to think that the NHS is really quite shit and that not everyone who works in it is an underpaid hero?

[Adenosine]

There is a strange British preoccupation with the NHS which I think prevents honest public dialogue about its many shortcomings. At the time it was set up it was innovative, but now there are many other universal healthcare systems most of which are better than the NHS and many of which cost less money.

It's ranked low globally and really quite shit yet few people dare criticise or. AIBU to think that we really need to be far more critical?

Talking about needless prescription of over the counter medicine, ambulance transport, drunken A&E attendance, even travel health, all these are just a tiny drop in the ocean of the NHS costs.

And it thousands of NHS staff with that attitude that causes the avoidable waste. The attitude of "doesn't matter" when they waste money on small things because of the huge sums involved in total. It may be a drop in the ocean, but that "drop" would probably pay for hundreds of nurses or doctors or operations when you add up a small amount of waste by each of the hundreds of thousands of NHS staff.

What's the issue with the NHS prescribing meds that can be purchased on the high street. I could be wrong but as I understand it there is a fee for prescriptions whether they're filled at the chemist or hospital pharmacy. If someone wants to pay £9.00 for a prescription when the item costs £1 over the counter then surely that's a profit for the NHS?

If however you're unemployed /homeless surely free meds are a necessity?

I know I'm missing something just wondering what it is!?

randomchatter

I know I'm missing something just wondering what it is!?

It is only in England that prescription charges apply.

@Dontdisturbmenow - good point. We do all need to think about how we can take some personal responsibility to reduce our personal impacts on the health service. Obviously many illnesses are beyond the control of the individual but by looking after ourselves a little better we can reduce the toll that we take on our bodies and therefore the risk of developing certain conditions. For me, I value the fact that our healthcare is free at the point of delivery and that we are not in a position like in the states, with their incredibly convoluted system where those in poverty are basically screwed because they can't afford insurance.

If someone wants to pay £9.00 for a prescription when the item costs £1 over the counter then surely that's a profit for the NHS?

It's not the people who pay that's the problem - it's the exempt ones who do it to avoid paying the £1, i.e. long term health exemptions, young/old people, those with prepay certs, and those on benefits. It's only a minority who pay the £9, the majority don't pay. The NHS doesn't just pay the pound to the pharmacist, it pays a handling/admin fee etc which is a lot more!

@user149720719 it's people like who don't get it. The resources involved in reducing medical prescription will be a complete waste when the funds need to go in reducing the level of diabetes in this country.

When funds and people are do straight, it's much better to focus on what cost 20 billion rather a million or so.

Tbh I get a little tetchy at the notion that it's people getting sick that are at the root of all the problems with the NHS. I mean, it's a healthcare system, the whole point is that it treats sick people. This is no great mystery.

Also, lack of funding/people being too fat (!) etc has little to do with the just-do-the-minimum hostile/sullen attitude that a lot of patient facing staff have - for eg the surly reception staff at the A&E department who left me standing around the crowded waiting area in full view of everyone with a cardboard box full of my own piss for twenty minutes because I'd had the temerity to ask where to put it but the employee who dealt with samples wasn't at the (shared) desk at that time. She later told me she'd come back two minutes after I tried to hand it in but no one had informed her she needed to collect it. I have no doubt that their failure to tell her was some kind of petty ridiculous power trip playback which is pathetic.

*payback

Imagine if we all paid a supermarket tax and when we needed food, we had to go to a state funded supermarket, where you sometimes needed to wait four hours at a checkout. And, if you complained, it was continually pointed out that the checkout staff were underpaid angels and, up above, checkout staff were promoted to senior managers, despite having very few qualifications and paid 2-3X the average national salary.

Of course, the supermarket tax would be mandatory and those wanting to shop at Waitrose would basically have to not only buy their food twice over but be berated for 'jumping the queue'.

And, of course, you would continually be urged not to go to a supermarket unless absolutely necessary and that it was your responsibility to manage both your diet and use of supermarkets to minimise the impact on the national supermarket service, the pride of the nation and, of course, the envy of the rest of the world.

Welcome to the NHS 2019!

I agree op. The NHS is utter shit and needa a massive change. Every trust pays different ammounts for different things loads of staff are not good at their jobs but any time you critisise it all you hear is "try living in america then". As if there is only 2 healthcare systems in the world. I grew up in germany and our hospital treatment was impeccible. Now in the nhs i have had many many complaints one of which 4 weeks ago almost cost me my life and yet i can't critisise it without being shouted down that i am wrong and the nhs is untouchable.

The NHS..ah yes there needs to be discussions but when my Dad has a stroke ..in the middle of a nature reserve the NHS..

