@StripeyFloorboards
I am fed up of hearing about how we can save the NHS. The NHS should be saving us, the customers, not the other way around and if they can't do that, perhaps we can get a massive tax refund and spend that money going private instead!
This. So people should try to avoid being ill in order to protect the health service, which we pay for? Can anyone else see how backwards that sounds?
Well, there are several issues with that summary of the state of affairs. Yes, lots of money is spent on the NHS. But, a lower % of GDP per head of population than a significant proportion of most developed nation. We have a significant staff shortage. And bed shortage. It really is not a case of everyone out playing golf/having coffee and cake whilst patients are left suffering at home waiting for a clinic appointment/their surgery or are stuck in trolleys in A&E or unable to see their GP.
Many of these issues have their origin in healthcare policy and so are largely due to political decisions regarding care models. Add in poor workforce planning, which is partly due to the fact that UK Plc did not anticipate that we might struggle to attract workers from overseas- our “go to” plan when we run short. And partly because, for some reason and despite plenty of warnings, the powers that be chose to ignore or did not anticipate the increasing exodus of staff who leave their professions, the increasing number retiring the minute it is feasible, those leaving substantive posts for locum roles (can walk out at the end of the day without all the additional work, extra headaches, being left to implement all sorts of changes- good, bad and completely terrible), nor the increase in those leaving for abroad. Many, if not most, of these were not decisions made solely, and in many cases not at all by, NHS management.
Many people underestimate how much private healthcare costs. I do some private work and I know how shocked some of those who are self-funding can be by the total cost of their care. Insurance can solve that issue- but if you have chronic/multiple health problems, certain disabilities, once you get to a certain age etc the cost of those premiums can be prohibitively expensive. Or not obtainable. Or obtainable but your chronic health problems excluded. And if you’ve ever had to deal with health insurance you’ll know how hard they can try to exclude all sorts of things from their policies and that they can be quite complicated- I’ve seen a fair few patients fall foul of not fully understanding T&C’s/exclusion/ policy wording.
Add in, that it is also true that complete privatisation is unlikely to mean costs lowering. We still won’t have any more staff, and there would need to be serious investment in infrastructure. Because, now the private sector wouldn’t be seeing the smaller numbers of patients, all planned/elective care which is much easier to manage and co-ordinate, which the private sector can easily manage right now.
Of course, we can- and I would argue should- look at alternative models such as those in France, Germany or even Italy. We could also stop trying to be all things to all people- maybe we could have a “core service” that is free at point if need and funded for national insurance and a shared model, or other form, of insurance for the “nice to haves”. I’m not saying that we have to do that, or even to copy another model (the French model does have it’s issues, as friends living there have discovered) and I have worked in Germany and it’s not all milk and honey either. There are positives and negatives in all systems.
We could also hope that patients could use the NHS more wisely than many do. I can already hear the howls of protest- but it IS an issue. It may be a sizeable minority, but at times of increased strain it is more problematic than at other times. The misuse ranges from wasting prescriptions; attending GP or A&E for things which could be managed by self-care as they really don’t require medical input or things that do need seen but could wait for a routine appointment etc; not turning up to appointments is rife in both primary and secondary care. In the area I work it’s just over 19% of out-patient clinic appointments missed, and 1 in 9 radiology appointments (x-ray, ultrasound, CT or MRI). My GP shows their stats and not dissimilar. My friend, a GP, has been frustrated at the number of DNA’s for her minor surgery/joint injection list (run in the practice) and also for coil/contraceptive implants. It’s wasting huge amount of GP and nurse time (as sometimes both required) and these are longer appointments. So much so that the practice are reconsidering whether to put these services on hold.
Sitting just one of these issues will not be enough. But to fix the problem faced by the NHS, to solve the things preventing the care from being all that we might wish at times, does require a proper understanding of the reasons fir it’s failings, the difficulties it faces, but also the things it does well (and why it does it well). I’m my view, the NHS currently hirples on largely on the good will of it’s staff and public support- both of which are rapidly coming to the end of their tether.