an appointment is a good half an hour so you have time to actually discuss things.

My husband has been having cancer care for the last couple of years as a private patient in a top cancer centre and has had access to treatments the NHS simply won’t pay for despite them being standard of care across the rest of the world. His treatment is discussed by an MDT the same as it would be on the NHS but everything moves at speed, no waiting for results they tell you them the same or next day, no wait for treatment, it happens immediately and immediate access to the consultant who emails back generally within the hour,

The only way that the NHS can even start to do this is to completely restructure and avoid the ludicrous double handling of everything. Make appointments online there and then, make sure that one person deals with care, don’t send people in and out to see 20 different people in the course of 1 appointment and stop funding some things. I think that we’d also need to go to asking for some contributions to some treatments

Private care is fine for some with certain conditions

On the whole we all need the NHS - every doctor i know says the same. And I know loads!

Privatising the NHS will be FANTASTIC for the few getting a nice chunk of cash and have e the money to pay for their nearest and dearest - let's just think though if the masses

Also let's start thinking about Investin g some taxes into the NHS to ensure they get more so they're able to float - the reason the NHS is broken and skint is the rich, Scoundrel, toxic government - they need to give more money - urgently

I've worked in the NHS since 1991.
I am totally and utterly shattered.
It seems to get worse year on year.
I blame the managers and their constant changes which will be changed back in a few years (because they have to be seen to be changing something).
I cant continue do more with less, there are no more corners to be cut.
Cant remember when I last had a lunchbreak. Probably near last Christmas.
On average I would say I'm working at least 8 hours UNPAID every week.
I do it because I still love my role, genuinely like to see people get better, (or die well) but we are getting abuse from the public because our service doesn't meet their expectations any more.
.....and yes to the post up thread.....procurement is a fecking joke.

He's scared of something like the US system which has, at points, been horrific and is still quite brutal in some areas today. I lived out there for a bit and had to come back here because I couldn't get insurance which would cover the meds I needed without taking a co pay amount that I just couldn't afford - co pay and insurance premiums between them would have been 75% of my salary.

Plus aspects of emergency care out there sucks - a friend of mine got landed with a $3000 bill for an ambulance ride for some dumb reason to do with only certain ambulances being in network.

Having said that I think we are a long way from the US system yet and there's a lot of options in between - Germany, France, Australia have more of a privatised element than we do and they do fine.

There's an element of scaremongering because there's no appetite in the U.K. to ditch the nhs but the worse case scenario is needing top up insurance for elective surgery, if you look at the US only emergency medicine is provided without proof of insurance and even then they will bill you and bankrupt you - employers typically offer insurance as part of your remuneration package though even 15 years ago we were paying $475 on top for family coverage plus $15 a visit/per prescription for hmo coverage (the cheapest kind of insurance) others had to pay 20% of their bill often. I know Australia there's a lot of discussion about top up insurance now, and disparity in outcomes at certain hospitals - they have elections today so it's obviously a discussion point

In the U.K. private health is top up insurance, they rarely can treat people requiring high dependency beds, quickly shipping you back to the nhs, they also can stop covering you once you have cost them too much. What U.K. private insurance is great for is routine elective surgery eg knees, hips, cataracts, also getting diagnostic tests done and some cancer treatments but depends on your plan. As a perk from work it's amazing, if it's costing you real money I would save it and pay cash if I needed elective surgery

the best thing for the UK would be to get rid of the NHS. But it won't happen.

@Gth1234 and your alternative would be?

I'd certainly put the NHS back to what it was designed for :

The NHS was created out of the ideal that good healthcare should be available to all, regardless of wealth. When it was launched by the then minister of health, Aneurin Bevan, on July 5 1948, it was based on 3 core principles:
that it meet the needs of everyone
that it be free at the point of delivery
that it be based on clinical need, not ability to pay

Point 3 - clinical need that's where its gone wrong.

Currently in the US and the shocking state of their healthcare system is one reason why I wouldn't stay long term.
The costs are horrendous. Many times what most countries healthcare costs are.
But there are other medical models we could look at in Europe, Oz, Canada.
Just don't copy the US.

The NHS was founded just after WWII when returning soldiers demanded better conditions, along with better housing etc.

Back then the needs of the population were simpler. Many conditions eg cancer just resulted in death rather than complex treatments, there weren't many expensive machines or scanners etc.

Before the NHS poor families paid out of pocket for the doctor, eg if your child is sick, choose between paying doctor's fee vs food for whole family. The NHS is based on equality and sharing risk which is why people love it.

But we have an ageing population and higher costs for treatments and politicians have been reluctant to admit this means we have to pay more. Patients often have multiple conditions and live longer needing more care where a few decades ago they would have simply died before that point.

There's a genuine need to improve healthcare but the block is ideology. Basically conservatives believe profit and personal gain is the reason why people work hard so they see a non profit system like the NHS as wasteful and inefficient.

Left wing people/socialists believe profit making just takes from poor people to benefit the rich and that delivering healthcare is enough motivation in itself to make the system work.

