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.

It is absolutely going that way.
I increasingly despair with this country

Lots of benefits need means testing, even if that means removing them from people that don't really need them yet are currently afforded them simply because of age. And there are several. Prescription charges being one example. Money could then be diverted to Camhs as pp said.
That's why charging for missed appointments wouldn't work, because 25 year old Johnny who doesn't turn up to my clinic would be penalised, yet 85 year old Joan wouldn't despite the latter statistically probably better able to afford. But there would be uproar. The number of older patients who look aghast when you suggest that the NHS doesn't supply a 'tonic', or the first port of call for cough medicine might be over the counter.
We also need to change the mindset that prolonging life at all costs is the very best thing. Cure this, cure that. Too many people living too long.

@Scrunchies

I’m at Gp and I think that there should be some form of privatisation. I don’t have all the answers but think the nhs at the moment is a failing system. As PP says camhs is absolutely atrocious service provision.

Overall there is too much demand, it tries to cover too many things. It simply cannot provide everything for everybody, and sadly it does get abused. Usually this means that the people who rarely use it struggle to even get basic needs met, and high frequency users become more and more dependant and have higher expectations about what they are entitled too. And nobody ends up happy.

I agree with pp that nhs staff are often rude and aloof - I certainly have been previously and it was because I was utterly burnt out, overworked, put upon and became emotionally detached. I stopped caring. The system needs to change.

I echo this entirely, particularly the second paragraph.

Talking purely from a mental health perspective - I'm a MH nurse and we have service users who frequently either get admitted into the ward, or who present at the crisis team on a regular basis who...don't really need to be there shall we say. People who approach MH services time and time again, because they have simply learned that we are there, as opposed to genuine need. Meanwhile, I have seen seriously mentally unwell people who desperately need to be admitted, struggle at home because they just cannot get a bed because the system is so clogged up.

I really don't know what the answer is. People who misuse and abuse the system will always do so and I can't think of how to resolve this.

@pubble

I’m not saying it shouldn’t be self funded. I was answering your question regarding how many have to sell. Plus your follow up question about thresholds, care at home costs and wether the he house is disregarded for children etc.

But if you want to know what my solution would be it’s euthanasia. Plain and simple. Once you can no longer look after yourself - it’s lights out.

@pubble

The fact that we can keep people alive longer doesn't mean we should...

I definitely think it should be discussed, I find it odd that people are so squeamish about it.

In my experience it’s not the older person themselves, it’s family members. Understandably so, but we need to be clearer about ageing, death and dying.

When I started nursing nearly 30 years ago it was very very unusual to have inpatients in their mid to late eighties. To see a patient pushing a hundred was rare - now it’s commonplace. We are living much longer, but not necessarily better. With advanced age comes ill health, comorbidities, reduction of quality of life. I’m obviously not advocating bumping people off as they hit 80 but as a society we need to rid ourselves of the notion that we can live forever and avoid death.

I was witness to a very uncomfortable conversation recently between a GP and a very elderly lady and her family. He was diplomatically and gently suggesting that further treatment wouldn’t be in her best interest (the cascade of pharmacology interventions) and that sometimes nature needed to take its course. The family were outraged that he was “trying to kill her” and “he thought her life wasn’t worth living”. He said no such thing, but that was their perception of the situation.

The NHS cannot be all things to all people. We need to have those difficult conversations. We also need a much better alliance between medical care, and social care, and a reduction in dependency in that people care for themselves more rather than expecting the health professionals to do it for them.

@sidge. We’ve become very removed from the idea of having a good life rather than a long life. I’ve had a conversation with my gp some years ago along these lines - only to be told I was obviously depressed.

@Bargebill19 that’s bizarre isn’t it? I’m not depressed but I’m quite clear that for me, quality of life is my priority, not quantity.

I have some wonderful older patients who are living relatively long healthy lives but they aren’t the majority.

@sidge. Agree. I’ve cared for the elderly within the family and volunteered in retirement developments, finally working in care homes.
There is a lot of truth in the saying old age is not for the faint hearted.
It’s something I absolutely do not want to reach ‘at all Costs’. So I’ve made my plans and all who need to know, know. They are not happy, but it is my life and choice.
I suspect because of that bloody GP it’ll
all be ignored on the grounds of ‘depression’
and not respected as a researched and long thought about personal choice.

There is just no limit to the demand on the healthcare service free at the point of use. There is no link between demand and costs, the only control is making people wait for treatment.

The alternative doesn't have to be the US model of pay as you go, with some people being bankrupted by medical bills and others having world class treatment on tap.

