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?

I want health services that are available promptly: 48 hours max for a GP appointment, two week pathways adhered to, reasonable waits for non emergency surgery, say six months tops. Optimal pain relief for all. Excellent communication and to be treated with dignity at all times. Privacy to recover rather than being parked next to someone who is disruptive and anti-social. I expect hospital facilities to be spotless and food to be acceptable. I expect all staff to be kind and polite, particularly on maternity/post natal wards. I expect staff to listen to concerns. I expect appropriate tests to be available. I don't want a different answer from every member of staff I see or to hear shit chatted.

If I have an outpatient appointment I expect to be seen within 30 minutes of my appointment and for there to be an apology when it is late. I want services to generally be joined up and not to have to chase and chase for hours on end and accessing healthcare to take hours and hours of persistence.

In relation to nursing staff I want there to be enough of them but also some clarity about who is who - it's hard to know who a healthcare assistant is and who a nurse is. There needs to be uniformity of uniforms. I also want nurses to be able to nurse and extend concern in relation patient comfort and well being.

Doctors and nurses should stop the hierarchy and treat each other as equals and both need to stop complaining about their job, their pay, how busy they are, the government when doing it.

The Service needs to go back into the NHS and I'm not sure it can with the current infrastructure and embedded paternalistic clap trap.

Every patient needs to be afforded as much respect as every member of hospital staff.

If the NHS can provide all of the above, let's see it do it. My fear is that given more money the NHS will roll out more services quantity wise but there will be no improvement regarding quality.

To previous posters who say we need more qualified nurses I agree. The student nurses who are due to qualify in September in my area have applied for jobs in the nhs trust and have been divided into 3 groups. The 1st will have a job but have no idea in which area. The 2nd passed the interview but have been told there are no vacancies for them. The 3rd group were rejected. These are all individuals who have 3 years of training and student debt and most expected to reach the standard to register and practice

I think we need a system like other counties where we have medical insurance and this should have been done years ago

I haven't used anything nhs in years I'm not rich or wealthy I have had to save for things i needed like private dentist COST me thousands took me over a year to get that money to get treatment i don't use my gp I couldn't get a appointment if I wanted one so I will self treat at home I won't go to the hospital either unless theirs absolutely zero alternative I fell down the stairs 3 months ago badly injured my foot still didn't go to hospital the NHS is not going to last much longer

Terribly sorry, but you are cherry picking the worst version of US healthcare and conflating it with a "Tory" vision. The US health care system really is not always like that -- despite what you have been told or have read in the Daily Fail.

If you are interested, rather than just trying to score cheap political points, Google Kaiser Healthcare or US HMO systems. These provide fairly full service, routine family healthcare, to a better standard than the NHS, in my experience, for the same employer cost as the gold standard, but without the high co-pay. So no, you don't get treated at Mount Sinai, but you don't go without care either. Medicare/Medicaid covers routine care for the unemployed and seniors. The shortcomings arise in the middle ground between essential and advanced healthcare.

A PP referenced Israel's health services. Where there are four national HMO systems and they compete for patients, but all the routine care is included. Some have developed expertise in particular specialist fields, perhaps fertility or senior health, but they all treat routine stuff like heart attacks, coughs and colds and diabetes or COPD, and have efficient hospital acute treatment paths. But you will need to organise transport or pay for the ambulance, and pay for medication if you are in the US (don't know how it works in Israel). The medical organisation will do the immediate intervention, but the survivor phase is often over to you.

IMO this is why the NHS appears to fail. It doesn't fail, because mostly the immediate problem is treated, but the ongoing costs of treating chronic conditions are not shared between the PATIENT and the service. The patient has to shoulder some of the responsibility. Unless you are under 16 or over 70 AND demented, then the individual has a responsibility to get fitter, eat less junk, take more exercise. I went for a booster Covid shot on Saturday morning with a waiting room full of "at risk" people, and 95% were either very very old (escorted by their children) or very very obese. I just have breast cancer.

There are 80,000 suppliers to the NHS. "These" companies are all subject to tendering, and can be paper cup suppliers, of whom there are thousands, to drug companies each from whom you buy a specific drug, to MRI manufacturers of whom there are only a handful. When you talk about contracts what are you thinking of?

Bear in mind the biggest costs to the NHS are staff, drugs, which accounts for 95% of spending. The rest, in the general scheme of things, is peanuts.

Can you point to any examples of sectors previously run by government, but now privatised, which offer better pay/working conditions than they did previously?

I think you're overlooking the consumable one time use items -- like rubber/latex gloves, which are changed everytime between patients, and even the same patient. A fresh pair is used every time.

As a tiny company that does a bit of work in the NHS, usually to supply hot water, can you tell me why the National Health Service can't run a national register of pre-qualified companies recognised as capable/competent? Every single Trust has its own qualification. We work from West Cornwall to St Thomas's. Why is it necessary for us to submit a 5-inch stack of paper for every individual project? The cost of the admin has to be paid for somewhere. To answer the question, the client always pays.

