Tories aren’t even bothering to hide their NHS privatisation plan anymore

[Letshaveablackcelebration2022]

I think it was possible Noam Chomsky who said that the route to all privatisation of services was that first they run it totally into the ground and then they offer up a private model as a solution . It’s actually tedious in its predictability. Pillaging everything good from the country- Royal Mail, water, utilities, rail network, even housing via private landlords - everything to make profit.

And of course as predicted, the NHS was the final prize.

We are short of HC professionals, and so we ought to fund training programmes for doctors and nurses, just not without strings. If you accept funding then you should be expected to be contracted to the NHS for the FTE of the cost of your training and the bursary that allowed you to live during training. Inflation linked, so no doctor or nurse can decide to move to Australia or Canada before paying back their training costs.

`All that would do is make even less people want to join the NHS... who wants to be tied to their employer for many years into the future?
regardless of T&C, pay stress etc

& what happens when the govt ups interests rates, to keep staff tied to the NHS for even longer.... like they have done in extending loan repayments and freezing thresholds?

Just another ill thought out proposal that would make matters worse.

Here is mine.... Make the profession attractive for people to work in... we don't have a shortage of people wanting to work in the financial sector do we?

I don't think that would stop recruitment of student doctors. I thought I read there are around 10 people chasing every Medicine degree place.

@Alexandra2001 of course there's no shortage of people wanting to work in finance. They are paid high rates because it is hugely, globally competitive, and they only want the top 1%. It's not comparable with the NHS, which needs lots of bodies to do more practical work. Finance is only an option for the very clever and the very sharp elbowed. I've always quite admired your thinking based on previous exchanges, but on this point, I think you are wrong.

Yes this is the same tories that said there would be £350 million or was it Billon on the side of a bus redirected to the nhs after brexit. Doesn't matter if it was mill or bill it evidently hasn't materialised has it. Maybe not surprising that scepticism abounds about 'protection' offered to low earners,it won't be upheld or met for that matter. It would be interesting to know what their idea of a low earner is. The monster raving looney party has more financial credibility than the tories....Michelle mone, nadim zahawi, ot forgetting rishi sunaks wifes domicile status, misspent monies on ppe. Thenicing on the cake is the wheeling and dealing with American healthcare companies because we all know just how patient centric, fair and equitable the American healthcare system is. Messed hunt and Sunak know well about dismantling the nhs he has written a book about it and the other was spearheading negotiations with the said American healthcare companies !! The tories (self) interests in healthcare begin and end in THEIR pockets nothing else.

Javid is on the back benches and is going to stand down at the next election. I guess he feels he is free to express his own views and opinions, which the government have already rejected. However his comment that the NHS is a religion to some is uncomfortably true in my opinion.

How much tax do you pay monthly now and how much more are you prepared to pay?

This is the problem: a lot of people who say they'd be happy to pay more are those who are not net contributors anyway, and when they say they'd be happy to pay more, they don't actually mean enough to become net contributors.

Then you have the super rich who don't pay enough but mostly don't care because they don't use the NHS. A few do and would willingly pay more, but it's such a small number of people proportionate to the population that it wouldn't raise enough to continue funding it in its current form, with exponential growth in costs.

And then stuck in the middle are those employees on PAYE with higher than average salaries, who are already carrying the vast majority of the tax burden that's been ramped up mainly on that group over recent years, and really can't afford to pay even more yet again to cover everyone else. And nor should they when they're the ones who've carried everyone else through the mess of the last decade and just about kept is afloat until now.

If you actually look at the stats and projections in terms of demographics and expected future funding requirements it's quite clear that the NHS as it stands can't be afforded by this country. Over a decade of no productivity growth certainly hasn't helped. Nor has the idiocy of Brexit. Or austerity increasing poverty and making the population more unwell. But predominantly it's an unworkable model that would always implode given the advances in medical science (and therefore costs) and changes in demographics, and this has been known for decades.

All UK infrastructure, services, food and energy security is screwed for the same reason: decades and decades of utterly incompetent management by economic illiterates who have no long-term plan whatsoever.

Frankly I wouldn't pay more tax governments misuse it.

Lobby your employer to set up a private plan for the employees. Do the research and make a case for it.

In 2021/22, UK government raised over £915 billion a year in receipts – income from taxes and other sources. So actually about 20%.

The NHS has been giving away too many things away for free/cheaply for too long. Things like prescribing medication such as paracetamol that can be bought for 25p in the supermarket. That would save millions if that was banned. I’m fine with paying NHS charges to go the the dentist, I would even pay 10-15% more. However, I don’t think anyone should be getting a freebie. I think all the people currently getting it free should pay a standard charge, say £5 per treatment. Introducing small charges like that could also raise a lot of money.

