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.

Find it pretty bizarre that people are advocating NHS privatisation after seeing how well the privatisation of water, energy, trains, etc has gone over the last 30 years or so.

For example, In 1991 when water was privatised, it roughly cost every household in the country about £2,000 more over 30 years in water bills, but the promise was that they would upgrade the infrastructure. The £60 billion those water companies took in that time period now sits in bank accounts in the Cayman Islands.

If the NHS is privatised it will likely be sold to the like of JP Morgan Asset management, UBS Asset management, Hermes Infrastructure Funds & Whitehelm Capital. If you expect these kind of outfits to prioritise yours and your families health over profit you're living in a dream world.

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

How do you think services are funded now?

Yes, the NHS is not fit for purpose in my opinion. Members of my immediate family have suffered terribly at the hands of waiting lists etc. I understand its the tip of the iceberg but GP's should not be allowed to prescribe basic over the counter medicines. In Scotland we pay nothing for our prescriptions but each prescription Costs NHS Scotland around £9 so people will go and get paracetamol prescribed but not take into account the knock on affect. It's no wonder local hospitals are closing.

I'm in favour of a system where people who can afford healthcare are charged, while people who cannot afford it are given free healthcare, funded by general taxation.

Similarly there shouldn't be state pension for everybody, only those that need it.

We could also balance the population by encouraging immigration. And that would require building more homes.

@wonderstuff

I think NHS is too big, and for the most part needs breaking up

I disagree. I think it's too fragmented. We have huge numbers of different NHS trusts. That causes massive unnecessary bureaucracy and cost when a patient's treatment spans different trusts, despite being wholly conducted in the same town!

It also causes different quality of care by different service providers. Just look at the GP fiasco, where as noted on here and other fora, some people can book appointments on line but others have to run the 8.00 phone gauntlet. Some people can easily get F2F appointments, others can't. That's down to different ways of working as not only are GP surgeries mostly privately run, their trusts will interpret the rules and requirements differently!

Take my OH. He needs regularly blood tests for chemotherapy, but the GP surgery refuse to do them because they don't get paid, so they insist they're done by the oncology dept, who don't do them in house, but have "contracted" them to a clinic's phlebotomy dept. Same with prescriptions, when oncologist sees that there's a deficiency (say iron or Vit D), she won't issue the prescription, and says it's the GP's job as it's not an oncology matter (they don't want it out of their funding, they want the GP funding to pay it as it's just vitamins which apparently is within the realms of GP funding!). It's complete madness as it wastes time, i.e. OH needed a GP appointment and GP blood test to "prove" a prescription is needed, despite the oncologist saying so - apparently GP need their own blood tests as "evidence" to get funding for the prescription.

Complete madness and lots of extra/unnecessary work just to play games with artificial internal markets, i.e. arguing between themselves which trust pays for a prescription or blood test!

Correct. Saying 'just copy X European country' isn't taking into account a lot of other social variables.

My GP surgery is a private business.
My local school vaccination team is run by a private business.
My local school nurse team and health visitors are run by a private business.
‘My local hospital is a business, but the vast majority of people don’t know that.
Just because it uses the NHS logo doesn’t mean it’s NHS. Commissioned companies can use the logo.

Yes it will happen, because people are too fond of going to A&E for a splinter, or getting paracetamol on prescription.😒

@Kazzyhoward absolutely agree. I’m currently on placement and a few of the students I’ve come across are quite overweight and I find this to be totally ironic considering we are supposed to be educators in prevention, I’m by no means perfect but I’m very aware of how I live my life to try and be as healthy as possible later in life

In France, with many times more nurses than the UK, a typical nurse will earn 35k euros, thats on par with UK nurse pay.
Nurse pay in UK is similar to most EU countries but is far behind US Canada Aus.

But we do have the most expensive tuition fees in the world.

There simply isn't enough people in the UK to do all the jobs that we have shortages in.

Privatisation, doesn't magic up nurses, it doesn't create more wards/equipment/care workers/midwives etc etc
What it does do is create the profit motive, so easy operations an treatments will attract investment, long term chronic/complex conditions will not.

29 out of 30 new midwives leave within 5 years.....

Jeremy Hunt is now saying he bears some responsibility for the staff shortages in the NHS... in other words, its not down to lack of reform but lack of forward planning on staff numbers and ensuring a decent working environment.

Long term funding, new hospitals, staff planning, some reforms are needed but just as with British Rail, privatisation is not the answer.

We also need to allow FOM from EU so we can get staff into the UK without costly visas and health insurances.

Huge parts of the NHS are already "privatised". When you next go to a mobile scanning/xray unit, look at the side, it may have the big blue NHS logo, but it will also have signage saying "Acme Healthcare" or similar, and staffed by non NHS staff provided by the operators of the vehicle.

Likewise, GP surgeries, opticians doing NHS work, Specsavers doing NHS hearing tests/hearing aids, dentists doing NHS work, are mostly private businesses.

Lots of locums and bank staff are self employed and provided by private agencies.

Catering, cleaning, maintenance and even buildings themselves are often privately owned contracted by the NHS.

Most non emergency ambulances are operated by private businesses who do NHS patient transfers, admissions and discharges on a "per patient" costing basis.

I'm in favour of a system where people who can afford healthcare are charged, while people who cannot afford it are given free healthcare, funded by general taxation.

The issue is who can afford it? Young people can't afford housing, have lower pensions & higher retirement ages & higher student loan costs?

Similarly there shouldn't be state pension for everybody, only those that need it.

How do you quantify who needs it?

