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?

Surely an element of the abuse is coming from the appalling (lack of) service the NHS provides though. The incredible frustration caused by hours of waiting, trying to get through on the phone, waiting hours for call backs or in A and E, getting constantly fobbed off , while being in pain and frightened about your health, this doesn't exactly lead to calm and grateful patients. My recent NHS experiences have been absolutely terrible, people close to me have been left suffering for days and probably died sooner because of it. This will inevitably lead some people, especially those without good communication skills, to lose control at times.

Interesting survey;

https://ceoworld.biz/2024/04/02/countries-with-the-best-health-care-systems-2024/

Ireland is 6th, UK 27th.

The US military are not on the private American system. The DoD has its own seperate health system for members of their military and their dependents (partner/spouse and children)

I would rather pay double national insurance than privatise the NHS.

What we can't say because it's immortal is cost of care and quality of life needs thinking about. I lost a family member recently. Thousands went on his care keeping him alive to suffer longer as he was never going to get better. Then there is the knock on effect to the care system as he couldn't care for himself by the end. Other people wait months with degenerating health that had it been treated promptly would not leave them so disabled as they are for waiting months without help. But morrally you can't say one persons life is worth more than another, if we start doing that then the elderly and disabled with be left without

This is incredibly inaccurate. The Irish healthcare system is an absolute disgrace at the minute

In a state backed system exclusions for pre-existing conditions are not generally allowed, and the prices care providers can charge for each treatment are set by the government each year. So there is no €300 bill for dispensing a paracetamol or whatever ridiculous billing you hear about in the US.

Yes, TRICARE health for active duty members is FREE with zero out of pocket costs. They then pay a small sum for any dependents which is taken from their pay before taxes.

Not everyone will be accepted by private insurance companies as they could have a genetic disorder, autoimmune disease, had a life changing accident or other illness. Their illnesses are not due to lifestyle.

My neighbour jumps the NHS queue with private appointments then expects the rest of her care to be NHS. Surely, if you have private health care it should pay the lot?

Or when things go wrong in the private sector (as happened to said neighbour) she was rushed to NHS. No emergency cover in her private ward.

True the NHS needs reform.

What do you suggest should not be on the NHS?
Fertility treatment, gender reassignment, elective C sections, all dentistry, eye tests, mammograms, smear tests, maternity services, orthopaedics?

Maybe we should make sure that ex pats who work overseas and don't pay into the system can't access the NHS without paying.
An aunt who never worked lived in South Africa and later the Gulf States use to abuse the system. Came back for all her routine medical care as she kept an address in the UK.

Do all of you who advocate private health care pay for it or is it a work perk?
If it is a work perk are you happy to be taxed more on this freebie perk?

Social care needs sorting out to stop bed blocking.
Every attempt by governments to self fund that has had opposition from the public.

Mainly, due to the idea that people don't see why they should pay and want to leave an inheritance. Many MN assume they will have an inheritance.

Should we introduce ID cards so that if we are in an accident and unconscious that we get sent to the appropriate provider eg NHS or private or provider with travel insurance?

OP Many of my medical friends went overseas after Uni. Around 60 +% actually came back to the UK and still work in the NHS. My best friend managed 2 years in USA and came back. Recently, two young Doctors I know came back from Australia. We had done the same thing in the early 90s.
We were in education and medicine.
The Grass is not always greener.

"Also healthcare is different to most other services. If I have cancer I need treatment quickly. I don’t want to shop around for the treatment and I can’t wait or hold off buying treatment so I’m more beholden than with other services."

Which is exactly why the NHS is absolutely useless!! If you need to wait 3 weeks to see a GP who then fobs you off and you don't get seen again for 6 weeks, then have to wait 2 weeks for bloods / scans + another week for a review appointment, they say you need an MRI, the wait for that is another 2 weeks etc. You can see why the UK doesn't have the best cancer survival stats (by a long way)

We absolutely need a system like Germany/ France / Italy.

Excellent post.

