People would be happy to pay more tax if it went directly to the NHS

[Blackcats7]

I think people would be happy to pay more tax if it was guaranteed to go to the NHS.

"And nowhere else is there a model that is exclusively free at the point of delivery."

That's not true.

Most primary healthcare is free at the point of use in Spain. Hospital treatment in New Zealand is free at the point of use. Brazil provide universal free healthcare. Ditto Cuba.

Re: Isreal - they have 3.8 doctors per 1000 population. We have 2.8, and a significantly older and less healthy population. The median age in Israel is 29. In the UK it's 40. What you put down to a 'better system' could just be 'more doctors' and 'a healthier population'.

@Papyrophile "And nowhere else is there a model that is exclusively free at the point of delivery." "Most of western Europe requires some element of co-payment for all but the very poorest or children, as does Australia."

This is not correct. I have lived in several EU countries - all had free healthcare at the point of delivery. Although they followed different funding models, none required any payment over and above what was already covered by the relevent national healthcare service.

Every other country has built in some competition between healthcare providers, which drives response, whether between hospitals or lab services or doctors."

Again, this is not true. England actually does supposedly have competition between health providers, and patient choice - both of which in reality are severely limited to the point of being virtually non-existent.

The danger with "competition" is that private companies exist to make a profit, and will be tempted to cherry pick the most profitable services, leaving the unpopular, difficult or unprofitable services to be covered by the NHS.

This is why in my ideal world the government would insist that an NHS steering committee was set up comprising of members from all main parties. The credit/blame should be shared and it shouldn't be allowed to be the political football that it is, as we all suffer for it

It already happens. APPG's exist for almost all healthcare areas. All the recent plans have multiple inputs from interested parties, NHS providers, charities, patient groups.

The issue is getting things done, which lies in funding and the lack of ability of NHS management l.

It seems to me allocating more money to the NHS isn’t going to solve the problem. I think (could be wrong) funding has been increased over the decades that the NHS has been failing. More money would just be doing the same thing over and over again and expecting a different result.

We have grown used to expecting less and less as the service has got worse and worse and now accept a health service that is not fit for purpose.

I appreciate it saves lives hourly, but many lives are lost that wouldn’t be if we weren’t relying on a health service that is circling the drain. Also a lot of people wouldn’t become critically ill if there was an adequate service that met health needs at early stages.

So many services- screening, specialist referrals are being out sourced, it is being privatised by stealth so why not be honest and say the whole system needs changing.

The only reason I can think of is that no politician wants to be the one to call it. Why else would it be left as it is instead of adopting any one of the successful health service models from other countries. Even better- cherry pick the best elements of those models and create the best health service.

@izimbra

"Posters like this are completely comfortable with the poor (a disproportionate number of whom are female and from ethnic minorities) dying younger and living more years of their life in poor health. Because that's the inevitable outcome of a system that rations healthcare by cost to individuals."

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so instead we have a system that rations healthcare by queuing and ability to wait.

Or to paraphrase your comment "This means that posters like this are entirely comfortable with the time poor receiving a worse healthcare provision "

No, we pay enough tax. It is just not distributed and used correctly.

What a bizarre comment.

What does 'time poor' mean in the context of sitting on a waiting list for an operation or treatment?

Nope. The NHS was performing relatively well by international standards and according to patients in 2010.

This follows a decade of strong spending on healthcare under new labour.

Experts in healthcare research believe that we need to increase spending on healthcare by 4% a year in real terms, to meet the growing costs of providing healthcare to an ever older population, and to meet the growing costs of medicine and medical technology.

Other countries have increased their spending in line with need.

We didn't. Healthcare spending increased by 2% a year after 2010, rather than the 4% needed, leaving the NHS struggle to provide adequate care.

And despite increasing competitive tendering and the growing involvement of the private & charitable sector in delivering care under the NHS banner, things haven't improved. I'm not surprised - where has privatisation improved efficiency and service in relation to public services? Water? Trains? Children's Care? 🙄

In Singapore they pay migrant nurses less than home grown ones - seems a good as we would then have a system with a pool of experienced nurses. But human rights /labour laws prob wouldn't allow it here.

For everyone saying that the country can't afford to put more money into the NHS - the country really can't afford not to.

Britain’s poor record on health is costing the economy £43bn a year and cutting the annual incomes of individuals affected by long-term sickness by up to £2,200 a year on average, a report says.
With official figures showing more days lost to sickness than at any time since 2004, the Institute for Public Policy Research said improving the country’s health was vital both for the economy and to boost the incomes of disadvantaged groups.

Wouldn't allow it as it's unjust and exploitative.

Are you ok with unjust and exploitative?

Healthcare HAS to be free at the point of use, just morally, it would be totally wrong in a country where the gap between rich and poor is ever widening for everyone to pay the same. I have been that poor in the past that I wouldn’t have had a spare £40 or whatever to go to the doctor. I only recently have been able to afford private dental insurance ( no NHS dentist for years).
A co-pay might be a minuscule percentage of one persons income, or big chunk of a family’s weekly food budget.
The only fair way to pay for healthcare is via taxes.

@izimbra

"What a bizarre comment.

What does 'time poor' mean in the context of sitting on a waiting list for an operation or treatment?"