Other systems (Germany, France, Australia) all provide excellent healthcare provision, funded by a mixture of employers/employees with family provision for children and country wide provision for pensioners.

People can use private insurance, or just pay as they go. This option tends only to be picked up by people temporarily working in the country who will move to other countries before becoming pensioners. Importantly, private healthcare is not significantly better than the standard provision.

The key difference is whether the system is organised for profit as in the US or nit as in Europe.

Overall, It does cost a bit more per person but then there are no significant queues so cost per procedure is probably no higher than in the UK ( where so many people have to queue so do not cost anything while they wait. The type of procedure they make need can be more complicated but that doesn't show in the stats ).

There are also no tricks like paying for an initial consultation privately and then being fast tracked into NHS provision. No one likes to think about the people who therefore stay in the queue for that much longer before seeing the consultant and getting into the system for NHS treatment.

I'm a great admirer of the NHS but really, nurses and doctors and everyone else should not be working overtime, starved of resources. It really doesn't have to be like that.

It's not unlike schools, if everyone has the option of a place at a hood, local school, there is much less pressure to go private.

Also when Labour's PPI/PFI hospital bills start coming due, we'll be in deep trouble.

@LalalalalalaLand123

Also when Labour's PPI/PFI hospital bills start coming due, we'll be in deep trouble.

Those bills came in as soon as the projects were completed, they were essentially mortgages. Most of them were 30 year contracts and some of them are already nearing their ends. The organisations with PFI projects will be infinitely better off when the contracts end.

Incidentally Major started the use of PFI.

While I agree that something needs to change I'm not sure what would benefit patients and staff most.
However I dont trust this government to do anything other than the USA model because they are all about the money.
If we had a competent government I might trust them to tweak things here and there and know they are trying to improve the nhs not sell it off to the highest bidder.

Your half of your property’s value is taken into account and the local authority reclaims it when your partner dies. The house has to be sold immediately if the partner is under 60.

@Blossomtoes the value of your home isn't taken into account if you have care at home which is what the majority have.

@pubble

Blossom did say if you went into a care home.
Care at home isn’t always suitable unfortunately.

@Bargebill19 when I was referring to the issues & costs arising with an ageing population & care I wasn't separating out the types eg residential & non-residential because they all need to be paid for regardless. Hence why I questioned that most people were selling their homes to fund their care. Some people are for some types of care & it's not enough hence the huge shortfall.

Depends what happens at the next general elections. Though people will probably be conned in voting against free at source healthcare and then 2 years down the line complain bitterly they didn't understand

@Bargebill19 blossom said The boomer generation is selling its houses to fund social care. Which is what I queried.

Care at home isn’t always suitable unfortunately.

Of course not & Im not disputing that but the majority are not in care homes.

[quote pubble]**@Bargebill19* blossom said The boomer generation is selling its houses to fund social care*. Which is what I queried. [/quote]
Sorry I wasn’t specific enough, I could have saved you a lot of typing. 🤷‍♀️

The NHS cannot be all things to all people. We need to have those difficult conversations. We also need a much better alliance between medical care, and social care, and a reduction in dependency in that people care for themselves more rather than expecting the health professionals to do it for them.

definitely but I have no idea how we get to that.

@pubble put like that then your answer is yes a lot do have to sell their homes. Some go into care homes for which the family home proceeds pay and some downsize, or move into retirement developments. The freed up money pays for care. Not all
Boomers have money in the bank, it’s often tied up in property.
Conversely some have the ability to be able to pay for care at home, or family help out with costs and some are lucky that the state will pay.

But we were talking about social care in the context of care homes hence the reply to your question, and not a reply as in care within the family home.

@Blossomtoes I accept your apology although it clearly pains you! 😜

[quote pubble]@Blossomtoes I accept your apology although it clearly pains you! 😜[/quote]
It wasn’t an apology. It was sardonic.

However I dont trust this government to do anything other than the USA model because they are all about the money.

I agree, I'm half French so have experience of their system & I like it but I think because any discussion is shut down we will end up with a shit system by stealth.

@WB205020

The NHS as we know it is doomed but its also a poison chalice and whoever is HS at the time will be reluctant to change anything major as whenever any changes are proposed pitch folks are out and its career ending. Look at Andrew Langsley i'm not getting into whether his changes were right or not but when he made changes it cost him his job because a baying mob wanted blood.

I genuinely fear the only way the NHS will change is when it has completely collapsed as trying to change it before only seems to end in career ending pushback and i doubt any MP will step up to the plate to do that only to have their career ended as a result.

Have you missed the bit on my OP about the NHS Bill currently going though parliament? The Tories are hell bent on getting their grubby hands on it under the guise of 'reform'.