To say the NHS should be privatised?

[Cheekypeach]

Preferably only partially, but still. I was talking about this with DH yesterday who is adamant it should stay as it is. I said I don’t think it can survive in its current form, and I for one would rather pay more and receive a better quality service. AIBU?

@DrBlackbird good post. Spot on.

The trouble with saying "not the Tories"is that the Tories are in power and Labour have an uphill struggle to be able to win the next election. The only way to genuinely improve the NHS is with better funding which can realistically only come through increased taxation. It's a rock and a hard place because the British public tends to want better healthcare without higher taxation and isn't likely to vote for a party that suggests it.

@CoconutQueen

I'm a nurse. Yes it should be, not partially but totally. The NHS is a total shambles and not fit for purpose; getting worse and worse every single day.... I am genuinely scared by the corners being cut and how unsafe it is. It's a fucking shambles.

Student nurse here and I quite agree.

Would you rather have a European-style healthcare system than the one we have now?

I’m sorry OP but this question is entirely rhetorical because we will never have a European-style healthcare system. You seem to ignore how many European governments publically fund their health care more than the UK despite the addition of private insurance. In any event, no system is perfect including European ones. Just be appreciative that we are bloody lucky to have the NHS, thanks to a Labour government and post war sense of collective endeavour.

Anything proposed today by this government will lead to greater inequality in care and a vastly more expensive system that would create immense profits for a tiny percentage of UK/US firms and some lucky mates of MPs.

@SurfWaves How would fully privatising the NHS help?

Plus why would a private provider or an insurance company take on someone with an expensive to treat chronic condition? or someone who say does mountain biking or horse riding or rides a motorbike?

Or would you ban these.

I had treatment for ovarian cancer , expensive surgery,drugs,care the list is endless.
I would be dead if I'd had to pay as i'm sure many more would be.
Also you start pricing at what you feel are 'reasonable' rates and market forces will soon push those prices up pushing healthcare out of the reach of many.

*My question was stupidly worded

It should’ve been

‘Would you rather have a European-style healthcare system than the one we have now?*

@Cheekypeach
The problem is,op, that a European model in the UK still wouldn't be any better because European countries spend more than the UK on funding it.

If you ask, 'do you think the NHS is doing better or worse compared to a European model' then most people would say worse. Except you'd probably be frustrated by those who point out that if properly funded their answer would be different.

...Which brings us back to the issue of properly funding it. If the argument to change our existing model is that it'll be better funded because its privatised, well that's wrong wrong as pp have shown. For it to work as a privatised model, the state would still need to spend much more on it than it currently does.

So let's assume the options are:

1. government increases NHS funds to compare with EU countries
2. government moves to a French or German healthcare system

Well, of these two the one that provides the better level of care is still a properly funded NHS, because it even if a properly funded French/ German model existed here the it would still be less than a properly funded NHS.

If you're question about moving further to privatisation is merely a hypothetical one that removes the Conservatives from the equation totally, then I and many other pp have answered. We answered No.

I can understand you getting frustrated at being thought a Tory but that's not what people are saying. They're saying you can't seriously think through the reality of moving to privatised model in the UK without considering Conservative motives and intention because the reality is:
A) they're likely to be in power for some years yet
B) even in opposition, Conservative business and financial goals still hold a lot of sway and influence

So, however frustrating it is to you, it is relevant for answers to refer to the political parties.

I'm not really sure what more you hope to gain from this thread?
It has acknowledged that other countries have a
healthcare systems performing better than the NHS as it currently is. But it has pointed out that that only happens because they're still much better funded.

If the NHS were properly funded then we wouldn't even be having this discussion.

God that's a lot of typos!

For fucks sake DrBlackbird NOT THE TORIES I can’t say it anymore times

Regardless of how many times that you say ‘not the Tories’, our health care is run by our politicians. Years ago there was a movement to take it out from political control and grant it more independence (like the Bank of England). But no political party could ever countenance losing health care as campaign leverage.

So given this reality, you may suggest that it’s Labour that enacts this new system. Will they then stay in power indefinitely to ensure it’s not subsequently amended by the Tories getting back into power? Even if it’s Labour that enacts change, do you really believe that any changes won’t be massively influenced by the already present private US health care companies that exist in the UK thanks to the ‘internal market’ that Thatcher brought in?

Rather than wishing away reality of our two party FPTP electoral system that quarantees the Tories will remain or return to power eventually or getting frustrated that you’re argument is being misinterpreted, use your vote and time to learn more and preserve what we have.