Sent an ambulance which FOUND us.
Gave emergency treatment to my Dad
Took him straight to Resus at A&E
Continued emergency treatment.
Admitted him
Scans etc and blood tests.
Kept him for a week giving further treatment and then life saving surgery
Discharged him home where he gradually recovered.

No cost except taxes everyone pays for the good of all.

Meanwhile June in America has chest pain...she’s not sure what’s causing it but the fear of cost stops her calling an ambulance.
By the time she is seen a few days later the damage to her heart is so extensive nothing can be done. She dies a few weeks later ...earlier treatment would likely have saved her life but as a poor woman of colour nobody cares.

In parts of Europe everyone pays an amount for health care. In some cases you can have luxury care which entitles you to everything the basic does but a private room etc. June wouldn’t have died there...my Dad would have paid a small amount but would also have survived.

Funny how good Europe can be isn’t it? And we want to leave it behind and mirror the USA. 🙄....or so it seems.

The NHS doesn’t get it right all the time but I’d rather have that than the likes of the appalling US insurance based system.

I’d be open to discussion about an European style system.

Love that analogy larrygrylls

When funds and people are do straight, it's much better to focus on what cost 20 billion rather a million or so

Why not both? Especially since it could be so easy to cut down on a lot of the small scale waste. It's your attitude of can't be arsed to do anything about the small stuff that's killing the NHS - hundreds of thousands of staff with that poor attitude of not being bothered about the waste/efficiency they could do something about.

I don’t know - I’m very grateful to the NHS for some things - they are amazing. A we have private medical as well though and where I’m from - there is only private medical. I think the English system is very generous to its people - I mean, free healthcare?! I thought was a joke when I heard but I suppose taxes are high here?

Really brave post.

The NHS makes otherwise sensible and intelligent British people lose their minds.

People seem to be completely incapable of discussing it rationally.

They either babble about BUPA, or USA, like it is some binary issue. Or use an anecdote as evidence.

@larrygrylls
it's the exempt ones who do it to avoid paying the £1, i.e. long term health exemptions, young/old people, those with prepay certs, and those on benefits.

You're kidding right? You mean people without money !

People. The NHS is a socialist construct. That is what 'free at the point of use' means.

People always sign up for free stuff. Therefore: demand always is greater than supply. NO amount of funding solves this or will ever relieve the demand. Thinking the solution is 'more funding' is fantasy. The problem lies in the essential construct (free stuff)

This, is the fundamental problem of the NHS, and we need to discuss it.

We need to discuss how to connect financing between consumer (patient) and supplier (health) in a way that is affordable.

At the moment the contract is between provider (government) and supplier (health) - which is why layers and layers of bureaucrats are required. Socialism!

It's not the people who pay that's the problem - it's the exempt ones who do it to avoid paying the £1, i.e. long term health exemptions, young/old people, those with prepay certs, and those on benefits. It's only a minority who pay the £9, the majority don't pay.

Pardon me, but buried in this rant was reference to people with “prepay certs” are those not people who have prepaid for their prescriptions?
Which means they do pay for their prescriptions only they have so many they just pay it annually or by monthly direct debit instead of at the till? How can you say that people who prepay are a “problem” compared to people who pay at the till later?

Screaminglady,

No. Demand does not always exceed supply with a public good. Look at fire and police which are also “free at the point of service” but funded through taxes. Healthcare is no different. It’s a need not a want.

Pardon me, but buried in this rant was reference to people with “prepay certs” are those not people who have prepaid for their prescriptions?
Which means they do pay for their prescriptions only they have so many they just pay it annually or by monthly direct debit instead of at the till? How can you say that people who prepay are a “problem” compared to people who pay at the till later?

Ever heard of the marginal cost basis?

Anyway, things like paracetamol and over cheap items bought in supermarkets etc just shouldn't be given on prescription. It not only costs the NHS the cost of the item, but also the costs of the GP and staff prescribing it, the costs of the NHS processing it and the costs of the NHS to pay the chemist to dispense it.

Same with dentist prescriptions for fluoride toothpaste on the NHS which is a well known "freebie" for those who don't pay for their prescriptions. I'm surprised it doesn't get as much criticism as paracetamol. My sister works for a dentist and can't believe the sheer number of their patients who have regular repeat prescriptions for fluoride toothpaste. She says its mostly the patients who don't pay (the same ones who don't pay for dental treatment). Some people really know how to play the system.

Perhaps it's time that, like free condoms, chemists just hand out free paracetamol and toothpaste to those who ask for it - it would save a fortune in admin/management costs!

Just found an article that also repeats this problem, not using the 'S' word:

NHS needs reform not funding, says leading consultant
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A leading cancer consultant has warned that the NHS is on the brink of implosion as millions of poun...

A leading cancer consultant has warned that the NHS is on the brink of implosion as millions of pounds of increased public spending is pumped into a bureaucratic system that cannot withstand the strain.

