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?

I'm well aware, Loopy. I'm just putting it out there for folks who can/want to self-pay and don't know they can self-refer.

I will also add that a lot of private consultants have an NHS list as well so if you are diagnosed with anything under their private care, they can transfer you back onto an NHS pathway (rightly or wrongly!)

@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!!

Totally agree with this. Chuck out all the non medical staff except for essentil admin support teams and put the money back into medicine.

It drives me bonkers how some people see the US as the only example of private healthcare. There are several, very successful examples, such as the German system which far surpasses the quality of care in the NHS.

Yeah OP fab. I have several medical conditions. I am on a group for one of the conditions which requires regular treatment. Lots of Americans on there The Co pay for the treatments can be hundreds of dollars .
DH a HRT payer receives meds that cost thousands per year.
We would struggle to pay so can't see how it would work. He would However be happy to add an extra 1% to maybe HRT bracket as long as it was for the NHS.

NHS management is normally pretty good, albeit struggling with a broken model and limited resources. Those suggesting the nhs get rid of managers have no experience of management or how much work goes into managing a massive organisation.

Ireland is pretty shit too. My low earning relatives have to pay even to see a GP and contribute
towarss essential things like Cancer and Heart issues.

How much roughly do you pay per month for these German and French models? If you include a likely tax increase to match health spending and a basic health insurance package I would imagine most households would be at least £100 worse off a month -think about the impact the gas price hikes are having on families with this kind of extra expenditure - all the threads on here about food vs heating ....And does it end up being like car insurance when you pay most things your self anyway to stop your premiums rocketing ?

OP I recently had my second baby, after a very straightforward delivery of my first. If I’d had to pay even £300 to have the baby in hospital I think I’d have opted for a home-birth even though it wasn’t my first choice. As it happened I had HELLP syndrome and probably would have died at home.

For those small sums, it isn’t worth disincentivising people to get medical help. It will result in higher cost emergency medical care later on where early symptoms could have been cured much for cost effectively.

I’m really uncomfortable with any kind of tiered system where the rich get better healthcare than the poor.

The tiny amounts you’re suggesting are collecting would seem even smaller if applied to everyone’s National Insurance bills, and would be ‘means tested’ in this way.

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

Most european countries operate a tax payer funded model, just like the NHS.

@babyjellyfish You can do all this in France because they have many times more Doctors and facilities compared to the UK.

@Tealightsandd

Why can't we be more like western and northern Europe? With things like healthcare, utilities, housing, social security.

Well my impression of it, from living in an EU country with good health care, is that it's a stark political choice. You have to be prepared to pay much higher taxes and therefore give up a percentage of your disposal income for the collective good. And for that you get an excellent free state education, and excellent healthcare, where you have to pay for a gp visit for example but you get most of that fee back through your mandatory state subsidised health insurance which is regulated and non-profit.

And there is a balance to be struck here. If the taxes are too high it stifles the economy and inhibits enterprise. And if they are too low, the public services go to pot. But the individual citizen needs to be prepared to have less money in their purse, having paid all bills and obligatory health insurance etc, therefore ultimately you have less control over how your earned money is spent. It's a stark choice between doing what is best collectively, or doing what is best for the individual. Imho, in the UK we have a different view about "society" ; we are much more individualistic. I see this difference in the way DC are taught at school to think about the group as much as themselves. And in the workplace it can be frustrating at times because people won't stick their heads above the parapet or make a decision because they are thinking about the collective "good". But overall I think it is a better outlook than our very individualistic one, as long as there is a balance and taxes are not so high that there is little incentive to strive and make a profit. It's arriving at that perfect point between the two that is difficult!

Where I live we have government hospitals clinics and a lot of private hospitals as private healthcare is often on offer from employers if you are an office worker. I’ve used both, a&e is only government.

I pay 10% excess so DD paediatric appointments cost about £12-13, max we have paid to see a consultant is £20. I can usually see a paediatrician same day which is great. Things like blood tests etc are great, most hospitals will turn around tests pretty quickly, usually within 24 hours and with some clinics I’ve been able to access my results on-line. I had a brain scan once and the consultant assessed my results there and then (was looking for a stroke). On the other hand my c-section cost be something like 10k (wasn’t insured). BUT I could have gone to a government hospital for that.

Government hospitals are busier because more people were using them but also very efficient. Probably because load is spread between government and private.

A mixed system is better tbh. Part of the problem in the UK is gatekeeping by GP’s for private health insurance whereas where I am you just make an appointment directly with whoever you want to see, you would take a load off the system if you people with insurance could skip the NHS. Most countries in europe have a mixed system and it works far better than the NHS.

Government hospitals do charge too but contribution is capped.

I think "co payment" would help whereby if a patient chooses to go private, then part of the cost is paid by the NHS, being the amount that the NHS save by not doing the treatment themselves. It would relieve strain on the NHS and encourage more people to go private, all at no cost to the NHS.

@gingerhills do you have any idea what the 'non medical' admin do? Procurement, payroll, the MHS,MCA, Dols, safeguarding teams, education, HR, recruitment, retention, legislative services. You're willing to lose all of those?

I have an autoimmune disease which requires weekly blood tests, weekly injections of immunosuppressant drugs (which I do at home and are supplied to me free of charge), disposal of sharps bins, steroid injections three or four times a year, regular X rays/scans/MRIs, pain relief, physio, etc. I can't work because of my condition but I'm not deemed eligible for any financial support. DH works but living on one wage is incredibly difficult.

