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?

We’ve all got to be realistic about the cost of good quality medicine. If high earners are not paying high taxes they will be paying a lot for health insurance. Good care and the latest treatments cost a lot to develop and deliver.

There are loopholes for business owners, paid in dividends etc but not so much people who are PAYE.
That's one of the reasons the NHS has a shortage of Consultants, the way the tax works they were better off working 4 days rather than 5.
I don't know the ins and outs of it but that's ridiculous that anyone is better off working less hours.

Most of them will already be paying for health insurance or getting it as a BIK and paying tax on it

@Needanewname42 What if they have children and cannot work full time. Benefits are there because they wouldn’t have enough to live on. Or just maybe employers should pay folk more ?

Yep, that would work!

I hadn’t realised that timely access to care along with the ability to actually rest + recover whilst in hospital which a private room brings was being flashy? I wish I had the hypothetical cash that you talk about!

So you feel a private room is essential for rest and recovery rather than a non-essential perk (or ‘add-on’ as you put it in your original post)?

And you are proposing that it should be possible to receive faster treatment via the NHS if you are prepared (and able) to pay to jump to the front of the queue? Rather than maintaining the principle of access determined by clinical need?

@MelifluousMint @Tootiredforallthiscrap I do use private whenever possible - more and more people are doing so- and this is a process of privatisation driven by market demand, and will result (has resulted?) in exactly the tier system you seem so worried about. The wealthy have been circumventing the nhs for a while, but increasing numbers of middle class patients are fleeing as well. It isn’t really about whether healthcare in the uk will be privatised, but how that privatisation is managed.

personally I don’t think an entirely market driven process is going to be good for the country, and I would dearly like to see the NHS remake itself in a way that ensures it maintains relevance for all sectors of society and doesn’t become healthcare of last resort. It will need to let go of some of its ideals in order to do so, though.

One person in need of treatment is the same as the next person in need of treatment. People are offered treatment according to clinical criteria and that alone. It’s a central principle of the NHS and a good one.

The NHS is failing across the board in that principle otherwise there wouldn't be the Postcode Lottery for treatment for various illnesses/conditions.

This. I’ve lived in one of these countries and the system made a lot more sense. The contribution amount monthly to the healthcare was usually provided by employers and was on a scale. And visitors etc did have to pay a bill.

You’re replying to the wrong poster in terms of add ons, I never said any of that - I am simply just flabbergasted that you think the basic dignity that a private room provides is somehow flashy. Look at any newer NHS hospital and the vast majority of rooms are in fact private for a reason. It has been proven that better sleep leads to improved outcomes, really and truly it is essential for the wellbeing of patients. Nothing to do with being too posh to share a room with others! Your post screams of the typical British jealousy that nobody can have anything better than them

Again, you are replying to the wrong poster in terms of fast tracking on the NHS, which by the way is already happening via private healthcare. Many people are skipping the queue by paying to have a private scan/initial consultation and then jumping back in to the NHS for surgery. I don’t believe that a system of top ups on the NHS is either ethical or workable

We need to wake up and smell the coffee. We either ignore the fundamental problems of the NHS, just pretend all it needs is more money, and watch it collapse and end up with a US style system by default. OR, we accept and embrace the inevitable, and move to a European/Australian/Canadian model of insurance/co-payment. I know which I'd prefer. Unfortunately, the political dogma, jealousy etc that will prevent NHS reform will be what causes it to collapse!

Instead of people seeing "better" services for those who can pay and being jealous, they should look at it from the NHS point of view and think how much income they could earn from offering enhanced services for profit, with that profit going into NHS funds for investment/improvement etc., rather than the patients using their money to go private where the profits end up in (usually) foreign investors pockets!

Exactly! Very well said.

Anecdata, sigh, but LATE dmil visited us in France on holiday, in 2009. Drove down with her Db and SIL at about 78 years old, to Toulouse and next day took the train across to Montpellier to us. DH collected her by car and when she arrived she was tired, so had a sleep. When she woke, she felt unwell enough to say she thought she needed medical attention, specifically an ECG (DMIL was a nurse) so we put the wheels in order. AT which point, the French emergency services blue lighted her to the local critical care system, with DH desperately following by car. DMIL was admittted.

DH came back to our accomodation saying he thought they were keeping her for observation overnight and that we were to phone Nimes for an update in the morning after 0700. DH does not speak French well so I called for the update, and was told that Madame's surgery has gone well. What surgery I asked? She had several stents but would be well enough to visit that afternoon, after lunch. So we did. DMIL was in a pleasant light two-bed room with another elderly lady, with bathroom ensuite. It was light years away from any medical experience she endured in the NHS, and there were several afterwards.

