To think the NHS is screwed

[jaspercabbage]

Elderly relative had cancer related surgery before Christmas. The surgery went well but there has been no follow up appointment with an oncologist since. Recently they have taken ill again (clearly to do with the cancer) and have been to a&e four times in two weeks. They are treated for the sickness then sent on their way for the same thing to happen a few days later.

They were admitted again earlier in the week and have been stuck on a trolley, in a bay, in a&e for two nights now due to no beds in the hospital. This is an elderly person quite possibly now requiring end of life care and they can't even have their family with them. I just can't believe it's this bad.

I'm also due to have a baby later in the year, could be complications and to be honest I am shit scared about staff shortages and aftercare. What if something goes wrong in labour and there is nobody to deal with it at the time?

How can things have got to this point? The people are crying out for life going back to normal clearly haven't had to visit hospital lately. Although this is probably to do with a lot more than covid - underfunding, Brexit at so on.

Just a rant really but interested to hear other peoples thoughts.

1 reason though private healthcare is so good is because only 7% of the population uses it. If more people used private healthcare, there would also be problems.

This is a really important point.

@VelvetChairGirl

You can pay privately, bare in mind that many of the private companies buy slots to use NHS equipment like MRI scanners etc because they are very expensive and it saves them money renting ones that are already in NHS.

what you can not do is pick and choose where your taxes go, whether it be healthcare, war, schools, propping up beady branson so he doesnt have to put his hands in his own pockets etc.

I'd love to go private. In other developed countries I could, as they have far greater competition. The cost of NHS keeps the demand for taxation so high, it's hard to see how I and a substantial number of people would be able to pay for both private insurance and still fund the bloated NHS. Something has to give.

If the proportion of my tax that goes to the NHS was handed back to me, I could buy significantly better treatment than the NHS "gives" me.

Your taxes will never go down only up, regardless of what they claim to be using it for, go private with bupa, nuffield or whatever or stop bleating and arrogantly dismissing everyone else on this thread, its clear all you care about is your own wallet and you are determined you will never need any help yourself, so stuff everyone else.

The issues seem to be under funding, waste and having less doctors per head of population than most of the rest of Europe.
Also those who say how great the NHS is or was aren't looking at current and historic survival rates in U.K. for cancer, heart disease etc compared to rest of Europe. We don't compare well. I'm no expert but would seem to me that there will be some connection with lack of preventative care in U.K. - very few GPs, no routine annual health checks such as are normal in France, Germany etc.
There needs to be a mature investigation and debate on the pros and cons of other funding models and healthcare systems. The bottom line is that the statistics ( and personal experiences of other health care systems) suggest that there are superior models elsewhere including for the poor and most vulnerable.
No one could speak or think more highly than i do of the majority of NHS employees I've encountered in my time, but the system is broken. I don't think additional funding is enough.

I lived in the states. Our family healthcare plan was $1,500 a month. before co pays and annual deductibles (5k). So for example giving birth was $6,000 after insurance negotiation and deductibles. Or each doctors visit might be $150. As an expat I had a platinum package and it was still extortionate. What people don't realise though is what happens when you get really ill. My co worker got breast cancer. In order for her insurance coverage to continue she had to keep working. She literally had to come into the office after each chemo session. She was a vomiting, wreck of a person. If she left her employment she would go on to disability and therefore only Medicare. She tragedically died within a year. I think of her often and wish she had just taken the time.

One issue with private in the UK is it only has set criteria of stuff it deals with. I bet nobody goes for their asthma, diabetes or cancer care privately.

People also make more use of the NHS in their last 6 months of life than they do at any other point.

Even Prince Philip ended up with NHS care before the end, OK he'd have had a private ward or whatever but private couldn't deal with it.

@Imnotafemistbut Dh and i have private health insurance as part of our work benefits. I don't actually think its that expensive compared to what my parents are paying in Singapore Or what higher income Germans pay. Certainly nothing compared to what americans pay. It wouldn't be so popular as a work benefit if it was expensive!

The private companies know that people may choose to use the NHS and they factor this in accordingly. I know plenty of people who could have gone private but chose to use the NHS for other reasons. Premiums would skyrocket if more people used private healthcare and yes there may be more providers, but it would still be more expensive. What would bring down costs overall is if there was a state insurer offering affordable premiums. The advantage of health insurance systems is that it is easier to scale up people's contributions rather than general taxation where it is a political minefield if you even try to increase it by 1%. The nature of healthcare means that it would inevitably have to go up with the development of new technologies and increasing wages etc.

One thing that the nhs has benefitted my family is training. It would have been almost impossible for my family to afford their medical training in, say, the USA. Students have to literally buy all the kit they need. Not a stethoscope but literally all the kit (drills/materials/X-ray kit) it’s tens of thousands of pounds. I don’t know how medics are trained in Germany actually but I’m guessing doctors/dentists get their tuition and kit paid for from the education budget via general taxation. So tax to the nhs could not go down without making some up in education if health sciences are to still be open to students on an average income .

