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.

How the fuck is putting greedy profit-mongers in charge of the NHS going to improve it? What it needs is a hefty thinning out of middle management and non-medical consultancies. It needs proper funding from higher taxation of the extremely wealthy, because they are the ones who rely on the health of the poor to do their drudgery for them, so even if they have never set foot in an NHS hospital they should pay a fairer share for the benefits they get from it.

I'm really not a screaming Communist - I'm very middle of the road in most political views but I am so sick of greed ruining our country and putting basic healthcare out of the financial reach of the workforce really isn't a sensible idea.

Surely a huge part of this is simply demographics? For the first time in britains history the population is now shrinking in terms of the birth rate- having less than the replacement rate means that those who cost disproportionately far more (the elderly) are not being propped up by a swelling young adult population. Young adults generally don’t cost very much, are generally very productive and are a great source of tax revenue.

At the end of the day socially funded care of the elderly to the lengths that we supply costs a great deal. Something like 40-50% of the nhs budget is spent on 65+, despite them making up less than 20% of the population.

You want socialised care for all until death? Best have lots of children that you raise well to be socially productive and contributory. This means a social political narrative that everyone more or less buys into and works towards. The “deconstruction” of culture is a marvellous intellectual wank but the fact is our culture does not encourage families to have many children, it encourages men to be obsessive porn users and it has raised a generation of children who are taught to think that being British is shameful and racist and you would be better to be anger or anything else.

Fine- net effect: not many kids. Proximate result: shrinking economic production in real terms (gdp growth fuelled by house prices doesn’t count). End result: less money for care. You want to fund care? You need proportional economic growth. This is achieved either through productivity gains (technology) or population growth.

now I agree that “there was money for banks and not social care” but there wasn’t really money for banks. There were loans for banks. And the continual use of finance to run government bank balances while inflation makes the poor ever poorer than each previous year because the government won’t raise wages in line with inflation nor will they increase tax brackets in line with inflation simply means you end up with a superstate whose responsibility is to do everything and can afford nothing despite having all the money.

So privatise or don’t privatise. Even if you privatise healthcare and replace it with some kind of insurance that’s still socialised care by an alternative route (socialised with insurance companies rather than the state). Fact is, you want to provide end of life care to over 65s you need many, many more children than we currently have.

There's a whole raft of opportunities to improve it beyond recognition before landing on privatising it.

Sorry there is an alternative: if the British don’t want to have many children, welcome many migrants and let them have lots of children, but ensure you assimilate them because otherwise in two generations the political settlement that drives the young caring for the elderly may be turned entirely upside down by a vastly oversized underclass of migrants who get rightly pissed off that they’re funding the care of a bunch of rich white old snobs. They’re not their parents so why the hell are they paying? If you are even unluckier you might import marginally educated migrants who vote and then you’ll be truly fucked cause they’ll stop voting in rich white middle class MPs and the political settlement in Britain really will collapse.

@hopeishere I paid for private antenatal care because I think 2 scans (one at 12 weeks and one at 19 weeks) then midwife appointments over the phone and then this method of using a tape measure to measure your bump and decide from that if the baby is growing well or not is stupid. Everyone I know has been sent for extra scans because their bump is too big/small and they're full of anxiety ahead of these scans.

I can’t tell if that’s a genuine question or in exasperation. Apologies if it was rhetorical

So many of you are talking about the nhs wasting money/too many managers/badly organised etc etc yet I bet you haven’t ever worked in it.

The nhs is hugely complex. It has become a victim of its own success. On the whole people are living longer and have greater expectations. Just in cancer care, treatments are keeping people alive longer, there are more drug options but these place a huge burden in that there are more patients than we have chairs/appointment slots/nurses. I imagine it’s the same in most specialities. And whilst it’s great that people are living longer, we have to accept that with that comes more people needing to access the nhs.

Someone mentioned postage if letters and whilst I agree that in some cases email or text is preferable, there are a huge amount of people out there that do not have access to email or know how to use it.

There aren’t huge amounts of managers. Of course there are some but every organisations needs management. Most people sitting behind desks will be very poorly paid admin staff. And without admin staff there will be no appointments made. There is an admin staff crisis as most could earn more working at Aldi.

The nhs is on its knees but it’s due to many many factors. Even if it were privatised in the short term it would not be any better. It would be the same hospitals, the same staff and you can’t one day suddenly become privatised and that’s it, job done.

As a collective nation I do believe that we need to take more responsibility for our own health. We need to stop the entitlement that some people have. You’d be amazed at how many expect transport because they’ve paid their taxes. However I’m not sure how we change that. How we stop people calling ambulances unnecessarily or expecting paracetamol on prescription.

if anything needs sorting before the nhs it’s social care. The nhs will never be able to function properly whilst there are people awaiting discharge and taking up beds. Again this won’t change even if the nhs became privatised.

Finally, please spare a thought for nhs staff. For most of us, working through covid has been incredibly tough. And working in cancer care is a parallel universe-I’m still having to test twice weekly, test my kids if they’re unwell as I need to be off work to protect immunocompromised patients. This is still placing a massive burden on our staffing levels. The hospital I work in is amazing, full of dedicated staff who go above and beyond and that includes managers. I admit to getting upset by contact nhs bashing on MN especially by people who have no clue what a complex organisation it is.

I would like to point out that NHS Consultants are not allowed to work private hospitals without fulfilling all of their NHS contracted hours. Basically they have a second job in their own spare time. How can you dictate what people should be allowed to do outside of their working hours?
In our local Trust (and I’m pretty sure it will be the same in most) they have to be on full time NHS contracts before they can start up in private.
Sp you might see the Consultant at the private hospital on a Tuesday afternoon, but you don’t know how many hours he/she will put in at the NHS hospital that week.