If I had to pay for my treatment I simply wouldn't be able to. My mobility would be even more fucked than it is. My autoimmune disease affects my heart, lungs and eyes and there can be serious complications. Ultimately having no treatment would shorten my life and reduce its quality beforehand.

I think it's pretty obvious how I feel on the subject, OP.

How much roughly do you pay per month for these German and French models?

I'm not sure. It's not cheap. A bit of Googling suggests that the social security system costs about 3000 euros per person, which is obviously going to be massively skewed towards higher taxpayers. Most people then have health insurance on top, which is not compulsory but generally ensures that you get all or almost all of your medical costs back. (When you pay to see a doctor, a certain amount of what you pay is reimbursed by social security, and the rest is up to your health insurance provider.) I pay 50 euros a month for my health insurance but I haven't shopped around so I could probably get a better or cheaper policy.

People on low incomes have additional health insurance which they don't pay for.

If you include a likely tax increase to match health spending and a basic health insurance package I would imagine most households would be at least £100 worse off a month

I genuinely don't know. It's really hard to compare. And between the two countries, some things are more expensive in one country and some things are more expensive in the other, so you can't really isolate something like healthcare. The energy price increases have been capped by the French government. Rent can't be put up at the will of the landlord. Mortgage borrowing is massively cheaper in France. But you pay to use motorways, petrol is more expensive here than in the UK now, and food and clothes are more expensive.

think about the impact the gas price hikes are having on families with this kind of extra expenditure - all the threads on here about food vs heating ....And does it end up being like car insurance when you pay most things your self anyway to stop your premiums rocketing ?

No it doesn't. That's not how it works. And a lot of the time the most serious illnesses are completely covered by social security anyway, such as cancer treatment for example, so your health insurance doesn't come into it other than for things like if you want a private room in hospital.

@babyjellyfish You can do all this in France because they have many times more Doctors and facilities compared to the UK.

Maybe, but also because doctors are self employed so you deal directly with them.

Oh and medical labs!

If you need a blood test you just go to a lab, queue up, and get your tests.

You can get them done without an appointment six days a week, at multiple locations in your area. The idea of waiting weeks or months for simple blood tests seems crazy to me.

@Capri3 No I'm not trying to imply that. What I'm stating is that the state of the post-2011 system with the abolition of PCTs, CCGs, CSUs and changing the shape of the GP role was to achieve what I stated.

abolition of PCTs, creation of CCGs and CSUs with their designated roles and changing the shape of the GP role was to achieve what I stated.

@Kazzyhoward

I think "co payment" would help whereby if a patient chooses to go private, then part of the cost is paid by the NHS, being the amount that the NHS save by not doing the treatment themselves. It would relieve strain on the NHS and encourage more people to go private, all at no cost to the NHS.

It wouldn’t. Because the pool of doctors would remain the same. Most surgeons work primarily in the NHS and do private practice in their spare time. It’s a finite resource and no amount of rearranging the deckchairs will increase it.

@Blossomtoes

It wouldn’t. Because the pool of doctors would remain the same. Most surgeons work primarily in the NHS and do private practice in their spare time. It’s a finite resource and no amount of rearranging the deckchairs will increase it.

There are apparently a lot of doctors who've taken early retirement from the NHS, who'd be available to continue working privately.

Also, a lot of the "private" services aren't doctor-orientated, such as private x-rays, private blood tests, private scans, private podiatry, etc etc.

My OH needed a MRI scan to monitor his cancer. He can't tolerate the tunnel ones that the NHS use, so after 3 aborted attempts, he went private and had an upright/open MRI scan at his own cost. If the NHS had suggested that and offered partial payment from the outset, the NHS would have saved itself 3 wasted appointments. As it was, his oncologist didn't even know it was possible to get an upright/open MRI scan as because the NHS didn't use them, he didn't know they existed!

Co payment will just mean some people will not visit the DR until their illness is far more advanced. That will cost the NHS more.
You can not make NHS policy based on well people who visit the Dr once a year. That is what many of you appear to want to do. You have to do it based on people who actually use the NHS a lot. That is very young children, disabled people and elderly people.
Co pays would simply mean my elderly father who it is hard to get to the Dr anyway, would have let his heart issues get much worse before seeing anyone. As it was a small operation has totally resolved its issues and he has been told he is now very healthy again.
We have campaigns in the NHS to get some people to attend e.g. suspected cancer symptoms, because lots of people do leave it. Why we would want to discourage people from going is beyond me. Or is it just this who suggest co pays have no understanding that a £10 charge will stop lots of people going?

If you want to pay for private healthcare, there's nothing stopping you from doing it now. But you won't receive the full support services of the NHS.

[quote user1497207191]@Blossomtoes

It wouldn’t. Because the pool of doctors would remain the same. Most surgeons work primarily in the NHS and do private practice in their spare time. It’s a finite resource and no amount of rearranging the deckchairs will increase it.

There are apparently a lot of doctors who've taken early retirement from the NHS, who'd be available to continue working privately.

Also, a lot of the "private" services aren't doctor-orientated, such as private x-rays, private blood tests, private scans, private podiatry, etc etc.

My OH needed a MRI scan to monitor his cancer. He can't tolerate the tunnel ones that the NHS use, so after 3 aborted attempts, he went private and had an upright/open MRI scan at his own cost. If the NHS had suggested that and offered partial payment from the outset, the NHS would have saved itself 3 wasted appointments. As it was, his oncologist didn't even know it was possible to get an upright/open MRI scan as because the NHS didn't use them, he didn't know they existed![/quote]
Ah so what you really want is taxpayers to subsidise those who use private healthcare?