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?

Did you live here in the 90s and 2000s ? It actually functioned then.

Most European healthcare is financed publicly by a mix of taxation and compulsory social insurance (like National Insurance). With some private insurance, just like ours.

If you are even considering paying for your children’s university fees then you are in an extremely comfortable financial position to be able to fork out £9k per year for each of your kids. You are more than capable of paying for your own healthcare and it is something that people with the means to do need to start considering in order to lessen the NHS burden.

By the way - living abroad in the past doesn’t equal automatic, lifelong privilege. Been there, done that and I could only wish to be in your privileged position of being able to pay my DD’s uni fees.

@Tootiredforallthiscrap i came here in the 2000s when Labour was still in power and it was dreadful. Truly traumatic, ptsd inducing experience when I was admitted to hospital for the first time. I think most Brits just didn’t realise how bad it was then because they had nothing to compare it to.

I would of course rather not have to make those kind of choices at all. Healthcare, education and housing shouldn't be luxuries but affordable and available for all, not only for the privileged. I would rather uni education was free like it was until 1997, and I'd gladly pay more taxes, and have a progressive tax system like in many European countries where the higher earners pay a lot more, and public services are properly funded.

Can you who argue for yet another essential service being privatised and become unaffordable for many not see how this would cause for the already massive economic inequality in this country to widen even more, with all sorts of disastrous consequences.

And people pay through taxation and national insurance, and I believe most people here very much value the NHS. I find the notion disturbing that only things you pay for have value!!

Profiteering from healthcare is a corrupt idea through and through.

I feel I am, at the moment. But that will change in retirement and I worry for my kids, hence any disposable income I have now has to be carefully saved to have a roof over our heads when we're old and hopefully help the kids who I know will face a very challenging and unequal society. I'd much rather pay more taxes, have less disposable income and have free healthcare, free higher education, affordable housing and so on. You know, like in most European countries!

of course things you don’t pay for have value, but that value isn’t similarly perceived. How many times do you see people posting about going to the go ‘just in case’ - I think it is bonkers the kind of things people call the gp about. Because you pay what you pay regardless of whether you use it or not there is no counter pressure to make you stop and think about whether it is a good use of resources. Some people are sensible about it, but as any gp receptionist and they will tell you that many are not.

as for profit from healthcare- why do you think we have seen so many innovative new oncology treatments in the past decade? You may find it distasteful, but the potential for profit drives a lot of excellent life extending/saving science.

Interesting topic OP, completely agree that we cannot carry on as we are. Throwing more money at the NHS is not the answer as many have already said, it needs a radical overhaul and restructuring.

I’m not in favour of a US type system, but having experienced the French system I think there must be a middle ground between these somewhere. One idea I wish they would implement is fines for missed GP appointments. My DH tried 3 days in a row to get one to be told there was nothing and ended up going private, and in the surgery they have god knows how many signs going on about 100s missed appointments per month.

I am incredibly lucky that my American employer pays in part for me and my family to have Bupa insurance, and after a lot of NHS cock-ups in recent treatments I don’t know what we would have done without it.

"MrsDanversGlidesAgain · Today 13:55

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?"

Yes. I'd say even if the parents can afford to pay, the kids treatment should always be free. They have no access to their own money and I'm sure there are plenty of parents out there who would rather not spend the money, and so don't bother getting their child seen. I am aware plenty of adults will likely do the same for themselves but at least that is their own decision to make.

The NHS is already becoming privatised but via the back door. Lots of procedures are carried out by private companies that then bill the NHS thousands. The companies hire consultants that work in the NHS or previously worked in the NHS but have left.

If GP appointments/a&e visits were charged people would think really hard before booking to be seen.

And this comparing notes on who is the most privileged is beside the point. Liveability and affordable essential services should be accessible to all, not only those who are lucky enough.

I am lucky at the moment in having 'disposable' income, but I don't know about extremely comfortable. If we want to interrogate each other's circumstances, do you own your home? If so, I consider you to be comfortable. I don't own a thing at the moment, and am not a high earner, but have low living costs for a period of time, so am able to save. But it shouldn't come down to that.