@Cheekypeach

For fucks sake *@DrBlackbird* NOT THE TORIES I can’t say it anymore times

But it is because of the Tories and their systematic defunding of the NHS that we have the problems we have today. On top of that we had endless pointless re organisations that cost billions and achieve nothing other than losing experienced staff - usually the administrators that no one thinks we need until we do, and the managers who no one thinks we need...until people want new services implemented and run. Then Brexit..... Then Covid where the govt put the safety of NHS staff way below making a profit for their friends and donors.

So yes, it is the Tories that have put us all in this position. Not fat people, not people daring not to die at 65, not smokers, drinkers, drug addicts - the Tories.

The reason people think you'll go to a US style system is because the UK govt is trying to do trade deals (is doing trade deals) with the US and the ability to swoop in and privatise the NHS is part of that deal. It is already too late for hand-wringing and "but in Switzerland/Germany/france...".

I'm in Germany. PP has posted the deal up there so i won't repeat it. But what you also need to know is that i have had 2 children on this system. Maternity care, the birth etc all included. What is also included is that your children are covered by your healthcare until they leave formal education. This means that my live at home, no job outside uni student DC is covered. For everything.

What the NHS does need is a complete top-down (reorganisation) with focus on recruitment. But where they really need to pay attention is retention.

@SecretSpAD

If much of the population is obese, or doesn't exercise, or drinks to excess, or smokes, or takes drugs and if there's isn't safe effective care for people leaving hospital, all the quality improvement in the world wont make much difference.

I think you are confusing public health with quality improvement.

In fact it goes beyond public health remits and into deprivation and poverty, an increase in which is due to austerity and the continuation of policies that are to the detriment of the working classes.

Properly funded public services can provide support for people wanting to lose weight, stop smoking and come off drugs. Unfortunately we don't have them anymore so those services are decimated and people can't get the help and support they need to improve their lifestyle and health.

The scary truth, however, that many people on here seem to ignore is that obese people, smokers, drinkers, hell, even drug addicts all,pay into the NHS too and so are as entitled to use the services as those among you who break bones cycling or ski ing.

Quality improvement is a process by which small changes in processes and pathways are identified and implemented by staff working in those services. In my long career in the health sector, I've found that given the time, headspace and trust, healthcare staff (clinical and non clinical) are very very good at improving their services. Fancy that.

After 35 years in the NHS I understand what quality improvement is, but thank you for the explanation

I'm not confusing public health and quality improvement; the reality is that the biggest issues within the NHS will never be resolved by quality improvement at service level. The problems are too fundamental for that.

I agree with you about poverty and austerity. We all know that poverty has a direct impact on health - 2 minutes looking at PHOF data will tell you that. The truth is that poor public health has a direct impact on the NHS. Of course obese people, addicts etc pay into the NHS, and of course they are entitled to treatment; the reality is however that caring for people with conditions directly caused by poor public health costs billions to the NHS, and billions more to society in general. That can be changed with an effective public health system, and investing in developing a healthy population should be the cornerstone of any health service (moving the responsibility for public health to local authorities was a backward step imho).

The care system is broken. We don't (or rather won't) spend enough on care. That
has a fundamental impact on the NHS, in terms of delayed discharge, but also in terms of outcomes for those patients who are discharged far too early to overstretched community health services.

How on earth we properly fund public health and care services I don't know, but we will never have an effective NHS without doing so.

What the NHS does need is a complete top-down (reorganisation) with focus on recruitment. But where they really need to pay attention is retention

Lol! long way from treating staff well and fairly.

My DD loves her job but will go abroad as soon as she has more experience.

My last word on this is that it’s clear that OP is frustrated about being misunderstood. However, this viewpoint i.e. that the NHS is "broken" or that there are better "insurance systems" like the "European model" is precisely playing into the hands of our political leaders!

Our politicians do not have our best interest in their minds as they seek to convince us privatisation, but called something more innocuous like the Health and Social Care Bill, is the only answer to this "broken" system.

And I despair that yet again they’ll be able to deceive the British public into voting against their best interests. Rather than be personally offended, read some of the independent health care think tanks assessments of current policy changes such as The Kings Fund. For example, the Nuffield Trust had this final conclusion about the current act before parliament The new powers for Secretaries of State risk creating a health service where decisions are taken to suit party politics rather than patients

[quote Monopolyiscrap]@Pinkyxx You are assuming we are ignorant. We are not. France also pays way more for their healthcare. If we did too the NHS would be in much better shape.
You keep comparing systems that get a lot more money. It is like comparing the local state school with Eton and saying - look if we privatised all schools all schools could be like Eton. When that is obvious rubbish.
We need more tax to go to the NHS.[/quote]
I don't think anyone's ignorant. I do however believe people are mis-understanding some facts and quoting figures which support a particularly view point.