Not almost impossible, entirely impossible.

I have private health insurance for the past 5 years plus - and it is useless. It excludes habving a baby, pre existing conditions, emergency care, or complex issues eg they can only test you for one thing at a time, menopause. It is £1000 + per year and very limited. I don’t think anybody really knows how much it costs to provide unlimited health care. I do think it should be a separate tax - clearly indicated on your wage slip/ tax form. The NHS is not free - it is paid for through taxation. There does need to be more money - but there also needs to be transparency on where it is all going - it just seems to be a big black hole at the moment

It isn't the case in France that premiums are astronomically high. Far from it. The NHS crushes most private provision that could arise, because the only customers for private care are those that can pay for everything, ie the very wealthy, and there's not many of them.

This is what people don't seem to understand about Continental healthcare provision - the suppliers are often private. Even in socialist France a good third of the suppliers of healthcare are 'for profit' organisations. The other two thirds being State run bodies and 'not for profit' private organisations. There is an actual market in healthcare. Need your knee operated on - you have choices between supplier, and also the opportunity to pay some more yourself on top of the state funded part. A State hospital will be cheaper, but the private hospital may be quicker, and offer better facilities. But crucially the State will pay the same amount to either, which ever does your op.

The easiest way to improve the NHS would be to say 'Every healthcare scenario has a fixed 'price' attached. If you go to a State hospital you get your procedure for free. If you go to a private healthcare company and get your care from them, the State will pay the standard fee to them too. You are free to add whatever you need to that fee to pay for your care'. This would mean patients had genuine choices, but it would also mean State run hospitals faced losing revenue as patients went private (and added their own money on top). This of course would mean a NHS hospital could go bust, or have to reduce the number of workers, streamline, be more efficient.

Which of course would never do, as we all know, the fundamental aim of the NHS is to provide well paid jobs and fat pensions for its workers, first and foremost, and any healthcare the patients receive is a sort of added bonus. Anything that meant the first priority was in any way thwarted must be stopped at all costs, even though it meant patients got better care, of their own choice. Which would never do......

The scope for private medicine in this country is constrained by the vast amount of money the state monopoly that is the NHS takes out of the marketplace through taxation.

That monopoly is a large part of the reason the quality of medical treatment in this country lags behind comparable nations.

@VelvetChairGirl

Your taxes will never go down only up, regardless of what they claim to be using it for, go private with bupa, nuffield or whatever or stop bleating and arrogantly dismissing everyone else on this thread, its clear all you care about is your own wallet and you are determined you will never need any help yourself, so stuff everyone else.

its clear all you care about is your own wallet

Thank you for the advice. I'm perfectly able to compare the proportion of what I pay to what I take from "our" nhs. The remainder of your ranting paragraph is based on a falsehood.

I am a net contributor to the NHS. Others take from me, and you have the nerve to write: "all you care about is your own wallet "? I take it you're not a net contributor and rather like the idea of other people funding your health care?

You know what you can do with your socialism !

I have private health insurance for the past 5 years plus - and it is useless. It excludes habving a baby, pre existing conditions, emergency care, or complex issues eg they can only test you for one thing at a time, menopause. It is £1000 + per year and very limited.

In fairness, private healthcare differs. My parents pay for theirs individually and it covers pre-existing conditions, whether complex or not. One of my dad's medical issues requires replacement of a medical device every 10 years that (from memory) costs tens of thousands of pounds.

Our healthcare is through a corporate scheme. It also covers pre-existing conditions. I've just had major surgery for a chronic condition I've had since childhood (and they allowed me to have it at one of their non network hospitals). It also paid for me to have both of my kids privately (the caesareans being deemed medically necessary).

It costs us £250 each plus one £100 excess a year. I get free access to a private GP (I can often get telephone appointments the same day), can see a consultant for 95% of medial issues plus unlimited physio and other benefits.

I wouldn't describe ours as limited. For us, it's probably the best value thing we spend money on.

@Thevoiceofreason2021

I have private health insurance for the past 5 years plus - and it is useless. It excludes habving a baby, pre existing conditions, emergency care, or complex issues eg they can only test you for one thing at a time, menopause. It is £1000 + per year and very limited. I don’t think anybody really knows how much it costs to provide unlimited health care. I do think it should be a separate tax - clearly indicated on your wage slip/ tax form. The NHS is not free - it is paid for through taxation. There does need to be more money - but there also needs to be transparency on where it is all going - it just seems to be a big black hole at the moment

I agree with your very reasonable points. As I've already written. The scope for private medicine in this country is very much constrained by the vast amount of money the monopoly NHS takes out of the marketplace through taxation.

That monopoly is the main reason the quality of medical treatment in this country lags behind comparable nations.

