To think free healthcare as we know it won't exist in five/ten or so years from now?

[flashbac]

And the NHS bill going through parliament is a confirmation of that?
Proposals are that:

Private companies will be able to offer services without any tendering processes (we know from the PPE fiasco how bad that is for the taxpayer),

the statutory duty to provide hospital services will be removed

private (FOR PROFIT) corporations to play a huge part in shaping virtually every aspect of our healthcare.

There's a demo about it today.

@FightingtheFoo

The NHS already do that *@Flamingo49* because they're trying to save as much money as possible.

I agree (I work in the NHS) but there is a big difference between trying to save money and trying to make money. I manage our team's budget and I am always trying to save money where I can, but my intent is always to provide the best service we possibly can, I'm not thinking about how we can make as much money as possible. The pathways and decisions made would be very different.

@LookABabyShark

I know this isn’t a popular opinion here, but the NHS as it is at present is nowhere near fit for purpose. I have had a couple of health conditions pretty much my whole life, and I can honestly, hand on heart say that I do not recognise the selfless, kind, caring “angels” the NHS have been promoted as over the last year or so. My PERSONAL experience has been very, very different even pre-Covid; rude, impatient sometimes aggressive medical staff, delayed or cancelled appointments with no notice, being left waiting weeks for important test results, only to be told they have been lost, the sense that I should be grateful that they are doing their jobs and treating me (almost verbatim from one nurse)...the Covid crisis has just highlighted that this is NOT a system fit for purpose, and the government have been trying to distract us from that with the constant fawning and sob stories. I’m not saying private is the way to go, but something definitely needs to change in my experience 🤷🏻‍♀️

Couldn't agree more with this.

The NHS is dying and has been for years and years. It can no longer meet the needs of the amount of people that live in this country.

@Whycangirlsbesonasty

Indeed. But the NHS in its current form is totally unaffordable, and every year that passes only makes it more so. We have some of the lowest doctor to patient ratios in Europe, the worst cancer outcomes in Europe too. It’s underfunded, and we cannot keep throwing money at it in the hope that things improve as the nhs in its current form is unaffordable.

We need to look at how other European health services are funded and take the best system they have. Germany for instance has a public healthcare system funded by employer and employees. We don’t want to end up like America but is it such a bad thing to try to aim to be a bit like Germany?

But, whenever changing the funding of the NHS is raised, so many different groups start screeching like banshees that the plans get shelved and we end up with the same underfunded, failing system we have now. A prime example is CAMHS. We don’t have a CAMHS that works even slightly in this country. If you can afford it you go private, if not your child sits on a waiting list for years. Things HAVE to change!

How can it be underfunded AND unaffordable at the same time.

The decision to underfund the NHS is political one. We spend less per person per year than almost any other developed nation, and we are supposedly one of the wealthiest.

If you're saying we cant afford it, and the stats say we don't spend that much on healthcare, then someone, somewhere is lying.

The money spent on Brexit for example would pay for the NHS for the next ten years. The money we're going to lose from Brexit each and every year going forward, would have paid for the NHS EVERY year. HS2, Trident would go a long way towards it as well.

I agree things have to change, but instead of tearing everything down and starting again, maybe start by just spending as much as some of these other countries and having similar numbers of doctors, hospital beds, MRI scanners.

I feel like the NHS wastes a lot of money and are pretty inefficient in some areas. So maybe this is a way to try and get it working better. Well one can hope!

I have had private Healthcare with all of my employers since about 2012.

It's not the silver bullet that people seem to think it is.

I take immune suppressant injections biweekly for a condition that up until age 30 was making my life miserable. (Age 30 I got access to these eyewateringly expensive injections and my life changed, frankly.)

It is a condition I have had since age 11.

Are my injections covered by any private Healthcare provider I have ever had? Are they f*ck.

Private Healthcare care providers are insurance companies really, and they behave like them.

Thank goodness for the NHS. I honestly don't know what my plan B would be. I dread to think.

The NHS is underfunded and unaffordable as the vast amount of money we send it’s way is not enough and we can’t afford to pilot in more. In Germany the health service is funded half by employees and half by employers, whereas here we have an NHS funded by the government which is on its knees and BUPA etc funded by companies and private individuals. Why not send the company money to the NHS instead of BUPA?

