What are your thoughts on privatising the NHS? Good or bad?

[Supernova23]

I would also love some input from those who have lived in countries that have private healthcare systems. Is it better or worse in your country?

For context, I love the prinicple of the NHS. I’m an NHS nurse. I also like a massive chunk of NHS nurses and doctors, think of looking for a way out on a daily basis. The lure of going abroad tempts me daily.

But as we know, we live on a tiny over populated island. People are living longer and getting sicker. People also abuse the system on a daily basis. I’ve been kicked, hit, spat at, called every name under the sun. I’ve been threatened numerous times. Me and my colleagues have been threatened by a maniac with a machete.

We are haemorrhaging staff on a daily basis. People either leave or go off long term sick. I can’t blame them.

Patients are becoming more medically complex with multiple co morbidities. In the nicest possible way, advances in medicine has meant that people who would have kicked the bucket long ago, are now people kept alive due to modern medicine. People are also getting much, much larger; this makes them more complex to manage in every sense. Even with basic bog standard care. We frequently have patients so large it takes at least 4 people reposition them. You try finding 4 spare hands on the wards; it’s a nightmare.

In my hospital alone, every single ward has multiple complex long stay patients that have been on the wards for 6+ months. In some cases it’s a year or more. The cost of these stays often runs into the hundreds of thousands, perhaps even millions, and is obviously reducing the number of patients we can admit.

I could ramble on. The system has been at breaking point for years. Would privatising the NHS improve it? Or is that cloud cuckoo land?

The NHS can't continue like this (for all the reasons you give). I would support a partially privatised system (as I understand happens in some European countries).

Regardless of the good or the bad or, more likely, the good and the bad, I think it's inevitable at this point.

Streeting seems to be gearing up to expedite the process. Although it will piss people off if it's done through more and more privatisation creep rather than open and honest discussions about the NHS.

I agree with Omura. We cannot carry on like this. Yet the usual suspects will bleat that some people cannot afford even 50p for a contribution to their health etc etc. Those people will be taken care of (but people do need to budget something schools dont teach).

And I am betting someone will scream about not wanting to become like the US... there is something inbetween though. Basially people agree the NHS needs a review/more money - they just dont want to pay for that funding themselves. That is for others to pay,

I’d prefer that not to be the route tbh as it’s massively inflationary and leads to unnecessary tests to bill the insurers, but it definitely needs reform. I think there is an assumption that there would be loads of money for the NHS of only they taxed rich people a bit more but unfortunately the maths doesn’t stack up on that, especially if considered alongside the additional money needed for social care and general demographics. Unfortunately I suspect we are entering an era when social care will to an extent need to be self paid or the responsibility of families or it’s just going to bankrupt every council across the land. There also needs to be a very difficult conversation about extreme old age and how long we should keep people alive and more importantly if they want to be alive. Pretty much everyone I know says they don’t want to live if they get dementia but it’s quite difficult to make that happen.

if I had to choose for the NHS I’d choose a publicly funded service with an element of self pay.

I think partially privatising would be beneficial, the difficulty would be in deciding which areas. Something definitely needs to change soon though before the NHS gets any worse

I can’t see how adding in an element of profit (for the private companies) will do anything except give worse value for money.

The US apparently spends $12,500 per capita on healthcare. UK spends $5,500 per capita. Germany is somewhere in between at $8,000.

I think the NHS likely needs reform, and a lot more money, but we also need an adult discussion about the cost of providing healthcare under any system, and how we meet that cost/who pays.

I don’t think privatisation will benefit ordinary people in any way.

I should add that privatisation is creeping in regardless. There are so many private GP practices where I live ( fairly affluent town in the south west with lots of old people), while a lot of the NHS clinics don’t have any appointments because they can’t recruit any more GPs Obviously I haven’t asked the private GPs why they are private and not NHS but I wonder if it’s about money or more about conditions or hours?

People seem to be absolutely terrified of paying a penny more tax, but how is social care going to be funded?
I really think that social care is the big problem here. We have an aging population that is living longer and no-one wants to pay for their care.
I'd like to see some sort of cross-party group set up to tackle the whole thing, but it just seems too tribal at the moment.
Privatisation has been a disaster for transport and utilities so i can't see healthcare being any better. Greed sets in.
My DHs late uncle was paying roughly a grand a week at his care home and it was really basic standard. The food was appalling.

Cannot overstate how much I do not want to see the NHS being reformed down a for-profit privatised route. I agree the NHS as it stands needs reform but I grew up in the US where the healthcare system is complicated and terrifying.

My mother drove herself to the hospital with a burst appendix because we couldn't afford to pay for an ambulance. She eventually died in her fifties. I really hope the UK doesn't become a place where its citizens are too afraid to call an ambulance or get routine health care because of crippling cost.

Also, I wouldn't trust the Tories AT ALL to oversee any sort of NHS reform given their track record of lining crony pockets.