Yes to charging for missed appointments, unless proof of why the appointment was missed is submitted. Reduce the numbers of very senior managers. I work for an NHS Arms length body and they spend so much time faffing about, I’m not sure what half of them do. Yet, our organisation still ended up with a huge underspend which is now being spent on crap which would be better spent on frontline services. Spoilers…it isn’t.

I ended up spending £300 on private physio because the NHS one didn’t do what I needed him to do. I also spent £250 to see a podiatrist as the NHS one didn’t carry out the procedure correctly. Luckily I can afford it but I know others can’t. I’m sick of it all.

Rant over for now.

My point in comparing to finance was that salary is what often attracts people to a lot of jobs/aids retention and finance employs 100s of 1000s, they aren't all hedge fund managers!
FS covers a huge range of jobs & many, indeed the majority (degree educated) will be earning more than a nurse & wont be any where nr the global competitive market place for employment.

Thats the reason we have staff shortages in NHS, which then leads to stress, burnout, leave... maybe for a job in the finance industry.

I see it with my own DD, many of her friends from Uni now earn more and have a more relaxed work life balance.
We really do under value HCPs and its going to hurt us all.... tying them to a poorly paid and stressed job will not help...

If we want to solve the workforce situation, we need to think about what would attract us to Health as a career?

I was a bit sharp earlier, sorry.

What "Rationing by price" actually means is making it unavailable to people who can't afford it. You only have to look at other situations where people with the lowest incomes are subsidised to know that there will be those that don't meet the threshold for help but will still struggle to find the money.

I don't understand the blind faith in private companies providing a better service. It hasn't worked too well with rail, utilities, mail, dentistry and so on. My NHS dentist has just dumped all their NHS patients and now there are no NHS dentists available locally. So that really isn't working at all. I'm struggling to think of any service that has been improved by privatisation.

There are a lot of issues with the NHS and it is not just about throwing more money at it. There is a complete lack of joined-up thinking. Social care (oh yes, private companies again) is a complete disaster. It's having a huge impact on the NHS. We are still paying for those people to be cared for, it's just that the money is being spent in hospitals instead of in care homes. The nationalised service is picking up the pieces for the failing private sector service. I don't know (and I may be wrong) but I'd hazard a guess that occupying a bed in a hospital is more expensive than occupying a bed in a care home or providing at-home care. So not funding the social care system properly is, I suspect, costing us more money than it would cost to fund it properly in the first place.

The internal market in the NHS causes issues too. One department makes savings by cutting services only to cause more problems for those patients down the line that end up costing far more for another department (or the benefits system when they can't work). For example, the amount of gatekeeping on referrals for assessment for ASD/ADHD etc means that people are going undiagnosed and unsupported leading to mental health crises further down the line. That's only one example, there are plenty of others.

Private healthcare providers shouldn't be able to just dump patients back onto the NHS to deal with when things go wrong. They should have to pay something if they do.

I think we need to sort out the social care system as a top priority. We need to address the fact that 10% of NHS posts are vacant. There is something horribly wrong to have that much of a staff shortage. Again, I don't think that is just about money either but it probably doesn't help if people can earn more in less stressful jobs. If we don't get these two things sorted out ASAP then I don't see how things can improve. In the longer term, we need a more preventative approach. It's less expensive to stop people from getting ill than it is to deal with the illness,

I have a (not imaginary) DC with multiple chronic health conditions who should be seeing a consultant and having health screening tests every 3 months. So far the appointments have been 5 months apart (so there have been 2 in the time there should have been 4). It's coming up to 5 months again now and we haven't received a new appointment yet. It's not ok. Something has to change. I just don't think the private sector offers a magic wand.

Ultimately, healthcare has to be paid for, and we are going to pay for it. The question is do we want people to pay for what they use (regardless of being able to afford it) or do we want people to pay in what they can afford to pay so that everyone can have the healthcare that they need? Adding in people paying a nominal charge at the point of use probably won't gain much, if anything, by the time the cost of administering it is taken into account.

It's also important to understand that there is a cost to not looking after the nation's health. People who are not working, of whom a sizable number are ill, need financial support and may need looking after most often meaning a family member not working so that they can care for them. So then that's two people not working and needing financial support. The economics of a country are not the same as those of a household. As a country, investing in some areas means savings in others and potentially an increase in tax income. It's not just a question of having to find more money.

Sorry, that was a bit of an epic.

Im type 1 diabetic, not easy but I work hard to manage it and have never needed A&E or emergency medicine. Just my routine appointments. I have type 1 family and friends who are in and out of A&E like a revolving door because they can’t be bothered to manage it properly.

The way you talk about other type 1 diabetics speaks volumes and tells me all I need to know tbh.

You sound like you have told yourself a little fairy story that the reason you never need A&E for your diabetes is because you are a good, worthy diabetic, and therefore bad things will never happen to you. Not like those who "can't be bothered to manage it properly".