In his paper, 'Resuscitating the NHS: A Consultant's View,' Dr Maurice Slevin said the problems of the NHS are systematic and cannot be addressed through increased funding.

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Dr Slevin said the NHS has insufficient nurses and ancillary staff and stressed concern that too much of the additional funding is being wasted on a proliferating bureaucracy.

'The problems are clear to anyone who works in both the NHS and the private sector. In the NHS, the vast numbers of managers are there to stop things happening. In the private sector, the small numbers of managers are there to make things happen,' he said.

Slevin claimed there are eight managers for every 10 nurses in the NHS, compared with just under two managers for every 10 nurses in the private sector.

He called for a dramatic reduction in 'the numbers of managers and administrators in the NHS, using the funds generated to substantially increase the number and pay of nurses and allied professions.'

To replace the failing system, Slevin proposed a voucher scheme that would allow patients to claim 100% of the cost of treatment on the NHS or 70% in the private sector. Any additional cost would then be backed up by insurance, or would be self-funded by the patient.

Stephen Walker, chief executive of Medical Insurance Services, agreed the NHS needs reform, but was unsure whether the voucher system is the solution.

'A voucher system is a good idea as those who cannot afford to provide top-up funding could still use it, but it could be argued that it would create a two-tier system ' which we already have. Money definitely is not the answer. The system needs radical reform, it is patently failing,' he said.

My daughter, who is 29 and has a young child, has had a sore throat for ages and has felt a lump in her neck. She is terrified it is cancer. Her GP doesn't know what it is. She wants to go to a HNO specialist and has now got a referral but has been told that it will take 5 MONTHS to get an appointment! This is terrible. It probably isn't anything serious but surely she should be able to get it tested just to be on the safe side, as early as possible? In Germany she'd had just walked in to a HNO specialist on the high street within days, under public insurance.
The NHS needs an overhaul.

@PlanDeRaccordement your comment just shows how otherwise intelligent people lose their minds over the NHS.

Instead of dealing with the problem, you insist that the ideology is a good one and must not be tampered with!!!

Your example is a false analogy.

It is extremely rare for a house to burn down.

It is also fairly rare to be burgled, raped, murdered or be in a car crash.

However, millions of people have health issues in varying degrees of severity every day. You cannot compare the NHS with the police or fire brigade in terms of DEMAND AND SUPPLY (which is the problem)

Dr Slevin's voucher system, for example, is attempting to tie up the patient with the supplier in terms of financing. At the moment they are completely divorced which is why socialism does not work and results in huge bureaucracy, shortages, rationing and queues. It is economics 101.

There is an economist called Charles Murray who has a very interesting solution to the problem of medical funding:

compulsory health insurance paid out of universal benefit
ending the spanish practices of doctors (ie, more technicians doing basic medical work leaving doctors as consultants)
reforming the laws of tort (less of a problem here than in USA)

One more which I can't remember, read the book ages ago.

The health insurance would go into a central pool. Because there are more healthy people than unhealthy, it would be affordable. Personally, I would like people with illnesses such as smoking, obesity, type 2 diabetes etc to have a cost imposed on their lifestyle choices - but by the market, not bureaucrats.

He said: these would drastically reduce the cost of healthcare and tie the patient to the medical profession in terms of payment, that they could afford.

The point I can't remember is definitely linked to the cost of medical supplies. I was sitting next to a senior director of a medical supply company (household name). He told me that an item like a cannula costs 2p to make. They charge the NHS over £1 per cannula and it is money for rope.

It is curious that the NHS is such a 'sacred cow'. My impression is that healthcare systems are better in many other first world countries (Germany, Spain, any Scandinavian country for instance) and possibly even in some non-first world countries.

I don't see why discussion around different styles of healthcare and how to fund it shouldn't be on the table. There's been a lot of 'out-sourcing' which is essentially privatisation.

For instance, the Priory healthcare group is a Ltd company so that means it's in business to make money. It was sold to a Dutch bank in 2005 for 875 million pounds. Many of patients treated there are on the NHS. So the NHS is effectively helping the owners and shareholders get very rich. I think the MoD had a contract for military personnel to be treated there for PTSD after the Iraq war. That contract would be worth a huge amount of money.

Since the general public fund the NHS via their taxes, why should we be funding a private limited company which is in business to make money for its shareholders?

See what corportatwatch. org has to say about the Priory healthcare group. Former employees of the group do not always speak favourable of the corporate environment of the organisation.

This is just one example of 'privatisation' of the NHS. I think it's probably one of the reasons that debate is discouraged.

Is it morally right to make money out of the treatment of some of the most vulnerable people in our society which includes children being educated at specialist schools?

Surely at least time to debate the pros and cons of the NHS and compare it with other healthcare systems in the world?