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?

But that’s notwhyFrances system has a better outcome than the UKs. The primary reason why is because the French Government, (even with the cost shared by being semi private), still spends on average 20% more per person on their healthcare each year via the public arm of their health system than the U.K. does.

The funding is part of it but it's not the only thing. The ability to choose what specialist you want to see and book an appointment directly with them without your GP acting as a gatekeeper was a game changer for me.

When my gynaecologist wasn't able to help with my recurrent miscarriages, I had total freedom to shop around for a different one, choose the one I liked the best and get the treatment I needed with absolutely no waiting time. He then provided all my antenatal care and delivered my baby. I paid around €4000 to give birth in a private clinic which included extra fees for having an epidural and emergency C-section and a five night stay in a private room. I got €4500 back from my health insurance.

Oh and every woman who gives birth can have 7 one to one birth preparation classes with a midwife before giving birth and pelvic floor re-education afterwards (as many sessions as you need depending on your level of pelvic floor trauma). I paid nothing for any of those because they are 100% covered by social security.

Absolutely not. Yes it can be run better and can be more efficient but profit making organisations are not the way to go. We don't want an American system here.

There's a lot of open water between the NHS and a US style system though.

I agree that a US style system would be very bad indeed. And unfortunately, that's probably the model the Tories would like to aim for, rather than something more sensible like they have in other European countries.

Given how much you think fees should be, I think you have absolutely no idea and probably couldn't afford a private service.

Yes, sure let's make it like in the USA where cancer patients get dumped in the street if they can no longer pay their bills even after they have sold their homes to pay for their treatment. Where you get sued for calling an ambulance for someone because they couldn't afford to pay for it. Where they want more than $200 for a single aspirin if a nurse gave it to you in the hospital. That sounds absolutely great.

@Fimofriend

Yes, sure let's make it like in the USA where cancer patients get dumped in the street if they can no longer pay their bills even after they have sold their homes to pay for their treatment. Where you get sued for calling an ambulance for someone because they couldn't afford to pay for it. Where they want more than $200 for a single aspirin if a nurse gave it to you in the hospital. That sounds absolutely great.

The majority of countries have healthcare systems somewhere between the extremes of the UK's NHS and the American system.

Almost all of your are being unreasonable. The plan is to get everyone focused on how terrible things are and that things need to change and that it's not about the funding. The classic - 'Something needs to be done' then 'this (steaming pile of faecal matter solution) is something'. Job done. Political donations, NED's, Consultancy, shareholders, USA trade deal galore.

Then we will be bent over and given change, just not the change most want, nor one that will improve things, nor more funding.

Don't ruin all that hard work by identifying the real problems relating to funding.

At the moment it's politically welcome to OK to the NHS is terrible and other systems are better until change has enough support. Then 'a change is going to come', as Sam Cooke might say. Then it will be 'Oh Oh we're in trouble' as Shampoo? might say.

Yes, and it IS primarily about the money.

It’s already being privatised by the back door. You just don’t know it! Virgin care are already on charge on sexual health clinics in the north west. Private companies already undertaking endoscopies and credit scans
I think people have this bizarre ideology that if the NHS is privatised, the care will be better. It won’t! As there will still be a demand for it! Clueless

@Abhannmor

All my American friends are adamant the NHS should keep out private health providers. They speak from bitter experience.

This! We lived in the USA for 10 years and healthcare and insurance was a nightmare. For a nebuliser treatment that I would get at my local hospital in UK for free I had the same treatment in USA and was charged in excess of $400, that was not including the co pay and was with insurance. When you go to a and e the first thing they ask you for is insurance. I could barely breathe and had to go through all the form filling and proof of insurance etc. I agree the NHS does need improvement in many areas. Lots of this could be managed with correct funding. Other areas just need modernised and maybe the bad apples weeded out. I used to work for the NHS and witnessed some tremendous staff and also some horrendous ones too!

@babyjellyfish

But that’s notwhyFrances system has a better outcome than the UKs. The primary reason why is because the French Government, (even with the cost shared by being semi private), still spends on average 20% more per person on their healthcare each year via the public arm of their health system than the U.K. does.