Anything other than the US system, which is awful mostly because of the insanely greedy and inefficient insurance companies. I had some dental work done a while back, was told it would be covered by my insurance and then received a huge bill. When I called up my dentist to find out why it wasn't covered they just told me that this is what the insurance companies do, just to see if you will pay their inflated sums without complaint. After several back and forth communications, they accepted a smaller amount of money from me. But multiply that by millions and it's an absurd waste of money and time. A single-payer seems essential to me.

Not to me room how many would just pay up not realising. (That would be me) @VeryQuaintIrene

I work in the NHS.

It needs depoliticising. No single party should decide how the NHS is funded or run. (I think the same about education).

It needs total reform but to do that piecemeal is virtually impossible. It’s huge and unwieldy.

I don’t have an issue with private providers tendering for NHS work if they can offer a better service for the same or less money as the NHS - they can mop up maybe less acute services such as dermatology, ophthalmology, podiatry, outpatient physiotherapy, etc. As long as the patients receive quality care and in a timely fashion without paying at the point of delivery who cares whether it’s a private or public provider?

I also think those that can pay, should pay, even a nominal amount. Not a two tier service, just a way of charging those that can afford it. A European model is far preferable to an American one though.

People don’t value that which is perceived as free. If they had to pay for it in the same way they do other life essentials such as housing, utilities and food they might appreciate it more.

For those with private medical cover, which company have you gone with?

@flashbac at the moment people who don't work DO have full access to medical and dentistry and SEN assessments. It's unlikely to change but how about creating equality to people who can afford it to have the same standard of care? My mum is 77 and spending thousands on her teeth. Her cleaner (cash in hand because my family are champagne socialists) has so far paid nothing for the same treatment because she doesn't work. She comes from a horrendous background and I went to school with her but she's fit and healthy and never worked legitimately.

With dentistry she can pay. Getting a GP referral for private treatment if a routine condition is almost impossible. She could and now would pay. She tried with her knee and ended up flying to me and paying for it just so she could remove the agony.

The NHS as it is is not fit for purpose now though.

So many conditions and treatments available for them which weren’t available at the inception of the NHS, and everyone believes that their issue is important and should be funded when actually there needs to be more consideration given to what should and shouldn’t be funded.

Fertility treatment for instance which has an extremely low success rate (approx 30%) shouldn’t be funded on the NHS. it’s sad but the NHS should be saving lives not creating new ones.

One of the reasons why the policies for implanting embrio’s was changed was because it increased the number of premature births which in turn increased the amount of pressure on neonatal units, now the reduction in the number of embrio’s put back means that the success rate of IVF has dropped.

Cosmetic surgery for anything other than disfigurement due to e.g. car accident etc shouldn’t be funded.

There are so many things which other people will feel shouldn’t be funded and there needs to be an overhaul of what is and isn’t eligible for funding.

The NHS simply isn’t a bottomless pit, and something has to give.

@AlternativePerspective

Brave! I have always believed that the nhs should treat life threatening conditions from which you could die. There are a lot of things which are sad but not life threatening. Totally agree with you on not funding things like ivf and cosmetic procedures.
Fully expect someone to to come along and say that they would have died without a nose job/boob reduction/ ivf etc. As I’ve had that in real life.
The reality is people expect too much from the nhs and medical breakthroughs have meant that more can be done, but it needs paying for - and a lot of people do not want higher taxes but not do they want some things to no longer be available on the nhs.
Would I be happy to see a reduction in services and pay a higher tax - yes, if it meant not waiting months for a GP /nurse appointment and hospital waits were down to weeks. That’s the pay off for me. Less services/ higher taxes but a better service for life threatening conditions.

@Whycangirlsbesonasty

Indeed. But the NHS in its current form is totally unaffordable, and every year that passes only makes it more so. We have some of the lowest doctor to patient ratios in Europe, the worst cancer outcomes in Europe too. It’s underfunded, and we cannot keep throwing money at it in the hope that things improve as the nhs in its current form is unaffordable.