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Time poor means that because the NHS is free at the point of use demand will always exceed supply so access is rationed by queuing.

This means that a single working mum is not able to wait 9 hours in A&E with a suspected fractured wrist so just tapes it up or that suspicious mole on her shoulder gets ignored because she can't wait 3 hours in a GO surgery or does. Whereas if you are retired or not working or without children then you are more able to wait.

Spending more money on the NHS will not prevent people from going to A&E with sunburn or going to the GP with a cold or as another previous poster mentioned asking for replacement child leg splints at a cost of £1k because they lost the previous ones.

Why would there be more of the experienced home grown nurses than there are now? The UK trains too few nurses and the occupation has gone from being well-respected and well paid to being a job slagged off by the public and politicians alike.

Nurses have been leaving the NHS in droves. Some because they have reached pension age (something which has been on the horizon for the last 15 years as the large cohort of nurses born after WW2 reached retirement age); some because working conditions, shifts and hours (including unpaid hours) have become intolerable; some because they are fed up with trying to do their best with too little equipment, too few beds and no support from managers and politicians; some because the pay is simply too low for the responsibility that they carry and some because other jobs pay more.

When I was hospitalised on holiday in Austria I was talking to some of the nurses, having myself worked in the NHS. There nurses are paid a bursary while under training (i.e. the classroom part of their education), and earn a wage in addition to this for the hours that they actually work on the wards. On-site student nurse accommodation costs next to nothing. Meals on and off duty cost €1 a day for 3 meals. I met a couple of nurses there who had worked in England - they said that they would never return, having experienced what they described as conditions that would never be tolerated (by the profession and by the patients) in Austria.

@1dayatatime "Time poor means that because the NHS is free at the point of use demand will always exceed supply so access is rationed by queuing."

And yet other healthcare systems in other countries which are also free at the point of use do not experience a situation where demand always exceeds supply.

"Spending more money on the NHS will not prevent people from going to A&E with sunburn or going to the GP with a cold"

It might do if some of the money were to be spent on public information and better educating people about what is and what isn't appropriate for people to go to A&E for. The general public is very poorly informed and educated about healthcare services and about how to look after their own health.

@PontiacFirebird

"Healthcare HAS to be free at the point of use, just morally, it would be totally wrong in a country where the gap between rich and poor is ever widening for everyone to pay the same."

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But because it's free at the point of use, people value it less, miss appointments and abuse it (and the staff).

Just look at supermarket carrier bags, when they were free shoppers used loads. Introduce a 5 p charge and use of carrier bags dropped 98%.

Without a nominal charge, demand on accessing the NHS will always outstrip supply no matter how much money is put into it. And all you do is regulate access to healthcare by the ability to be able to queue and wait.

@Havanananana

"And yet other healthcare systems in other countries which are also free at the point of use do not experience a situation where demand always exceeds supply"

The NHS is one of the very few publicly funded healthcare systems in the world. The majority use some form of combined private / public healthcare insurance system where you often have to pay something for an appointment or operation.

The only comparable system I can think of is in Dubai but that is only for nationals not foreign workers.

@Havanananana

"It might do if some of the money were to be spent on public information and better educating people about what is and what isn't appropriate for people to go to A&E for."

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Sorry but not a chance- it is human nature not to value things that are free whether that be carrier bags in a supermarket or a handful of napkins in McDonalds.

Why do you keep banging on about carrier bags 1dayatatime? It’s not comparable! There are easy alternatives to plastic bags. Nothing bad will happen to anyone if they don’t buy a plastic bag.
The alternative to healthcare being made unaffordable to many is … no healthcare!

Do you see how it’s not the genius solution you seem to think it is?

No thanks.

Definitely not without cast iron reassurance of where the money goes.
A proper expert tram made up of all sorts to help, whilst looking across the world at the very best.

Without a nominal charge, demand on accessing the NHS will always outstrip supply no matter how much money is put into it. And all you do is regulate access to healthcare by the ability to be able to queue and wait.

That simply isn’t true. The NHS wasn’t perfect but it was light years better in the decade before 2010. Demand outstrips supply now because there are huge backlogs and no plan to tackle them.

@1dayatatime "The NHS is one of the very few publicly funded healthcare systems in the world. The majority use some form of combined private / public healthcare insurance system where you often have to pay something for an appointment or operation."

This is simply not correct. While revenue is raised through taxation in the UK, most European healthcare systems operate on a similar basis.

In the UK funds for healthcare come from general taxes and National Insurance. In Scandinavia the system is broadly the same - healthcare finance comes out of the general taxation pool, be it income tax, VAT, Corporation Tax and various other taxes and duties.

In Germany and Austria, healthcare provision is paid for through "Krankenkasse" - mutual insurance funds to which contributions are compulsory and which are paid by employees and employers. The major difference between this system and the UK system is that the money in the Krankenkasse is ringfenced for healthcare and social care. The unemployed and others not in work (students, carers, pensioners etc) have their contributions covered by the State, which also makes up any shortfall in the finances - i.e. the State ensures that as incomes and GDP rise or fall, there is always enough money in the system to pay for the healthcare provision. Some other European countries operate similar systems.

In all these countries, healthcare is free at the point of delivery. Patients do not pay for appointments or for operations - nor do they pay any proportion of the costs.