The funding is part of it but it's not the only thing. The ability to choose what specialist you want to see and book an appointment directly with them without your GP acting as a gatekeeper was a game changer for me.

When my gynaecologist wasn't able to help with my recurrent miscarriages, I had total freedom to shop around for a different one, choose the one I liked the best and get the treatment I needed with absolutely no waiting time. He then provided all my antenatal care and delivered my baby. I paid around €4000 to give birth in a private clinic which included extra fees for having an epidural and emergency C-section and a five night stay in a private room. I got €4500 back from my health insurance.

This.

NHS GP gatekeeping is a huge problem. Everyone is now so used to being told to “go away for a month and see if (whatever problem) has improved” that people book appointments to log issues so it’s on their file in case it doesn’t get better. So many wasted appointments logging issues that do get better. Also a whole month wasted for problems that don’t get better. It would be way quicker and easier if people could just book appointments directly with podiatrists, osteopaths, gynaecologists etc. Most other countries manage to do this without a problem.

Privatisation doesn't mean better service. It means profits.

As some one who works in admin in the NHS there is a whole lot of overpaid management…I’ve worked alongside them many times. Our hospital has a whole team dedicated to communications….ie emails to the staff about wellbeing and the CEOs weekly message.

It doesn’t need privatising, it needs a serious streamlining of unnecessary teams of admin staff who earn between band 4 and band 7 salaries to send out communications!!

it needs a serious streamlining of unnecessary teams of admin staff who earn between band 4 and band 7 salaries to send out communications

This is hard to achieve in any public sector but yes!

Partial privatising and subcontracting will make things even more expensive and bloated.

Full privatisation is out of the question.

I for one would rather pay more and receive a better quality service.

Just like the better service we receive from energy companies, rail services, dentists and opticians?

It's a service. The priority should be on providing the best service so that we have a nation of fit and healthy people. If privatised the priority has to be making money. That will not lead to a healthier nation. I wish we as a nation took greater pride in things other than making money. Like quality of life and community spirit.

@Capri3 GP 'gatekeeping' is a deliberate design by the government intended simultaneously to manage down demand and to reduce trust in what at the time of the 2011 reforms was found by research to be the most-trusted and valued component of the NHS system (GP services) - Unfortunately a feature, not a flaw.

Am mildly sceptical whether UK acute could cope with an alternative though I know other systems have this. Would make my job easier though IME, many more patients would not end up where they need to be and would, at best, delay being seen by the correct specialism than for whom this would save time. Wouldn't give acute any more capacity either without..... funding.

@JoshLymanIsHotterThanSam

As some one who works in admin in the NHS there is a whole lot of overpaid management…I’ve worked alongside them many times. Our hospital has a whole team dedicated to communications….ie emails to the staff about wellbeing and the CEOs weekly message.

It doesn’t need privatising, it needs a serious streamlining of unnecessary teams of admin staff who earn between band 4 and band 7 salaries to send out communications!!

That does sound like a complete waste of money. ☹️

On the admin theme, why on earth can’t the NHS manage to set up a proper online appointment system? It would save there being lots of missed appointments due to illness, the letter not arriving on time, the appointment at an inappropriate day and patient can’t get through to the department on the phone to alter it (very frequently happens) or patient just cba on the day. Patients could book a consultation or follow up appointment with whatever consultant at whatever time is available and suits them. If the patient is unable to attend the appointment nearer the time, they could rebook, but the cancelled appointment would be available for another patient to book last minute instead of being wasted. For those not able to manage online booking, the phone systems would be way less busy. It’s bonkers that hair salons, beauty salons and so many other places can do appointments this way, but the NHS can’t.

I know I'm banging a bit of a drum here but in France there is an app called Doctolib which you use to book appointments. You can use it to find a healthcare provider (e.g. if you want a gynaecologist with a particular specialism) or simply find someone available quickly (e.g. if you want a Covid jab or an emergency dental appointment).