I'd hazard a guess that the people on here who bang on about how wonderful the NHS is, and how I'm selfish and how anything other than the useless NHS would be a disaster, are the very same people who call Brexit voters bigoted Little Englanders, yet said supporters of the NHS will never have experienced foreign healthcare systems and how much better they are than their beloved NHS.

Naturally I've been called a xenophobe for complaining health care tourism. But the true xenophobes are those that refuse to accept that the British/NHS way is not best, and the fact that not one other country in the world has copied the NHS is a pretty good pointer to its failures.

@Imnotafemistbut I have lived in 2 other countries and experienced very different medical care systems, including the German healthcare system. I also have private health insurance in the UK so know what private medicine is like here.

Switching to an insurance model will inject more funds into the healthcare system but it will not solve many of the other problems i.e. lack of medical staff. It will also cost more money for the individual. For middle income people, it might be more worth it than having to go privately in the UK. But I am not sure British people are willing to pay the extra.

I personally don’t think it’s the ‘best’. I don’t think there is a best. But I do think it’s the best of the alternatives for the uk. It’s context specific.

*Thank you for the advice. I'm perfectly able to compare the proportion of what I pay to what I take from "our" nhs. The remainder of your ranting paragraph is based on a falsehood.

I am a net contributor to the NHS. Others take from me, and you have the nerve to write: "all you care about is your own wallet "? I take it you're not a net contributor and rather like the idea of other people funding your health care?

You know what you can do with your socialism !*

Ad hominem what makes you so sure you will never fall on hard times and need other peoples money, its highly unlikely you will be paying for yourself do you really think your taxes alone cover everything you get or will need as you age?

are your children in private schooling? are you elderly relatives getting treatment, was your pregnancy free etc? how do you know you wont need a state pension, bereavement allowance, UC etc one day or need the police or fire service or this country may need defending from a foreign enemy.

@aristotlesdeathray

YANBU

I'm at the point where I'd welcome a fully funded model like in the US

Having had hospital treatment in both the U.K. and US it's far superior In every way possible

The NHS we all knew and loved is dead, time we move on

What happens if your insurance doesn't cover your condition or the treatment you need?

Spoiler... in the US you pay for it out of pocket or you die

Paying for private health care would end up screwing over the low-middle earners on 16-30k per year as usual.

Unemployed, children, students and those on a lower income would have healthcare subsidised (quite rightly). Those on higher incomes wouldn't feel the burden as much.

It's those stuck in the middle bracket who would once again be screwed by being too 'well off' have financial help whilst watching costs rising, and not having a payrise anywhere near in line with inflation for 15 years.

@Imnotafemistbut

"If the proportion of my tax that goes to the NHS was handed back to me, I could buy significantly better treatment than the NHS "gives" me."

Well you could do the same with your contribution to the police (hire your own security firm), your children's education (private school), waste collection (hire private contractors).

It's not really how it works....

@VelvetChairGirl

*Thank you for the advice. I'm perfectly able to compare the proportion of what I pay to what I take from "our" nhs. The remainder of your ranting paragraph is based on a falsehood.

I am a net contributor to the NHS. Others take from me, and you have the nerve to write: "all you care about is your own wallet "? I take it you're not a net contributor and rather like the idea of other people funding your health care?

You know what you can do with your socialism !*

Ad hominem what makes you so sure you will never fall on hard times and need other peoples money, its highly unlikely you will be paying for yourself do you really think your taxes alone cover everything you get or will need as you age?

are your children in private schooling? are you elderly relatives getting treatment, was your pregnancy free etc? how do you know you wont need a state pension, bereavement allowance, UC etc one day or need the police or fire service or this country may need defending from a foreign enemy.

I don't suppose "all you care about is your wallet" counts as ad hominem, does it?

My financial situation is none of your business. Neither is what provisions I've made for the future.

Do you really think everyone can be a net beneficiary? Where do you imagine the money is going to come from?

[quote Kdubs1981]@Imnotafemistbut

"If the proportion of my tax that goes to the NHS was handed back to me, I could buy significantly better treatment than the NHS "gives" me."

Well you could do the same with your contribution to the police (hire your own security firm), your children's education (private school), waste collection (hire private contractors).

It's not really how it works....[/quote]
No, because they provide a service that I am, for the most part, quite happy with. The same is not true of the useless NHS which takes fortunes from me and provides me with an incompetent GP and jam packed hospitals that can't improve cancer survival rates.

@Alexandra2001

for those that say "insurance funded model" how does that work for millions with pre existing conditions?

European government health service insurance have to accept everyone regardless of pre-existing conditions... they are not allowed to pick and choose. But it is often cheaper for younger people to buy their co-payment element in the private sector because the premiums are lower thanks to the risk profile. Like car insurance, but the other way round!

Thank you @Theresthat... sorry not to acknowledge earlier..... I've been at hospital appointments this morning.

HRTFT but USA isn't the only model for a health system - France and Germany seem to have excellent outcomes (apparently for similar costs). Maybe we could look at what they're doing that works?