NTRTT but perhaps disentangle aggregate funding with privatisation which, of itself, will change incentives and introduce transaction costs without improving anything. Privatisation will benefit HCPs and disadvantage the majority of patients, IMO. Still will benefit the wealthy and, depending on how it's done, create investable opportunities and lots of consultancies and NEDs for MPs and politicians to fill their boots so a further win for some. Wonder why there are £10s - £100s of millions being spent on funding and lobbying political parties and MPs and thnk tanks, and not by the cuddly Western European insurance/mutual model stakeholders who won't want to get involved. There is no viable trajectory to a Western European delivery model.

NO!!!

@user1237865 This is what the Tories and their mates in US based health care multinationals WANT you to think.

Don’t fall into their trap. Your family’s treatment would not improve in a privatised medical system. Instead it would cost you up to 10% of your income. And if you are unemployed or chronically I’ll or elderly, we’ll you’ll get a service worse than the NHS.

PLEASE don’t fall for the effects of over a decade of deliberate underinvestment aimed at deceiving you into thinking what you’re suggesting now.

How it actually works: the tories don't explicily privatise the NHS, they just let it run so badly that privatisation seems attractive and necessary. The OP has fallen for it. I got tired of waiting for an NHS dentist the other month so I booked a private one. I fell for it too.

And 25% pay no tax at all !!!!

Missing an apointment at my physio, dentist, hygienist without a really valid excuse costs anything from 25 to 72 € depending on how easily the slot can be filled.
I pay 5€ at the pharmacy for every medication prescribed unless exempt or a minor.
For a hospital stay I pay 10 € per day unless exempt or a minor.
Regular check ups are recommended and reduce personal contributions.
Preventative courses (i. e. pilates, nutrition, migraine management etc.) are refunded.

Why is America always held up as the comparison?

Why is it not look at France, or Italy, or Japan or Australia?

And yes OP you are not wrong. The NHS system is no longer fit for purpose and needs to be completely restructured.

This sounds great @Prokupatuscrakedatus which country is that? Although it depends on the reasons for exemption.
It really irks me that over 60s unanimously get free prescriptions. Nobody should be getting free prescriptions except those on benefits, minors and pregnant women in my opinion. 60 year olds are still working FFS and if they're unable to pay then they would be exempt for the same reasons a younger person would.
The elderly already (through no fault of their own admittedly) cost the NHS more than any other group. Why are we subsidising them for prescriptions when it isn't necessary? Oh because of the grey vote. That's right.

@KnittingNeedles because there isn't a viable trajectory to a mutual/insurance/Western European model. Once that door is forced open, a commercial USA model is politically the only destination. And because introducing transaction costs and the changes to incentives that will result will only make delivery worse, IMO. Apart from that, 'looking at France...' is a helpful tool, together with deliberate structural underfunding, to build a consensus to change. Transaction costs aside, the performance of the French system can be explained by the results of the small but significantly better funding applied over the long term. I find it mildly amusing that the HCPs disadvantaged by the monopsony model are culturally in favour of the current model in part because they understand how the poorest/majority of patients will be disadvantaged even though HCPs will probably benefit from the fragmentation of privatisation.

Everyone pays VAT.

YAB-HUGELY-U

Save our amazing NHS. DO NOT PRIVATISE. We don't want to live in a corrupt american style setup where they charge extortionate amounts for basic prescriptions, vaccines, surgery and more. It would widen the inequality gap horrendously.

Straight out of a Labour Party beer and sandwich meeting but don't ask Durham Police !..

The way it actually works is the Government provides the funding, currently 40% of all central expenditure with an additional £12Billion on top of the planned increase to the Healthcare budget, with control and management of the NHS being the responsibility of the NHS executive.

The issue you have is that the NHS, the third largest single employer in the world , has become a political sacred cow. It is impossible to enact widespread reform or restructure without the likes of Lammy and Rayner frothing at the mouth and falling over backwards.

What should happen, as per most other countries, is a structure focused on providing effective and efficient healthcare, irrespective of who delivers frontline care, public or private, and free of the Jarrow March dogma. That simply isn't possible here.

Oh, and I work for the NHS so I see it from the inside.

One of your points - we have to send letters as appointments as most people don't want them emailed / don't have email accounts and more importantly - we have a really high DNA rate with appointments made over the telephone or via email - don't blame the NHS for the general public being crap with admin.

This with bells on.

People seem to think privatising they NHS is going to open some golden gate to this amazing accessible health service that's hidden away somewhere out of reach by the hideous NHS. It's so so far off the mark it's laughable.

Any change to the NHS in any form will take decades and decades to enact and will get much worse before it gets better.

Apologise for not reading entire thread yet.
We pay the least for health care of any Western Democracy.
This continued under all governments. Labour and Conservative and allowing for different variations of Leftish or Rightish tendencies within either of them.
Trade Unions want better pay and conditions for the workers but separately they are opposed to tax cuts.
We always vote for the party that will reduce our taxes.
There is no Magic Money Tree!

@Faciadipasta I am in Germany - when the amount you would have to pay exceeds a certain percentage of the gross income (often by OAPs with ongoing health problems, or people with chronic illnesses etc.). You provide evidence to your insurer and get an exemption.
I had to read up on this, because I only contribute 20 € a year for my thyroid meds.

In the past 4 years I can think of 3 occasions where the NHS let my family down and where private healthcare saved them.

@salmongrey if you had to pay £25 for an appointment I wonder how many no shows there would be!