To think the NHS will eventually have to be privatised ?

[Felixsmama]

When the NHS was founded 1 in 2 people died before the age of 65. It's now 1 in 8, the last 10 years of people's lives can be spent with multiple co-morbid conditions which are expensive to treat and keep under control. The NHS wasn't designed for what it's not having to do, we have an aging population. Shouldn't we start to have conversations about what going forward our health service should look like? There's multiple models not just the US one.

Do we all stop paying NI then?

Absolutely we do! And it's long overdue. But no one will touch that with a barge pole ...

NI is a lie it doesn't go solely towards your healthcare costs it goes into the big tax pot. You get pension contributions but it's just an extra tax.

Yes, the current model is not sustainable. But until our politicians stop behaving like children in the media and in Parliament, there's no hope of either improvements to our current model or any different model.

"Grown up" mature behaving politicians would agree between themselves not to use the NHS as a political battlefield and set up cross party working committees to come up with solutions.

Until they get their act together, the NHS will just get worse and eventually collapse into itself.

Agree, or, if people want the nhs to exist, be prepared to take more responsibility for their own health and for different ways of doing things. Not doing 20 mins exercise a day for example - no excuse, just go for a walk! Diet is trickier, I realise because processed foods are addictive for some.

We should have a hybrid system. Plenty of other countries have it!

Privatising the NHS won't suddenly magic up 50,000 nurses and 12,000 docs...
And not everyone gets a huge private pension.

I’m constantly astonished at the way most British people I know think about the NHS. These are intelligent, educated people to whom it should be perfectly clear that the system is broken, but they are unwilling/unable to accept it. As the OP states, the NHS was set up long ago, in very different times. It definitely needs a revamp, if not to be scrapped altogether.

To be clear, my criticism is of the organisation and how it is mismanaged - not of the over stretched, dedicated, hard working HCPs who are working for it. I have nothing but praise for them.

Just seen an article on Facebook (ladbible so not reliable or anything) saying a think tank is suggesting charging people for staying in hospital, I think £8 per day, making over 60s pay for prescriptions etc. stupid idea when many are in hospital for months due to care crisis

The NHS pays HCPs very poorly compared to other western countries, that might be a reason why.

And actually if they sorted the care crisis first there wouldn’t be so much bed blocking which is a big issue

It's in the guardian today. Sadly anticipate that it won't be those people paying the £8 a day as they are the key tory voting base.

Well the Tory party certainly think so, and they’ve been starving it of cash for 12 years to condition us all to be so fed up of it that we start to demand it is. As if that’s the only way to fix things.

But there are other ways.

What are your politics affiliations, OP?

So if we paid taxes at the same level as other countries perhaps we could free up some cash to pay decent wages

Because it will still be cheaper than a private system

I'm in Australia now, and the system seems ok- if you earn above a certain amount and don't have health insurance by the age of 30, your tax contribution to health care increases. There is hospital only cover which is pretty cheap, and is less than the tax increase. If you're low income, there's no expectation to have private, or pay extra- so basically if you can afford it, you're expected to have it. Hilts the system here definitely has its faults- not claiming otherwise, it does seem to be better resourced. Also they have TAC- your yearly road tax has an insurance component. Any road traffic accident is covered by TAC- so they pay all the hospital fees, and ongoing care regardless of fault, again taking that cost away from the public health system and tax.

Isn't the £8 a day for food? MIL was in hospital in Spain and I'm pretty sure food had to be bought or brought in.

The care was great though. She saw consultants within a couple of weeks.

I wish I understood the Spanish system more. It seems to work really well.

And how do we manage the ageing population issue which is going to put even more strain on.

This exactly!

They have been underfunding it for years so when they do privatise it no one will care.

Throwing more money at it isn't the solution. The NHS is a money pit and should be completely re designed.

I am a floating voter so no political affiliations

Uk is completely different from Europe in many respects. Housing in particular is much more expensive, state pensions and benefits in general are some of the lowest, wages lower. The country has some of the most deprived areas in Europe. Solve those things then come back.

So perhaps you can provide an example of a system that gives the same level of care to the whole population that costs less and we can follow that model

It's a money pit because health is expensive and too much is already in private hands - pharmaceuticals for example whose charges to the NHS for medicine include a larger percentage for marketing than research

It's true the way the NHS operates now is outdated and insufficient for modern needs. We have a much larger, older, and in many ways unhealthier population. The challenges it faced when it was founded have changed.

But that said, there is a crisis across multiple theatres causing the overall massive bombshell coming down the line; not just how the NHS operates.

We have a severe staff shortage, because HCPs are poorly paid and badly treated in the UK.

The government has been closing hospitals rather than building and opening more.

The cottage hospital is a rare sight nowadays. We need them and convalescent homes back in numbers to fill that crucial gap between hospital and independent living.

The investment in GP services has not kept up with population growth and planners often fail to account for healthcare (and education) when building hundreds and thousands of new homes.

Our care system is in an appalling state. We need vastly more care homes, staff to man them, and staff to help people in their homes.

NHS dentistry is also in an appalling state. We need serious money invested in dentistry.

So many healthcare issues could be prevented by investing heavily in care at ground level - your GP, your dentist, your care home staff.

So yes, the NHS model of free at the point of use may need an overhaul. But honestly it would not be the top of my list. The first thing I would do, if I ruled the world, is embark on a massive recruitment drive for nurses, care staff, and GPs, and build more care homes. Then I'd build / reopen hospitals and sort out dentistry.

Define starving it of cash? Does a 20% increase in spending (pre Covid) sound like cash starved?

It’s both.

There are definitely shortages of money.

Just two examples: a) we are short of the more expensive equipment like MRI scanners, which means delays in diagnosis. Just one of the impacts of this is that it blocks beds in hospitals while patients stay in because they need the scan results before a treatment plan can be agreed and they can be discharged. There are a lot more knock on effects than that, of course.

b) charging nurses to train for an underpaid career was madness, and an example of poor money management, by trying to save tuppence now but ending up spending a fiver down the line. This is common in the NHS. In this case, putting more money in at the training stage will result in fewer staff shortages and a better system.

There are certainly inefficiencies and overly/bureaucratic processes that could be improved as well. So why haven’t the government done that?

As pp said we have so many issues. low wages, asset inflation, lack of investment. I'm not sure how you fix it all.