Both sides have a bit of a point but neither side is honest that we just need to pay more, as this is not an election winner.

Lots of countries mix public and private provision well and give good care, but US healthcare doesn't. People go bankrupt if they have cancer. Giving birth can cost £4000 or more. People turn up to hospital with life threatening conditions and are turned away if they can't prove they have insurance.

It's US companies that are most interested in moving into the UK if the NHS is privatised.

The debate has been going on so long that it's all entrenched and stale and the main parties don't trust each other enough to ever really change things.

Sorry that's a bit of an essay but you did ask!

If you want to know what could happen, have a look at what happens with patient dumping on skid row in the US and the US health care system in general.

Yes, the poor can be left to die without services if they can’t afford health care. I lived in the US (I’m American so at the time would have had no access to NHS services). I had a screen come up pointing towards cancer. I lost my health insurance the same month. The biopsy would have been around £1500 just for the initial procedure. I couldn’t afford it. I had to wait 2 years to get it done. It thankfully wasn’t cancer or I’d be dead now. That’s privatised health care for you.

But I would hope we are foolish enough to go down that road here.

There are the usual internet myths on here.

Here in the US it’s illegal for a care provider to refuse treatment due to inability to pay if someone has a life-threatening condition.

Whilst it’s probably true that the number one cause of personal bankruptcy here is medical expenses, ill-health is also one of the biggest causes of bankruptcy in the UK also. And that’s with the NHS to take care of things.

Under ACA you cannot be denied insurance due to previous medical history or due to pre-existing conditions. Neither can you be forced to pay more than anyone else because of this.

Under ACA employers with more than 50 employees must offer healthcare to their employees, either at reduced or no cost to the employee. My employer provides it at no cost. I also live in a state with no state income tax so my tax burden is much less than someone on an equivalent salary in the UK. I would be in the 45% tax bracket in the UK with my salary here but I only pay around 25% (and that’s higher than most). So although we have co-pays abc deductibles to pay we only pay them if we actually receive medical treatment (whereas the UK government takes money for the NHS from every worker, whether they have seen a doctor in the last year or not) and our maximum out-of-pocket each year for our household is $5000. Last year my husband had 3 major surgeries and has regular physio and hydrotherapy. Last year his medical bills were over $550,000 but we paid $5000. The rest was covered by insurance. Did that to our income tax and we are still much better off than I was in the UK and we have a far better standard of care. No postcode lotteries here. No waiting lists. Private room in the hospital every time.

It is possible to survive without an NHS. Like anything else, it’s not perfect but is anything ever perfect?

the nhs is crap look at survival rates of various cancers/ infant mortality way bellow what other comparable countries are.
then you find out the nhs spend 3 pounds on paracetamol yet in shops it cost pence you have t wonder whats going on but you cant criticize it as it gives a crap basic level of care to everyone for 'free' in reality if you pay taxes you obviously do pay for it.

the nhs is crap look at survival rates of various cancers/ infant mortality way bellow what other comparable countries are.

Totally agree, my husband is only alive today and currently dissecting yesterday’s FA cup final with our DS because we have private healthcare and his cancer is treated privately. If we had stuck to the NHS where he was diagnosed he would have been dead a year ago. That is a fact. They went rare cancer = incurable no treatment = try a bit of chemo but it won’t work. Get your affairs in order

Privately went = oh that’s rare and incurable but we have a few ideas but need further testing to be sure. Ok now we have those tests back let’s try a) then b) then c) and then we’ll do a few more tests and speak to some experts abroad and see what they suggest and then we might look at d) e) and F) and try this which strictly speaking isn’t protocol but we know can have a positive effect.

That’s the difference!

As a matter of fact, the NHS is, elected the best healthcare service in the world years after years.

The reason why it is struggling as it is because of lack of workforce. The NHS has fallen into a vicious cycle it can't get out of. It started with massive cuts, changes in services, redundancies and increasing staff pressure and frustration. People are leaving the NHS at an alarming rate and these people are mot replaced to make up the financial deficit. Those who stay have to bear the burden, they are getting stressed and ill and they go themselves. The shortage of nurses is horrifying and as more nurses retire than new nurses are trained, sane as gps, bit is, really not looking good.

It is the same with social care. More people relying on social care, budgets cut and more people not getting social care ending up nhs patients.

The only solution is increased taxes. Private health is actually struggling as fewer people have been able to afford it and there is still a deep seaded feeling that you should pay for something you are entitled to get freely.

Here you go.

The NHS is pretty rubbish really. Average at best. It's so good NO other country in the world has copied it.

The UK is populated by needy claimaints, who aren't willing to do much, and expect everything to be done for them. This applies to the health service, of course, but to much more. The left wing rallying cry is always "more services"

So instead of saying NO, we featherbed everybody in the country, and make our country a magnet for claimants from other countries.

Not just the NHS. Lots of things. At some point we will become Greece on a large scale, and we will be forced to address things we should be addressing now.

Glad I could help.