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.

Unfortunately the insular ‘little Britain’ attitude is no more at play than when talking about the NHS. Ignorance and fear of how other countries do healthcare wins out over logic and common sense. People simply do not care to understand how there are better systems than the NHS. They think that they are being oh so compassionate advocating for a broken system because it’s free to them. It’s not free, net contributors pay for it and the outcomes are still poorer than competitor economies.

I think it's good to ask questions.
There's always going to be a difficulty in that the people most likely to need expensive care are those least likely to be able to afford it at the time, because, you know, unwell and all that.
So there's always going to be some sort of state subsidy.

If we move to some sort of mandatory insurance model, the upside is that - to an extent - we should expect an improvement in provision. At least to the extent that French ex pats in the UK don't go home the moment they get anything seriously wrong with them!

The downside is it will cost more (spending more is partly the point, but in a way more under the control of the patient) and prices will go up. The places everyone has really good healthcare are often the places where a coffee costs a fiver...

It does seem an artificial distinction that (until you're down to your last £whatever) you have to pay for someone to feed, water and toilet you, when you're too old and frail, but you don't have to pay up to your last £whatever to treat the cancer you got ALSO because you're old.

What's the answer though...

I agree. I appreciate the public/private mix here.

Also, to expand slightly - annual car registration includes third party insurance (and you can choose from several providers). Additional insurance is available separately if you want it. So every car that is registered is insured and easily checked. That means far fewer drivers on the road without insurance.

I'm actually a labour voter but this is a demographic time bomb. It can't be avoided.

Something needs to change because we expect a high class first rate service which we pay only a fraction for. Health insurance should be encouraged but not exorbitant as it is now. No idea what the answer is but we either pay a significant amount more or start paying for things like missed appointments, or services they can afford.

I think we are going to have some kind of paid fund to pay for healthcare and care costs. You don't have to pay for care if you dispose of all your assets 7 years before. Many people don't pay for social care. I think the government might have to put a mandatory savings scheme linked to your employer.

@Lockheart

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.

They've just done a recruitment drive for GPs. The last few years of GP training have seen record numbers of trainees and we have... 700 less GPs. Working conditions and pay need improving.

700 fewer*

The French system is rather good, and generous with its means-testing, which means no UK government will ever adopt it.

Yes, it costs more. I don't understand why people have a problem with this, isn't health care one of the most important things for a government to provide for its people? As they say, if you don't have your health, you don't have anything. And a healthier population would reduce costs in other areas.

If the political parties would stop coming up with stupid sound bites and using as a vote winner, get rid of all the ridiculous layers of management/random consultants/pfi contracts and then funnelled that money into paying for more nurses and hcp then no I don't think it would need privatising. However at the moment the Tories are hell bent on destroying it so that we will all end up supporting privatisation, which after all is their real end goal.

It doesn’t need to be privatised, it’ needs a proper government running it. Waiting lists reduced under Blair and they employed lots more nurses, with plans for more. Then the Tories got in😏

Also charging for health care will affect older people disproportionately. I struggle to pay for dental care.

think the government might have to put a mandatory savings scheme linked to your employer

Ehat about those who don’t work or are retired.

Lots of older people won't want to pay more though and we cannot really load any more burden on the young.

@whiteroseredrose i’m not sure don’t think it elaborated but the hospital I work in has it’s own catering staff and all food is made on site for patients and staff, I know the next hospital along it’s all brought in from elsewhere

No. Blair screwed the NHS with public-private partnerships that are financially crippling trusts to this day.

Those expensive treatments are profitable to someone. Give those someones positions in the NHS or ones where they decide policy around healthcare and demand incentive eradicates any chance of a system that tries to keep people healthy. It will become overloaded with demand which can then be marketed to the public as necessitation of privatisation and even more profit.

It's a great business model but you can't incentivise ill health and expect a system to be set up that will eradicate ill health.

A lot if it already is.

No, privatising would be a disaster. It would result in increased costs for no net benefit to patients. Haven’t we learned that not only from privatising trains and utilities but also by looking at countries that have privatised their health systems?

Yes the NHS isn’t the best system in the world, but multiple studies have shown that compared to countries that spend the same per capita, it is the most efficient system with the highest patient outcomes. So we are literally getting the best we can get for the money paid.

Systems elsewhere in the world may be better but they all spend considerably more as a % of GDP and per capita than we do.

The NHS doesn’t have to have been “designed for an ageing population” FFS. It was designed to provide universal, equal access to healthcare. It doesn’t really matter if there are tons of maternity wards and pediatricians for a young population or tons of oncologists and heart surgeons for an ageing population. It’s not some inflexible system with quotas for each type of healthcare.

The point made repeatedly above is 100% true the NHS has been slowly starved of cash for decades resulting in a massive gap between the level of funding it should have and what it has now. Showy announcements every five years of a few billion here and there don’t close the gap. It’s just window dressing to convince you the NHS has plenty of money, when it doesn’t. Not when you compare to healthcare spending per capita, # hospital beds per capita, # MRIs and other equipment per capita, # GPs per capita, # nurses per capita, and so on that our peers economy wise like France and Germany. Do you not even wonder why in Covid we had to scramble to get more ventilators and ICUs set up but other countries did not so much? It was because we already had fewer ICU beds and ventilators per capita than anyone else in the EU…due to lack of funding.

Parts of the NHS are privately run, eye tests and hearing tests are out-sourced and means tested. For straightforward, inexpensive treatment that works well.

I think we need to understand that privatisation isn't a magic bullet, the US system costs about 5x what we pay in the UK and outcomes aren't always better.

I think a new system needs to be not for profit in most cases, but with HCP being paid well, with pay and conditions amoung the best globally. Obviously social care needs fixing alongside - again, better pay and conditions, a clear career path for carers should be put in place - it will cost more money - but if we can set up an co-operative model rather than profit driven that will keep the costs down and reduce worst practice (look at private childrens homes for example of profit driven care = disaster).

I think NHS is too big, and for the most part needs breaking up (I think procurement of medicines and NICE guidelines work as national structures mostly). A regional model should be better, but regional inequalities in the UK are a massive issue and some funding model needs to take account of that. If we seriously tackled regional inequality that would have an knock on effect of improving health and taking some burden away from the healthcare system.

Other European systems seem better - but I suspect are more expensive to run. I think we probably need to start paying more tax.

There are lots of ways of encouraging people to take more responsibility for their own health but people just don’t want to know (speaking from experience working in nursing) getting paracetamol from your Gp instead of 20p a packet from Tesco. Worm medication is another one, I just buy it over the counter. Diabetes is a massive one and it will increase over the coming years, type 2 especially which could be easily diet controlled but what we are seeing at the minute is people not willing to engage and then it ends up being medication controlled and some even end up insulin controlled which is not cheap and neither is the BM monitoring machines (libre) which are currently £70 a pop even more frustrating when people pull them out or decide to change them before the 2 weeks are up just because

Whilst I agree, the NHS doesn't give out the right message with the sheer number of obese staff, staff smoking in large groups outside the entrances, etc.

I don't think you can tackle health though without looking at socio economic factors as we have large gaps in life expectancy in poorer areas.

I think we probably need to start paying more tax.

we do but it needs to be equal & not just income.

I live somewhere with a functioning public health system. It’s not totally free though, anyone who is not on benefits has to pay very low fees. Also most people use a lot of excellent private healthcare and have insurance. NHS could work if any government chose to manage it.