We need to look at how other European health services are funded and take the best system they have. Germany for instance has a public healthcare system funded by employer and employees. We don’t want to end up like America but is it such a bad thing to try to aim to be a bit like Germany?

But, whenever changing the funding of the NHS is raised, so many different groups start screeching like banshees that the plans get shelved and we end up with the same underfunded, failing system we have now. A prime example is CAMHS. We don’t have a CAMHS that works even slightly in this country. If you can afford it you go private, if not your child sits on a waiting list for years. Things HAVE to change!

Absolutely this

Totally agree with those saying nhs not fit for purpose. Child has been ill since Jan and the care he has received has been non-existent and dire. Worse thing is when we have offered to go private we have been told we can, but no team has the experience they do and he won’t get care and treatment he needs. So I stuck with them and am just exhausted now. We were told we would have appointment in June. Got cancelled day before and we are waiting for a new one and told unlikely to be before September.

You send emails. If you get a reply it generally contradicts what someone else says.

The nhs is used as a political football. Tories don’t want to touch it (I know there are something things, but not wholesale reorganisation) as then they are accused of privatisation. Labour the same but they don’t want to be accused of being blue Labour or pissing off unions.

@Whycangirlsbesonasty

I worry that by banning all discussion of an alternatively funded NHS we are going to end up with a choice between an American system for those that can afford it or an unworkable NHS for those that can’t. Bad for the UK public regardless of which we choose.

Could I just point out that this bill will affect only England. Westminster has no say in how the NHS is run in Wales, Scotland or Northern Ireland.

No, it is not all that matters. A private company is not operating health services out of the goodness of their hearts, they are in it for profit.

Each and ever healthcare worker is a private provider. They, quite rightly, don't work for free, out of the goodness of their hearts, as you put it.

The difference between a private corporate provider and an NHS lab doing certain tests, say, is that the private provider can be sacked and replaced with someone else if they're not up to scratch.

Presumably the people who think the NHS should be a monolithic organisation that subcontracts nothing, not even catering and cleaning, believe that the Soviet Union failed because over a period of 70 years they just didn't try hard enough to make communism work, there weren't enough five-year plans to raise production and standards. They believe its failure had nothing to do with the absence of market forces to price goods and labour accurately, facilitating accurate allocation of resources.

Our routine NHS provision is bad, the GP is over-worked, the receptionist has no concept of customer care, appointments are given seemingly grudgingly. Consequently I often use the good private GP and consultant led services nearby for routine things, it's not that expensive, they're civil on the phone, and an appointment is routinely 20 mins so you don't feel horribly rushed.

I would be happy paying the NHS more for better service but I fear that privatisation, without paying any more overall, will just further erode the quality of care. What motivation do private providers have to provide a good service? Their contract will undoubtedly be awarded on the basis of price and they'll provide a cheap poor quality service through NHS, and a good service for private-paying clients. We'll be exactly where we are now.

The £350m on the side of the bus was criminal, the NHS desperately needs the money and has been starved for years, and then using the false promise of giving it more funding to make citizens vote for something which isn't actually in their best interests. Pah.

The difference between a private corporate provider and an NHS lab doing certain tests, say, is that the private provider can be sacked and replaced with someone else if they're not up to scratch.

If we had a track record of funding healthcare appropriately I would agree with you. As it is we will invariably procure on price. Sacking a cheap and poor quality private provider and replacing them with a competent but more expensive one just won't happen.

I've thought this for years, there will be no free at the point of care or prescriptions when I approach retirement.

also think state pension age will move out.

I think it will definitely become less 'free' over time. The sad thing is that you could do it in a fair way -- you could adopt the French model where you pay according to your means. A huge percentage pay nothing at all, lower income pay a few quid, and even the highest income people don't pay loads (25 quid for the GP). And French health care is very good.

I like the French system.

We are going to have to address the fact we have an ageing population & the burden that comes with that but no one wants to "pay" n

I think if changes are needed to ensure we have the system then they should be for all or none, not layered depending on salary etc.
I think there are plenty of ways to raise funds, charge for a gp appointment, prescription charges for all, missed appointments at hospitals charged etc. Better than just raising taxes as the extra is funded by those using it.