Once you've made an appointment you can set up an alert for an earlier appointment (if someone cancels) and you can change your appointment easily if your plans change. You get a text 48 hours beforehand to remind you of your appointment.

[quote Zilla1]@Capri3 GP 'gatekeeping' is a deliberate design by the government intended simultaneously to manage down demand and to reduce trust in what at the time of the 2011 reforms was found by research to be the most-trusted and valued component of the NHS system (GP services) - Unfortunately a feature, not a flaw.

Am mildly sceptical whether UK acute could cope with an alternative though I know other systems have this. Would make my job easier though IME, many more patients would not end up where they need to be and would, at best, delay being seen by the correct specialism than for whom this would save time. Wouldn't give acute any more capacity either without..... funding.[/quote]
Are you trying to imply that gatekeeping has only existed since 2011? It has always existed in the NHS. Most people I know have at some point been at least initially refused a referral for a problem they feel needs further investigation by a specialist.

Personally, I had a misshapen, slightly painful (then) and mildly discoloured toenail approx 25 years ago. My GP refused a podiatrist referral, insisting that I had nail fungus for which the treatment was a course of pills that could cause liver damage, so regular blood tests would also be needed. I refused and decided to just live with it. Several years later I saw a GP in a new area, who also refused a referral and wanted to do the same pills and blood tests. I refused again. Six years ago, my toenail had gone from being occasionally painful to actually causing me to limp with pain constantly. I was thankfully now able financially to book an appointment privately with a local podiatrist for a toe nail removal (£250). The podiatrist said it wasn’t toe nail fungus, but a damaged toe nail bed, and filed down the misshapen parts for the grand total of £19. Not something that can be done with a nail file! I had tried. It needs re-doing every 3 ish years, but if I was able to book directly via the NHS £19 per appointment would be way cheaper than a GP appointment, several blood tests and pills which was the supposed cost saving opinion of two gatekeeping GPs.

@babyjellyfish

I know I'm banging a bit of a drum here but in France there is an app called Doctolib which you use to book appointments. You can use it to find a healthcare provider (e.g. if you want a gynaecologist with a particular specialism) or simply find someone available quickly (e.g. if you want a Covid jab or an emergency dental appointment).

Once you've made an appointment you can set up an alert for an earlier appointment (if someone cancels) and you can change your appointment easily if your plans change. You get a text 48 hours beforehand to remind you of your appointment.

Sounds brilliant, and would not only save the NHS a fortune, but would help to speed up the appointment booking service too.

I have relatives in France, and another thing that’s great is when you have an x-ray or MRI, you have your scan in the morning, go have lunch/coffee for 90 mins, then go back for your results. You’re then told all is ok, or the receptionist calls and books you in with whatever specialist you need to see next at a time that works for you. No massive delay waiting for your results, then waiting for another letter with a random day/time (which probably doesn’t work) to see a different specialist.

@JoshLymanIsHotterThanSam of course you need a Communications in a large organisation. Their work will be far more wide reaching than the weekly CEO message. Press enquires (daily) engagement with the local community and organisation development for a start.

Our comms team in our trust do get a bit annoying with the well-being initiatives that most of us have no time to access but are very much needed and I've accessed training and new opportunities through them which has stopped me leaving so good for retention . Also a band 4 salary is only £22,000 Ish so they're hardly starting at an 'overpaid ' wage, in fact when you compare nhs wages with other areas such as council jobs they are very good value for money. (My old nhs job I would have got another £7,000 doing a similar job in the council)
I hate this 'overpaid managers' rhetoric. There is a lot of evidence of the benefits to patient outcomes of well led teams and most managers are nurses themselves with lots of skill and experience . When covid first hit our managers were really responsive and communication throughout the pandemic has been vital and really effective in my trust .

Like the sound of the French system a lot.

FWIW (and not really the point but), one can access consultant appts here in the UK (depending on area and availability) without having to go through the GP if willing or able to self-fund. You made need a GP ref (NHS or private) if you have private insurance.

One self paying appointment with a specialist consultant, with no tests or prescription, costs upwards from £200. Not affordable for most!