Latest OECD data shows France spends $5564 per capita. The UK spends $5268 per capita. The difference isn't as significant as is being implied.

data.oecd.org/healthres/health-spending.htm

France's healthcare system also isn't privatized, it's public, just like the NHS.. as are most European healthcare systems so unsure why you like my comparison is like Eton vs the local state school. Eton is sitting on buckets of assets and generates income from eye watering fees. No money to pay = no access.

I use France as an example because it's a public system. The difference between the French system and the NHS is the way it's managed, access to care, # of doctors & quality. The majority of costs are funded through the equivalent of French national insurance contributions. The element not funded by these contributions is covered by mandatory insurance employers are required by law to provide. The net effect is that beyond one's French NI contributions care is free - just like in the UK.

FWIW Italy spends less per capita than the UK and I found the care there to be just as good as France..

It's disingenuous to suggest funding is the only factor. A poorly managed enterprise needs a lot more than more funding. The issues in the NHS are deeply systemic, no amount of money is going to solve that.

I have as much confidence that the Conservatives have the UK's best interests at heart and that health provision won't be in play in USA trade negotiations as a farmer has about the same and about the Australian trade deal and about the future farming subsidies. Might add that Regional aid will match or exceed EU equivalents. And the Erasmus programme being bettered by the shiny equivalent to English speaking nations.

Still have that bridge for sale, OP. A shiny, better funded insurance model is entirely likely if not certain given the millions being paid by lobbyists to MPs, Ministers, parliamentary interest groups and political parties by the parties who will benefit from that cooperative model will massively exceed those already being paid by USA health care representatives.

@Pinkyxx what are the deeply systemic issues ?

I don’t think the NHS should be privatised but I do believe that root and branch reform is needed. At the moment it is simply too big, too unwieldy and being asked to do too much by society as well as by the government. It is a money pit. No amount of cash would ever be enough to solve the problems.

Loads of big words like 'top down reorganisation' to improve retention. What exactly does that mean ?
Swapping a few trust board members, removing a layer of management doesn't do anything for recruitment or retention. But more investment in staff nurses, medics, better pay and conditions, more feet on the ground so nursing staff can do what they are employed to do, better IT systems so you aren't nursing a computer rather than a patient.....

It only takes being on the inside through a number of structural or 'top down?' reorganisations greater than zero leads someone to think they are not a solution, unless the problem is a government wanting to be seen to do something without spending more money on delivery (or indeed wanting delivery to improve). Great mechanism to channel hundreds of millions to the favoured consultancy of the time (McKinsey et al) in return for .....

If you think privatisation = better care you can think again

Contracts are awarded to whoever will do something for the lowest cost. Leading to poor resource allocation, poor staff treatment and poor clinical care.

Quality assurance of smaller providers is an absolute minefield. And when they are deemed too unsafe to continue to provide “care” the NHS has to pick it up. But being the £ has already gone to private providers there are no resources left for the NHS to get on with the job

Couple of examples

www.hsj.co.uk/greater-manchester-ics/waiting-lists-balloon-after-suspension-of-private-provider/7031830.article

Another

www.hsj.co.uk/quality-and-performance/private-centre-for-nhs-kidney-failure-patients-placed-in-special-measures-by-cqc/7031920.article

And these have only been reported this month…..there are many, many more

@Cheekypeach

With each of your posts it does sound as though you are speaking from a position of a certain amount of financial privilege.

I will repeat - I earn the National average and not a penny more.

I don’t believe anyone earning National average pay would be suggesting such a thing. In the UK in 2021 £ 26900 was deemed the average pay, where I live most jobs (with experience) are advertised in bands of £22k-£25k. Factory / process workers rates advertised between £9 -£10 ph giving £19k a year tops. They would not be able to afford it.

I understand that you would not get cover for diabetic, and it’s associated illnesses, but as others suggest, there is nothing to stop you going private, for the other little things.

Go on….have another re questionable quality…..I’m feeling generous today!

www.hsj.co.uk/quality-and-performance/111-callers-eight-times-more-likely-to-abandon-calls-in-some-areas/7031924.article

People hoot enough about losing their inheritance to care home fees - wait until you're loding your home when you still need to live in it to keep you alive if you get cancer.
Isn't the biggest cause of bankruptcy in the US due to health care costs?
A better European system.might be good - but that's not whst we'd get here as it costs more for the govt and their pals wouldn't become rich off the back of it.