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?

How much evidence of the shit effects of privatisation do we need, in order for supporters of greedy entrepreneurs to get the message?

Well, you chose to pay for an online assessment? Surely you knew that had its limitations? I had the same choice and opted to pay more for in person. and fwiw I would still go with an online assessment over a 3 year wait..

the other experience is terrible, but also illustrates the benefits of private care - when I see a doctor that I don’t like privately I can choose to see someone different the next time. If said doctor is such an ass to all of his patients, he won’t have much of a private practice. He WILL have a robust nhs practice though - remember it is the same doctors in both systems- as his nhs patients can’t pick and choose.

I wouldn’t say that anyone on this thread is in support of your so called ‘greedy entrepreneurs’. They just want timely, high quality care which at the minute the NHS typically cannot provide. People are getting desperate and any alternative seems better than the current failing system

Depends on your definition of "privatise" surely. Obviously we don't want a private system like they have in the US. But the system we have now IS NOT WORKING. people are dying because they either can't see a doctor at all, or if they do see one they are repeatedly dismissed until they are so unwell it's too late for treatment to actually work.
If we had a decent system of insurance + state like they have in parts of Europe everyone would be covered. Those with very low income or under 18 would have their insurance paid for by the state, everyone else would have to pay a monthly sum, depending on their income level. Also a small charge to access a GP (or at the very least charged for a no-show)
Then the system would have a lot more money coming in and people that work in the NHS wouldn't think that they're doing their patients a favour and patients would value the service because they're paying. Win win.
And the absolute madness that means that once you hit 60 everything is free needs to stop. The only people who should be getting everything for free is kids (as no income) or those on v low incomes.

The only people who should be getting everything for free is kids (as no income) or those on v low incomes

Even if those children have parents who could afford to pay?

@Itsrainingten

And the absolute madness that means that once you hit 60 everything is free needs to stop. The only people who should be getting everything for free is kids (as no income) or those on v low incomes.

Fully agree. All the "OAP benefits" should be means tested at the very least. Absolutely crazy to continue giving free prescriptions, state pension, winter fuel allowance, bus passes, etc to the wealthier OAPs many of whom have incomes higher than the average household income of workers. And we need to charge NIC (or equivalent) on OAPs who have higher incomes, usually from occupational pensions, property rentals, etc.

No, I didn't. We were referred through the NHS after a 3-year wait. And no, I don't think the NHS is perfect. I think it needs more funding, better wages so nurses, doctors and other NHS workers can make ends meet, and how about those 40 new hospitals BoJo promised? Or the new nurses that David Cameron did? And there needs to be large scale building of affordable housing and proper controls of the rental sector so NHS workers can afford to live a decent life. And reverse Brexit so all the EU workers who left might return, better trade deals with EU countries might bring living costs down again, making live more liveable and affordable for NHS workers and EVERYONE.

And to your second paragraph, not everyone has the luxury or headspace to shop around for a doctor, least of all a rape victim referred by their employer.

But the NHS referred you for a sub-standard service? That's not the fault of the private sector.

It's the fault of the government that doesn't fund it properly.

BUPA won't cover everyone with pre existing health conditions.

I’m disabled, paraplegic from birth. I have worked all my life and keep myself fit but I’m on a low income and can’t increase it.

Until my income dropped below the tax threshold (because of taking what job was available after redundancy, not laziness) I have paid tax all my adult life and was happy to do it.

What you are proposing is that i wouldn’t be able to access healthcare that keeps me well enough to work and have a normal lifespan, meaning I’ll die early through no fault of my own but an accident of birth.

That is not, and will never be fair and I’m totally against it. If we need to pay more tax (including both people like me those high earners who think they are “average”) then so be it.

I mean you could Google but the nearest and best example of a country very similar to the UK would be the Netherlands. Also see France and Germany, Switzerland. Other countries have state funded but co-pay Norway, Sweden, Denmark, but with very high taxes.

Other top ten health systems in the world are Japan, which is co-pay, Singapore, similar. Australia insurance and co-pay.

Most other health systems use private enterprise to supply healthcare. Much more than the UK does. The NHS is very singular in its set-up.