How many times are we going to have this one !.

Last I read they did this in Singapore. A portion of your tax was put away in a special account that would top up from mandatory care which was paid for from government/taxes. So if you wanted anything extra you tapped into your "savings" fund. Sounded alright to me. We pay tax anyway and we could easily be forced to save via tax. I don't think it should be extra tax though, but remodelled.

And politicians should not be allowed to profit from pharmaceuticals or screening equipment or anything around it, which would go towards eradicating demand incentive.

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

Spent a lot of time in Derriford recently, taking my FiL to various appointments, yes over weight staff, just like in society... no to smoking outside entrances, discouraged on trust property.

However, what does annoy me is folk like my FiL, circulation issues, told repeatedly to stop smoking, ignores and now the complex operation he will soon have may not be successful, leading to amputation and even more costs.

Probably the most important concern facing the country right now, which the Tories, after 12 years in power, have completely failed to address... they just throw money at the problem with no plan :(

7 million waiting months years for treatment.... of course its a burning issue.

10-15% of the NHS is already privatised and owned by Richard Branston. The Tories are slowly and secretly selling off as much as they can to private investors over time.
Privatisation will solve nothing at all. It's not the answer.
I come from a country where you have to pay for all healthcare and it's awful. It's upwards of €85 just to see a GP (for anything at all, no matter how minor or major). A lot of people can't afford that, so don't go, even though they're unwell. It's also even more expensive to visit an A&E or minor injury department. My sister still lives in the country and she recently got an infection and had to pay €85 to see a GP and €35 for antibiotics, then a further €35 for more antibiotics because the initial antibiotics he gave her weren't effective for the infection she had. (Not his fault at all and even if it is, she's still the one paying the bill so it doesn't matter).
And the healthcare is not 'good' or 'better' either by any stretch of the imagination. Literally 9/10 I know that got cancer in that country have died and the rest have been allowed to get to stage 4 because doctors will not give chemo, radiation and operations the way they do here.
If we go private, you will literally get a bill for £100s and £1000s for a couple of days hospital stay. You literally get charged for every single thing- admission, blood tests, all scans (each upwards of £250), overnight stay, operation, food, medication etc
Honestly, once we go private in the UK, you will all be full of regret and wishing it never happened. I promise that. Please take it from someone that comes from a place where healthcare is not free at the point of delivery.
Here are some average cost examples below to the NHS of basic treatment and GP/ hospital visits-

www.kingsfund.org.uk/audio-video/key-facts-figures-nhs

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

Are we now wanting eugenics for nhs staff. Maybe they overeat because they’re stressed and knackered?

Exactly, what's the cut off? So work more get taxed more and then get told if you need hospital or healthcare tough unless you pay?!

And also GP’s can’t prescribe over the counter medication anymore. If it’s available over the counter you have to buy it.

This is the most sensible thing I’ve heard for ages. Fancy running for PM, you would get my vote ❤️

Dear public you're being played. You think NHS isn't functioning so it must be privatised. This is precisely the point tories wanted to bring you to, by starving it and making it dysfunctional so they could justify privatising it. Please don't be stupid. Ask for more cash to the NHS. Ask for the 350 mil they promised from brexit to go to NHS. People were also living longer 12 years ago, but NHS was working. There were nurses from abroad. Brexit and lack of funding resulted in this. Yes some things can be improved, more taxation from corporations can go to NHS, but healthcare and shelter and food for those who need it is a governments duty, otherwise why tf they're there? To make laws to benefit them?

@thejall
The issue is who can afford it?
People who have assets (savings, property, and investments) that can be sold to pay for their care.

I'm all for a bit of charging in appropriate places, but the £8 per day in hospital idea seems a bit silly. It's an insignificant amount, firstly. Secondly, it's just an additional funding mechanism, which creates extra admin. It would be simpler and more sensible to just raise tax.

To illustrate what I mean by appropriate places, I'd see nothing wrong with GP services being paid for directly by consumers. GP's could charge patients the full cost, with government maybe paying 80%/90%/100% of the charge for anyone on Universal Credit.

The purpose of insurance (including social insurance) is to cover things people can't afford out of normal income, or even short-term savings, and for the vast majority of people, GP visits are are cheap enough to count as non-insurable expenses.

The reason it would be appropriate to charge for GP services is that then supply and demand would match, it would (eventually) completely eliminate the shortage of GP appointments.

The difference between charging for GP services and services your are referred to such as hospitals and specialists is that the consumer decides GP services and GPs are gatekeepers of other services. So there is control over appropriate use of other services, but no control over consumption of GP services. So charging for GP visits would serve a useful purpose, regardless of the impact on government/NHS finances.

The same arguments as apply to GP services could apply to ambulance services. (Although I suppose it depends on whether you think operators can triage calls to see if an ambulance is really necessary, if they mostly can then I guess that counts as a referred service that you don't need to control access to.)

The NHS is transforming though- it’s been slowed down due to Covid. Have you not heard of integrated care systems and the long term plan? We had a people plan and digitalisation plan which cannot be delivered now, thanks to staff shortages and demand soaring.

The staffing shortages mean both can’t be delivered. So there are delays. Money is not the problem. Neither is poor management. The Tories are not trying to run it down to privatise it. We were about to embark on massive transformation then Covid and Brexit hit.

The staff shortages are a National crisis and need addressing by a competent government…. which we don’t have. We also need to get a grip on lifestyle diseases that account for over 50% of NHS spend.

Sorry but there is soooo much ignorance of NHS strategic plans and policies on this thread!!