Just privatise the NHS

[user1237865]

Totally prepared to be told IABU but I've just got to the point where I think the NHS is so far gone it should be privatised.

Totally outing so I've Name changed. In NI we have 2 private hospitals but they don't do emergency's, they don't do ante natal care. Really they only provide you with an appointment with a consultant who will then decide in treatment which in most cases will happen on the NHS. If it's something like cataracts they'll do it but the private hospitals here don't do anything major. Perhaps the rest of the UK is the same. I'm not sure.

Today DSis was sent to A&E by the GP. DM and her have now been waiting 7 hours to be seen. While waiting another man collapsed and died in front of them. I think this is beyond ridiculous how can they let this happen?! If people were seen in a decent time frame this would be less likely.

FIL has terminal cancer again nowhere to treat him when he gets recurring sepsis so most times he sits on a chair (around ever 2 months) for 36 hours getting an IV in A&E before he's finally gets moved to a ward.

I paid for private ante natal care each time I was pregnant. It did give me appointments every 3 weeks and scans with a consultant but when it came to giving birth it was a time when the consultant was working a shift for the NHS thus using their resources and beds. Yes the care was probably therefore cheaper than had I been paying for my stay in hospital too but it isn't an option here.

The whole things a complete joke. Those willing to pay/ have insurance are still stuck blocking the NHS which in my opinion should be there for those that can't afford their own treatment or can't get insurance through their job.

Surely if a lot of it was private, pay would be better, meaning more people choosing it as a career (and not leaving) meaning people actually get proper care! Though so much of what I think could be wrong as I don't understand it all fully.

I think the fact that they see it as a good process might just suggest how many people do waste doctors time

There are nurses at the centre not doctors. So they need someone on reception to answer calls, someone to call back and then someone to see you.

@XingMing it’s very common for junior doctors to take a year out at various points to complete an MSc or PhD, to spend time working overseas to get more experience (I did a two year post-doc in Canada which simply wasn’t available in the UK), or just to have a working holiday/mental health break.

Banning people from doing this would be detrimental to the health service - I used my experience in Canada to set up new-to-the-UK services in the NHS on my return.

If you're wondering why the NHS is underfunded relative to many developed countries, then you don't understand the Tories.

Has there been any investigations done as to how the French or Spanish systems are run? Co payment for those that can pay? Not giving out prescriptions ad nasuem to people over the age of 60 who can well afford to pay for say a pre payment card? It seems a lot of people want to keep it free for all but dont want to pay any more for it themselves.

I know our taxes cover the NHS but would anyone honestly want to pay say another 2p on tax to fund the extra or will I just get people talking about the big bad Tories or mention the US system yet again...

We have a huge issue with the NHS. I was a supplier to them for many many years and know full well the waste, the cottage industries and such like that are going on in there.

I wasn't thinking of a PhD or two-year study leave @Changechangychange ; more like the friends-of-a-GP-friend who did about three years after qualifying as a GP, and then emigrated to Australia because it was better paid and better quality of life. And this was long before university fees began. And over the years I have met lots of nurses and midwives who have left for the bigger bucks overseas. The Philippines and several Caribbean countries train nurses for export, way more than are needed for their domestic requirements.

Just the same as anyone who went to university on a military sponsored course had to serve a minimum commission, which used to be at least eight years, plus the long vacations during uni. They earned a modest salary during uni too; it wasn't indentured servitude but, if you decided it wasn't the life for you, there was a buyout option equivalent to the fees.

The NHS is so unnecessarily bureaucratic. We deal with eight or ten hospitals, from Truro to St Thomas's and they all have idiosyncratic purchasing protocols for qualification. It would be easier and cheaper if there was a national register of proven qualified contractors, with an agreed schedule of charges, and the local estates manager had to pick one off the list. We only deal with heat transfer equipment that provides the hot water; it's not medical or IT systems.

@urgen most EU health care systems are a variant on state-mandated co-pay insurance for employees, with the state covering the co-pay element for the disabled/unemployed. Retired folk with decent pensions continue to pay their 'mutuel' but the state covers those without too. These regularly top the rankings for the best in the world. I believe Australia does something similar.

Israel, another well-regarded health care system, has four or five national Health Maintenance Organisations which compete locally for patients.

's children were born in a private clinic. Though so much of what I think could be wrong as I don't understand it all fully.

You got that bit right.

So why don’t we hear anything about these fab systems in other countries?

We do. There's been loads of MN threads on this topic in the last few months.

This is a very hot live politics topic on MN right now @urgen. There are lots of intelligent people suggesting that there are better ways to deliver healthcare than the NHS, and as equally as many suggesting that it's a choice between the NHS free at delivery or US arrive with your credit card in your mouth. Most of Europe takes the middle path, and does a better job than the NHS.

Yeah that will fix everything. Just like the water and the trains and the gas... It's all so brilliantly maintained and affordable, too. Privatisation solves everything. The evidence is all around us.

Like I said @urgen. this is a very hot political potato. Any view posted is going to get a contradictory opinion, in minutes. It's pretty fierce, but I sincerely hope that everyone wants to achieve something better, even when we are not agreed on how to get there.