Out of curiosity, what is your a1c/ time in range/ standard deviation?

You may very well find yourself someday needing A&E care if your luck runs out. DKA from a vomiting bug or flu can happen to any type 1 and fuck up your management in a matter of hours, for example. Good diabetes management is really important, yes, but there is also an element of luck and genetics at work as to who gets complications down the road.

Perhaps you shouldn't be so quick to shit all over other diabetics and dismiss their management struggles as "can't be bothered".

The UK has one of the worst rates in Europe for type 1 young adults meeting management goals, for example. And no, that's not because they are all shiftless layabouts who can't be arsed.

It is also widely accepted that diabetes affects mental health, and in turn the ability to self care.

The way you talk about other type 1 diabetics speaks volumes and tells me all I need to know tbh

Yeah of course it does 🤷🏼‍♀️ because saying anything other than ‘everyone does their best and if not then MH’ is the only accepted view on here. You’ve proved my point exactly. And unless you’re type 1 I will know far more than you on this subject, yet ‘omg you can’t say that, so judgey’.

Time in range is usually ~80%, my A1C is currently 6.0% (or 42 old money).

I just don't think the private sector offers a magic wand

It doesn't. And no-one ever suggests a fully privatised system, ever, not even the Tories or Labour. What is being suggested is a blended system. Why not have private hospitals do the simple routine stuff? Hips and Knees, Gynea, Cateracts, the kind of stuff that is easy to do and at volume. The kind of things that are simple but can improve life immensely. How about we re-implement the cottage hospital system, for intermediate care of the elderly, that could be privately run. The NHS is then retained for all critical care, complex care, care for complex conditions. We already have specialist NHS care centres, they become better and more competent at what they do, because they focus on a speciality, they attract better and more innovative surgeons, which leads to better care and better outcomes.

Apologies if already been discussed here, I haven’t read all the comments but…are you aware that Labour is fully in support of private health? (Using the illusion of using it to clear backlogs…but it will undoubtedly be made long term). Wes stressing has spoken out in support many times recently, as has Keir. Privatisation really is not as scary as people make it out to be…the poor will always be accommodated.

Our health board in Wales are sending patients to private operator in Cheshire for cataract surgery, there's a huge backlog . They've done it for male sterilisation in the past. When I went to the clinic spoke to people drinking coffee in reception who had been sent from our health board for hips and knee surgery.

I hear what you are saying but where would the staff come from? So profit and shareholder dividends... how would you seek to control ownership so this is re invested? not given out in director pay and shares.

Ah! regulation i hear you say... look at how water, electricity and train companies ignore their regulators, who are toothless tigers.

The majority of cost to the NHS (after salaries) isn't cheap routine surgery, its chronic long term conditions, not least age related.

We already have privately run nursing facilities for the elderly in the UK and residential care too, it doesn't work because the Govt sets the funding and its not enough to pay staff and if it were, staff in this sector would then earn similar to that of an NHS HCA etc.... so they would leave the NHS to work in a less stressful care/nursing home.

I really don't see how privatising sections of the NHS gets us staff or increases wages.... because the bottom line is ... we relied on EAA workers in our health sector and they have gone home and we have not enough uk workers to fill the gaps.... and other countries paying more are competing for healthcare staff worldwide and actively recruiting in the UK too......

Gordon Bennet, the Tufton Street misinformation bots are out in force.

Labour may be "in favour" of private healthcare, but that is somewhat different to wanting the entire NHS sold off to private companies for profit.

I'll let you guess which party might be keen on that...

www.opendemocracy.net/en/elective-recovery-taskforce-private-healthcare-nhs/

Interesting meetings with the private sector

Hip replacements must be rising due to age increasing

A quick google showed figures and projection

The statistics make it clear. In 2017, the number of primary hip and knee replacement surgeries in England, Wales and Northern Ireland totalled 91,698 and 102,177 respectively, based on numbers submitted to the National Joint Registry.

According to projected figures from a 2015 study published in the Osteoarthritis and Cartilage journal, the NHS will need to perform an estimated 439,097 hip replacements and 1.2 million knee replacements by 2035 to keep the population in England and Wales mobile and pain free.

www.theguardian.com/business/2021/sep/09/spire-reports-47m-profits-on-back-of-long-nhs-waiting-lists

Spire are helping reduce waiting times

Yep and where will the private sector get staff from to fulfill the extra NHS work they will bid for (and get)........ already wait times for private patients are in the months, dependent where you live and what you need.... 1m extra people signed up for PHI last year.

I think the next 2 years will see the NHS pretty much privatised for routine care, with the NHS left with chronic and AE.

@Alexandra2001 likely from bank staff, the cost of living crisis means many are happy to pick up shifts if the £££ is right.

Well here many nurses left our health board which has been in special measures for 8 years now. They either went into the private sector or agency work.