I think what concerns me is the costs. Something like 60% or more of bankruptcies in US are due to medical costs even if you have insurance. You can get amazing care, while you have money, but it seems a bit of a nightmare if you don't.

Social care. Social housing. Energy and water. Actually also the NHS.

I'd vote for a partial insurance based system.

At the moment we have the worst of both worlds. The bits that are privatised work very well but the cost comes out of the NHS budget and the areas that are sub contracted are cherry picked. So things like cataracts or hearing aids are very efficiently done by private companies but never messy stuff like diabetes .
I would be very happy to pay a supplement and as always those who are on benefits wouldn't pay.

Well if it gets privatised and my mum would have to pay, she wouldn’t be able to afford it and she would be dead without her treatments and care. Similar with me, i have a severe complex chronic illness, which leaves me in unbearable pain all hours of the day, without my treatment and surgeries and medication - I don’t know how I would cope. I cannot work due to the pain so I’d be in a situation where what would I be able to do to afford it?? All the people who are in favour of it being privatised are those who obviously would be able to afford it… what about a majority of the people who can’t? I think it’s vile that people with the finances would be able to get treatment for their health whilst us ‘poor’ folk would either get in severe debt or not be able to access the treatment at all.

Life already revolves around money, don’t make something as vulnerable as peoples health a money issue also.

This is a really good point! Hadn't thought of it this way before.

They should start with privatisation of gender services / cosmetic procedures

Why could we not pay more directly, instead of feeding insurance companies their cut?

Im from the UK but have lived in Switzerland for the last 5 years. Here its mandatory for anyone residing in Switzerland to have private health insurance, there is no free healthcare. But it is so worth it. And one of the reasons i don't want to come back to the UK. We are a family of 3 (2 adults and 1 child) and it costs us around 1000CHF per month. But the healthcare is the best ive ever experienced. My child has a pediatrician who has followed him since birth. I can get same day appointments, i have her direct email address if i have any questions. For any referrals the longest wait i've had is 3 months but typically its around 4 weeks. Ive had health problems diagnosed here that were missed in the UK. The longest wait i've had in A&E is 1h 30 minutes. When i was pregnant here i had a few problems in my pregnancy so i had consultant led care - i had my consultants mobile number so i could ring her to discuss any concerns. My gynaecologist rang me one evening at 5.30pm, said she was worried about one of my test results and wanted me to go and see her for an appointment that evening, because she couldnt go home unless she knew i was ok. C section stay is mandatory 5 days in hospital, shared a room with one other woman then moved to a private room, exceptional care and support. When you go for scan in the hospital, they give you a website reference so you can access your scan there and then and take forward to any referrals.
Wages are higher here too, i wonder if that makes a difference, all of the medical professionals i encountered were conscientious, polite, hard working, diligent and professional.
It is such a contrast to the NHS and what i experienced whilst living in the UK, i quite frankly would never consider having a baby in an NHS hospital (partly because i have complicated health problem related to preganancy and zero confidence in the NHS). My mum worked as a nurse for 45 years in the NHS and by the end she said it was terrifying. She had cancer a few years ago at the age of 70 and thankfully her experience as a nurse meant she was able to do alot for herself during her hospital stay (emptying her catheter stand because the nurses cant be bothered, questioning medication because she was missing some or given the wrong dose, advocating for those in the wsrd around her who were receiving appalling care). At one point post cancer surgery she ended up in A&E in agonising pain, and left in a chair in a holding room waiting for a bed for 24 hours, no hot food, no care. It is an utter disgrace what is happening.

I can very safely say from working in a busy private hospital that morale amongst our staff is miles above what it is in the NHS at the minute. As a previous NHS worker there is no way that I could go back to those dire conditions. The grass is in fact greener whether you’d like to believe that or not.

Immigrants don’t pay taxes? That’s quite some claim.

I work in a field in health care. It is appearing health care is becoming more and more for those that can afford, those that can't very much a tough shit approach. I hate it. I think privatising will end up pushing us further and further along that path of people not being able to afford to remain healthy (and before anyone says well if they eat healthy etc they wouldn't get ill - healthy food is so much more expensive than a bag of nuggets etc.)

I agree however those alone I don't think would make much of a difference, some genuine medical services would need to be included, perhaps physiotherapy, x-ray services, that kind of thing

SnakesAndArrows
I talk of illegal immigrants, not legal ones

Unable to write more currently.

https://x.com/weownit/status/1788928382371004867?s=61&t=JdkndO417wUfB5xJiVIJww

Massive death toll, massive debts, utter misery.
This is supposed to be a nice place to live, but not if you die of preventable diseases and injuries.

That screen shot is not informative, or useful, I'm sad to say. @AncientSkaterGirl , perhaps if they spent less on nuggets, or any other takeaway foods, they would need less health interventions....... perhaps

You want someone with a broken arm to fork out £200 for an (essential) X-ray? 🧐

Because it costs twice as much as the UK system, and it’s inequitable.