That's not true though. What most people are proposing are European systems. Do you think the disabled are neglected or not treated or unable to access treatment in Europe??? If course not. In fact they get better treatment than here

No one is proposing that @WingsofRain . Virtually all hybrid public/private systems have provision for those on low income to ensure everyone has access to healthcare. Even the US has this - several family members rely upon it due to disability - and it is far better than what we have in the nhs in terms of wait times and quality of care. It just happens to be less excellent than what other family members on private insurance get.

So if we have full privatisation what happens to NHS hospitals ? Are they bought by insurance companies ? Where do we get the nurses from to staff this new shiny system or the doctors or radiologists ? What happens to the small district hospitals in deprived areas that no one wants to buy ? Full of poor people with chronic health conditions that aren’t easy to insure, who can’t afford multiple visits to the GP and end up sicker than they should be…
What’s the cut off point for free care ? £20k £30k ? And is the free care basic in comparison to the super duper care provided by a better insurance package ? Ironically you could end up with nurses providing superior care to their own patients whilst themselves only being able to afford ‘basic’ care ? On the other hand a free market for health care theoretically should mean much much higher pay for HCPs (scarce commodity in demand) so in the end wage costs will cause higher premiums. It’s an absolute mine field especially in a country that cannot build a high speed railway or keep its domestic water supplies clean and healthy !

@Labraradabrador what wage would be the cut off ? I can’t afford £300 a month to fund this as well as NI for social care or whatever and I’m on a just below average wage.

@Tootiredforallthiscrap there are loads of different models to choose from, and it doesn’t need to be a fixed cut off between state and private provision. When I lived in Switzerland everyone is required by law to have basic health insurance and those under a certain wage receive it for free, and then there is a middle group that has a cap on % of income required. Those on middle to higher wage had choices in terms of level of coverage beyond basic.

When I lived in Switzerland

Sorry but I think this says a lot about where you are coming from, really. I think some people who argue for privatisation (even in part) of a free health service speak from a position of privilege and have little understanding or experience of living in precarious circumstances.

I would struggle to pay £300 a month for health insurance without making sacrifices elsewhere. If that became necessary I could see myself choosing not to pay that and take my chances, potentially facing a disaster if something unexpected happened down the line. I would prioritise saving for somewhere to live in retirement or paying for the kids' uni fees. So a system that looks at your income and decides what you can afford to pay for healthcare scares me. And I'm not any kind of high earner, but not the lowest either.

Why would you pay for your kid's uni fees before you looked after your health? Do you mean the parental contribution?

If it seems like I'm being pedantic, I just know that there are some posters who feel obliged to take on the actual tuition fees on behalf of their kids, and I do think that it in the realm of a luxury choice.

Because I hope that paying for healthcare through private health insurance will never become a reality here.

I would prefer to pay for them so they don't end up some £50k in debt, only to struggle at the mercy of the wild west rental market while struggling to find a job. That's why. I've been there.

Right, well that would be your choice. I think it crazy that you think we should be struggling along with this failing system so that you can insulate your child from paying their tuition fees.

@meimei80 absolutely.
@Labraradabrador this country is nowhere near as capable as Switzerland. Our public services are pitiful, the population poorer and sicker. The chances that the UK system will run as smoothly as a Swiss or even European version are tiny. The tories are in thrall to US health insurance companies, no way will we get a well thought out non profit making humane system. All this talk is a Tory wet dream.

people of all incomes live in Switzerland @meimei80

i actually grew up on welfare in the US, reliant on Medicare for healthcare for many years, and have a fair few family members still in that position. I am intimately familiar with what it means to live in precarious circumstances. I have also lived in 5 different countries, all with different systems, so have a pretty broad exposure to different ways of approaching healthcare. The UK system has been the worst experience for healthcare by a long shot.

i think it is critical that people pay out of pocket to some extent for healthcare, as otherwise no value is placed on it. It will be a difficult adjustment for many, but I think critical both for shifting mindsets as well as driving revenue into the service (which you agree is needed).

@Labraradabrador i think you know nothing much about this country tbh.
Heard of the struggling middle ? What with huge mortgages and child care costs, general living expenses, pitiful public transport that costs multiple times more than Europe you think people have much left to fork out for health insurance ? You’re thinking in the abstract sadly, this involves real people, not just figures.

@Tootiredforallthiscrap it doesn’t need to be as good as Switzerland to be a damn sight better than what we have right now. I would be very pleased with half as good as Switzerland.