When she was discharged after four days, it was with a prescription for drugs, which I filled at the local pharmacy and paid for privately. About £140 worth, and then I took her home to Kent to local SIL across France during a rail strike on a BH weekend. in a wheelchair (borrowed from SNCF). At which point the NHS took over. threw the named drugs into the bin and substituted the cheapest generic equivalents.

After this debacle, she developed vascular dementia but had very poor treatment from the NHS for another 10 years thereafter. She died of a fracture wound, six hours after discharge from an acute orthopaedic trauma unit (where she had spent seven weeks) but mainly because she was 93, and did not have a reason to live. But in between the NHS left her on a floor in a care home for 29 hours before the ambulance arrived.

For a very proud woman, a degree qualified nurse equivalent (SRN), I do think this was shabby. She had asked me, years ago to accompany her to Dignitas, if she were ever diagnosed, and I had said yes. She was a fully paid up subscriber to Dignitas, and left her body to medical research. Sadly, before she could say I would like to go to Zurich now, she had lost the agency to make the call.

@MelifluousMint , I can tell that you have never visited an acute geriatric orthopaedic trauma ward. Full of old (nobody under 80, except the staff), mostly somewhat demented people in pain, screaming all day and all night. All with hip and shoulder fractures from which they will NOT recover. After age 70, anyone who sustains a hip or shoulder fracture has less than 25% chance of surviving 12 months.

What???

So you think private rooms are essential and wards should be scrapped?

May I ask why you are attributing my question to jealousy? What is the basis for this? Are you suggesting I support the principles of the NHS because I’m poor?

I haven’t described private rooms as flashy – think you are replying to someone else

Likewise I wasn’t replying to the wrong poster about fast-tracking – I was responding to your reference to waiting times: “I hadn’t realised that timely access to care was flashy” (your response to the conversation upthread)

Could you spell out your point as it’s not clear

Most people work all their lives @Tootiredforallthiscrap and pay tax every month too. I agree that employers should pay much much more, but it's hard to work out how when employers won't hire people for more than the minimum 16 hours per week because 18 hours commits them to sick pay and pension rights. It is much cheaper for a supermarket to cap part time hours at 15 or 16 per week, and there are lots of people for whom those hours are convenient and the wages just enough to top up a partner's earnings. So the supermarkets expect the net tax payer to stump up the two hour shortfall plus all the social and long term costs. B*gger that for a game of soldiers.

@MelifluousMint no, I won't, read it again and pay more attention next time around. Did you struggle at school too?

What a shame you feel the need to be so rude

Do you speak to people like this face to face or just when you’re anonymous on an internet forum?

Terrible idea. Just like everything else that’s been privatised, it will be an absolute disaster and only the very wealthy won’t be affected.

The NHS has already been partly privatised by stealth. I’m currently paying an osteopath, a podiatrist and a dentist (for a procedure no longer available on the NHS) for treatment I would only get on the NHS if I waited for months, or until the situation was acute, or both. One problem we have now is that few people remember how brilliant the NHS was when it was properly funded. Loads of people on this thread are repeating the Tory mantras of ‘it needs reform’ and ‘it’s too expensive’ as if they were facts. They’re not. These are political slogans that people have been hearing for so long they no longer recognise them as lies. The problems the NHS has are chronic underfunding, the imposition of Tory privatisation on parts of a public health service that was not designed for it and a population that has grown up under Thatcherism and remembers nothing else.

There are a lot of people on this thread who are Tory shills.

This post is rather dramatic. I don't live in the UK, but our health system is somewhat similar to yours in that hospital treatment is free, and is struggling with the same issues.

Our local hospital has a rehabilitation ward where patients go to recover from bone fractures, strokes etc. so not everyone is old, but most are, and when my DM was there many of the others were recovering from broken hips, as was she. She was there for nine weeks and I visited daily and never once heard anyone "screaming in pain". My DM wasn't in pain at all.

As for saying they will NOT recover from hip and shoulder fractures, my DM did , as did her friend in her 90s who broke her hip a few years later. I know that many people do die in the 12 months following these fractures, but some don't and they do recover.

You are correct that the nhs is overcommitted, and cannot reliably
provide services that have been pulled into their remit by stealth, such as podiatry, dentistry and osteopathy.

I first came to this country under a Labour government, and the nhs was shit then relative to other countries as had lived in. I assumed Brits just had nothing to compare it to, but I had better medical care in third world countries. It really isn’t a Tory conspiracy- the nhs was a grand experiment but isn’t sustainable as originally envisioned. There is a reason why no other country has tried to copy the nhs.