FWIW, from personal experience of healthcare in Europe, I think it's better than the NHS.

I remember when they privatised the railways.

It hasn’t gone very well.

NHS is broken and massively overextended but privatisation just passes the problem on to somone who cares even less about fixing it.

It hasn’t gone very well.

It's not all bad though. I've just taken an LNER train from Edinburgh to London. Nice train, cheap fare and a one-click refund email sent automatically as it was over an hour late (due to a circumstance outside their control).

Appreciate that some train companies have been stripped of their franchise for valid reasons but I travel by long distance train regularly and I'd say it's a decent service.

UK trains se rubbish and hugely expensive compared with most of mainland European rail.

Ive lived in several countries and the NHS is by far the worst healthcare system I have experienced. It is horrific and terrifying, and most people here have no idea how poorly they are being treated.

But I'm not sure they are from the trains I've taken. I found trains in Switzerland punctual but expensive, Italy cheap but not particularly reliable. France ok but not particularly nice inside. I've taken a very nice train in the Netherlands as part of a return Eurostar leg.

I'm not being awkward, i personally haven't travelled on a European train that's any better than the ones I take in the U.K. My ticket for 3 from Edinburgh to London in first class cost £130 yesterday - I think £40 odd per head is pretty good for a four and a half hour journey with free food and drink. I don't usually upgrade so my experience isn't based on first class.

Back to the point, if France and Germany are delivering better patient care, it would seem sensible to investigate it. It would be a painful transition but I genuinely believe the NHS isn't sustainable with a large population and dwindling numbers of medics due to the pressures at work.

I travel by train to work every week. My train takes 34 minutes to travel less than 20 miles and is delayed around 75% of the time. About once a month I am delayed more than 2 hours and last month I got home at midnight. It costs me £10.10 every day. The wifi doesn't work. Often it's a bus train and there's no desk or plug so I can't work. The trains in this country are absolute dogshit outside London.

I'm sure your daytrip to London was fine, but it's not a functional mode of transport for necessary journeys in most of the country.

Now... tell us all how much better gas and electric is in the UK compared to France.

You can't compare comfort on a journey! The UK has closed lines, lowered frequencies. There's no high speed rail the likes of TGV/AVE/ICE. Even in city transport, France is doing a better job than the UK--there's been huge expansions of public transport around Paris in particular. Compare that to Crossrail. The French really are excellent at this type of project. They are building 4 new Metro lines in Paris, and since 1992 there's been 9 new tram lines.

The French and German systems (and the Israeli one which I have some familiarity with) spend a larger percentage of GDP on healthcare, as well as being organised along different lines. When you are used to the NHS, it sounds rather complicated: in Germany you have to choose your sick fund or insurance company (for high earners), in France you typically want supplemental insurance (not expensive) as the basic insurance covers 70% of the doctor's fee. In Israel, it's rather simpler as there's only 4 funds and depending on location, not all 4 may be accessible. You have to enroll in one and your health tax guarantees you the basic basket of services. In addition your fund will offer 2 tiers of supplementary services with set prices based on age. A family might pay 200 shekel or about £40 for the top tier which would include things like additional fertility services, second opinions, more therapies.

Canada is a bit easier to understand for British people as doctor and hospital care is free at the point of use, and is funded by the provincial health care programmes. (Pharmacare and various non-doctor services provided outside hospital are not covered; people typically have supplemental insurance.) Hospitals can be run by the province, or independently, and doctors aren't employed by the government; they bill the province for their services.

Not giving out prescriptions ad nasuem to people over the age of 60 who can well afford to pay for say a pre payment card?

I doubt very much, making people over 60 and under 65, pay for their prescriptions will save the NHS!

There was an article in The Guardian yesterday about how women, aged 60 in the most deprived areas have the same ill health, as women aged 76 in the richest areas. So, all you are doing is taxing the most ill, over 60, who are likely to be among the most deprived? There are plenty of people on the NMW, who won’t qualify for the low income exemption scheme for prescriptions, meanwhile the wealthiest women enjoy much better health and won’t need as many prescriptions!

We need to be looking more at what are we going to treat, as a society?

Thanks @knitnerd90 for clarifying some of the differences between the French and German systems, and for a very useful explanation of the Israeli system which I don't know much about.

I was, in a previous life, a member of an American HMO which was an option from my employer (a mutual fund with a sideline in healthcare insurance) and was very happy with the care provision. It seems to me that having several such organisations would create some internal competition without being either nakedly profit-driven or ridiculously onerous on admin.

Just imagine how busy the NHS would be if there was no private healthcare in the UK. People using private healthcare are paying for that and the NHS through taxes.

But I'm not sure they are from the trains I've taken. I found trains in Switzerland punctual but expensive, Italy cheap but not particularly reliable. France ok but not particularly nice inside. I've taken a very nice train in the Netherlands as part of a return Eurostar leg.

Swiss trains aren’t particularly expensive for residents or commuters. Even a GA (Country wide travel in all Public transport - trains; buses; trams; city boats; night taxis and a chunk of ski lifts is only 380 francs per month, when the average salary is twice that of the UK).

Swiss health insurance is expensive but the access to excellent care is simply better than in the UK (NHS or private).