Yes, it is a broken system feeding anger at staff who then leave. It's appalling. My friend waited 19hrs in A&E to be told it was all in her head then sent home, only to be told 3 days later she had a serious condition where she could have died. Common sense surely should have told the staff she would not have waited for nearly a whole day on a chair with one sandwich to eat if she wasn't actually feeling terribly unwell? She has zero trust in doctors now and has had no follow up care since finding out what was actually wrong with her, just put on medication.

One of the main issues is going to be affordability of insurance. Those
Most likely to afford it comfortably are likely to be the same people who need it least. Whereas those who are struggling financially are more likely to require it. This is why insurance linked to employment benefits can be such a problem.

so it’s an interesting one for me
my daughter is half American( dad ) and half British ( me )
we lived in the USA for the first 5 years and now the last 5 years in the uk
DD is complex health needs, very complex and if my decisions was just on health or I was in a position to take her back to the USA
I would choose to do so.
even her condition she was born with 50 percent chance of surving the first 3 months in the uk … 85 percent survival rate in the USA

the amount of therapy she got that we didn’t pay for ( OT / physio / salt etc )
Compared to here is mind blowing !

That is scandalous and I do think those doing it should be sanctioned unless they have a very good reason for not turning up. If they were paying privately or a Private Insurance Company was footing the bill you can be sure they would turn up. Unfortunately a lot of people in the UK have the attitude that the NHS is free so it doesn't matter whether they turn up or not, whether they take responsibility for their own health or not because the NHS will do it for them.

However, talking of no shows relative of mines husband was rushed into hospital his wife telephoned another NHS Hospital where he had an appointment scheduled in a few weeks later, thinking give them plenty of notice he won't be able to attend so they could fill the slot. Was told that she could not cancel the appointment it had to be him personally, explained he was in another hospital unable to do so but still NO. So he was listed as a no show, the appointment which could have been offered to someone else was wasted. This is the level of bureaucratic incompetence that is rife in the NHS.

Compare with similar circumstances of friends who live in Europe, same scenario, wife telephoned to cancel an appointment due to husband being in hospital - response Thank you so much for letting us know, would you like us to pencil in another appointment or would you rather wait and telephone us when your husband is discharged from hospital?

The objective of the NHS is to try to people's health better.

The objective of private healthcare is to make money.

People already don’t go to the dentist as they can’t afford it even on decent wages so that’s likely what will happen with wider healthcare. People won’t go and they’ll die of preventable and treatable diseases more frequently.

Sorry for your loss, @PurpleBugz. You raise a fair point about keeping people alive just to suffer. I've never really understood the huge opposition to the right to die vote. I fully appreciate that checks and balances and safeguards have to be in place, but beyond that, I think we should allow people in terrible pain to die in dignity.

I don't disagree. But the facts are that the NHS is not achieving it's objective, so something needs to change.

Yes, but how many people is the NHS failing right now. How many are getting worse while they wait to be seen? How many people are out of work while they wait to be seen?

European systems are much better, you pay a basic level of insurance, you co-pay depending on salary, and everyone gets a basic level of treatment, free at the point of service, provided by private companies (shock horror). You can choose to top up for a higher level of care. Your company can also offer top ups. You can choose where to go for your treatment. Costs are capped. Pre-existing conditions are covered. Healthcare salaries are ballpark UK, but assume working conditions are better. What's not to like?

Privatising definitely wouldn’t help!
Its been desperately underfunded for over a decade because the government kept giving tax cuts to the very rich. We also need to have police and social workers in hospitals so that lovely people like yourselves don’t have to put up with awful behaviour. Finally, we need early intervention. People don’t get extremely overnight - funding support to stay healthy would pay itself back many times over.

You think we still have an NHS? Not one that works we don't.
I haven't seen my GP since before the pandemic. People I know are going private for their operations because they can't near the wait.

First off you need to explain EXACTLY what you mean by "privatising the NHS".

Until that point is settled, any opinions are meaningless.

This!!!!!

Sign me up.