I’m a member of a Facebook group for people with colostomies. A lot of people on it are American and they often post desperate for supplies. They are having to buy bags from Amazon from their own money because their insurance companies say they are only allowed a certain number a month, or asking where there are charities that might have bags and cleansing equipment to give.

This is the system we would be heading for because our government is so wrapped up with the people who own the insurance companies. Insurance doesn’t cover preexisting conditions and the costs are huge. I’ve spoken to people from the US who can’t afford insulin, who can’t get epipens, who can’t afford a trip to A&E - whatever might happen in Europe that is not what we will end up with.

You only have to look at some of the other threads on here recently to know that a lot of people begrudge disabled people even the minimum to live on, let alone expensive mobility aids and medical appliances - without “free at the point of delivery” we would be in a terrible situation.

Which is why we need to accept and embrace the inevitable and move to a European/Canadian/Australian system of insurance and part pay.

@WingsofRain do you honestly not think a US style system is EXACTLY what we'll end up with if we just leave the NHS and pretend that everything is OK? Rather than actually have a sensible debate as a nation? The NHS is already fucked. People, a lot of people, are dying because they can't get care at all, or the waits are too long, or they get fobbed off.
There's no use in having "free at the point of delivery" if people can't get access to that point of delivery. We are already in a terrible situation.

They wouldn't "think hard" if they were within the many groups who'd be exempt from charges. It'd just end up yet another "tax on workers" as the OAPs, children, unemployed, etc would almost certainly be exempt.

👆

In the Blair so-called golden years, the NHS nearly killed me and my baby with a delayed c-section, and killed my father and mother in law both with botched cancer treatments that were so delayed they never stood a chance. Add in a few A&E visits where they ignored you for 3 hours and then a mad rush to push you out of the door before you'd been there the 4 hour limit whether treated or not. It certainly wasn't all a bed of roses. You could easily tell what treatments/services had waiting list thresholds - they either bent over backwards to meet them (often artificially) or just ignored you completely if they missed them.

You mean US I think?

No, I didn’t miss it. The fact that maternity care is terrible in the U.K. has no bearing on the fact that some people lose their homes and go bankrupt to fund chemotherapy and are unable to afford insulin in the USA.

We should move to an Australian style system.
Ive worked in a few countries as an anaesthetist and it seems the fairest system that is most likely to succeed in the UK.
We should be encouraging far more private healthcare in the UK with tax incentives for policy holders, but also reforming the PBR/tariff system so NHS hospital are far better compensating for taking on the complex/co-morbid cases.

Operative word being 'some', from a population of over 350 million.

Since the ACA, access to insurance and therefore to healthcare has exponentially improved.

No, I do not own my own home but I do find the £200 a month to pay for private healthcare for myself + DD as due to personal and wider experience I don’t feel that the NHS can be solely relied on anymore. Categorically you are far more comfortable than me yet you are still entitled enough to feel that you shouldn’t be at least partly responsible for your own healthcare when the system is already on its knees with people in less fortunate circumstances who can’t afford to pay elsewhere. Happy now?

I’ve been in hospital both in Germany and in the UK. No complaints with either.

In 40 years I’ve generally received great treatment from the NHS.

One issue I did have in Germany was the insurance office having to deal with an incompetent HR office (outsourced to my employer), which ultimately saw me stranded, having navigated public transport with a broken leg, and forced to completely reschedule an operation as a result. So, rather than just going to the hospital, I had to travel in person to the insurance office, several times, before being admitted. So while the hospital was fine, it’s not necessarily all streamlined and plain sailing with that system.

Really sorry to hear you had a traumatic experience.

Wow! I think I do pay through taxation and national insurance, but it's not just about me and what I can afford. And life shouldn't being just about being OK right now, but potentially only a couple of pay checks away from the street, as the saying goes. This is what I'm trying to avoid for myself and my kids by saving for the inevitable down the line. As I said my line is high taxation, free public services and affordable, secure housing, which would benefit all.

Is there anything in the UK that has been privatised and actually improved?