In another country I've lived in, healthcare is privatised for foreigners and free for locals. As a foreigner you can't live there (legally) without a job and your employer is obliged to pay for healthcare costs. All employers provide healthcare insurance, with an element of co-pay. There are different levels - although the basic level is still better care than I've ever received from the NHS (this is no criticism of the amazing people who work in the NHS - just a criticism of the whole system which really isn't fit for purpose currently). I honestly don't see a way forward for the NHS without at least an element of private healthcare. I'm not sure how private healthcare works in the UK, but for me previously, I wasn't sent for tests etc to ramp up the costs - I just had the care I needed, when I needed it (which is definitely not the case now).

Privatisation is great if 1) you’re wealthy and 2) your employer gives you great benefits. Not so great if 1) you’re poor or 2) in-between jobs for whatever reason and cannot afford private insurance. So there’s a big divide, and it depends on what side of the divide you’re on. Once everything’s privatised, costs go through the roof and everything is billed and itemised…think £500 for an ambulance, £20k for a&e, £50-200k for cancer treatment, £1k for an x-ray, £10-30k for a baby delivery. Medical debt and medical bankruptcy are REAL and I would prefer not to lose my home due to medical debt. We need to fight as hard as we can for the NHS.

We need a system based on social insurance like in: France, Germany, Austria, Australia, etc.

We have a home in France and the difference between access, delivery and standard of service is significantly better than in the UK.

Services should remain free for the vulnerable and for children but the concept of service will not prevail unless in some parts, money changes hands.

It'll be dumped back on to the shoulders of women when the care sector breaks under the weight of demand. There's an ever dwindling upper limit of how many people are inclined to do this kind of work.

Absolutely not. Privatisation in this country has never ever resulted in a better service for lower costs. It would be literal madness to expect the NHS to be the exception.

I thought the £350,000,000 per week that Boris promised us was going to save the NHS. When will that cash flow start?

I would also like to see a definition of base line services for everyone. If people want more than the baseline then they should insure or pay. Examples are: ozempic and barbaric surgery.

Also, let's take away some of the absurdities. DH and I still work full-time despite being over 60. Yet we are entitled to free prescriptions and free eye tests - why?

Having worked in the NHS as a nurse, I don't think more money is the answer. Only radical change will improve health care in this country. The NHS is massively expensive and wasteful.

Unfortunately, as a nation we have this romanticised image of our health service and since covid, many people worship it like a religion. This makes proper reform politically toxic. Therefore, no government of any party will ever have the courage to make the changes it needs.

That's why the left banging on about the Conservatives wanting to privatise or destroy the NHS is utterly ludicrous. They've been in government for longer than they have been in opposition since the NHS was created. Yet we still have an NHS.

We are constantly being told that the NHS is the envy of the world, yet no country in the world has chosen to emulate the NHS model.

This.

Privatising the NHS would be totally insane.

NB: we already have a degree of privatisation through the backdoor, with those who can afford it and/or are desperate paying for dental treatment, surgeries and other ways of getting seen/treated more quickly.

I think it would be a tragedy to privatise one of the greatest ideas of all time and that we are perfectly capable of turning things round. Nothing a private company can achieve can’t be replicated. Selling off our nhs would be the most shameful move of our generation.

I don't think it's as simple as how much it costs. We could change a lot of the factors that make health care and social care so expensive if there was the political will to do so. The key thing is preventative care.

Levelling up has to be one of the key strategic approaches to this. Decades of "on yer bike" attitudes to work have meant that many families are geographically spread and can't rely on each other for child care, social care or even just a once-a-week shop. That's a situation that was actively encouraged by government but this is the result. Ensuring jobs and affordable housing over the whole country could do a lot to combat that. Not having people living in poverty could tackle a lot of health problems as people don't fill up on crap food which doesn't cost much to cook. Making leisure centres free for under 18s and those on low incomes might encourage more exercise. That's just a few things.

I've always wondered what would happen to the NHS staff in terms of what the NHS would pay towards their private health care? Surely there would still have to be some healthcare that would be free for those not working etc? Would staff working for the 'nhs'therefore be at a huge disadvantage contribution wise compared to some private office worker for example?
Personally I feel we need to be fighting as hard as we can to keep it, but I agree some serious changes need to occur.

have you seen the state of our water, energy, rail and telecoms - once for profit we all suffer.

We privatised the utilities and look how that’s ended up.

UK spends $5,500 per capita

Is that particular to NHS costs or does it include the costs for those people who have sought out private healthcare because the NHS is on its arse?

Most of Europe manages very well on state backed regulted insurance models. They are nothing like health care of 20 years ago in the US.

Having used them and having family using those models I'd have no problems going over to that system, not least because people who see the bills and have some choices typically put more money into the system voluntarily. Low income (for whatever reason) citizens are paid for by the state.

The current system isn't "one" system nor is it state owned - from inception it was kept semi private due to lobbying from doctors whose support was critical to implementing any kind of state supported healthcare.

I'm philosophically a strong believer in state supported health and education and have voted as such most of my life. Having worked with the NHS rather too often, bucket loads more tax will be used to massage the numbers and add to bureaucracy rather than really transform and improve services for patients or working conditions for staff (the NHS's appalling working practices often make Amazon look like a Victorian paternalist quaker company).