To think the time has come to abolish the NHS healthcare model

[OptimismvsRealism]

Free at the point of use also means denial of care to a lot of people. What torture to know that new medications are arriving regularly (eg lecanemab) but it's only for the very wealthy.

The UK is different from how it was in 1948. We should be brave enough to move on from then.

@Whyhaveibeencutoutofmamsnot - well thank ye kindly for explaining some of the reasons behind the use of all this 'new fangled' technology n' all. So we swap mercury for lithium instead. Maybe being able to perform simple tasks using both the 'old fangled' ways and the outdated, cumbersome tech saves staff and patients waiting around for a 'unit' to become available.

That is just one of my grassroots suggestions. Next I might suggest that MRI scans are indeed a very costly provision and that patients really need a very good clinical case to have one.

There are many biologics available through the pathway. They've funded all of mine, for a start, along with many tests, scans, multiple physio referrals and podiatry.

@OptimismvsRealism
It's not possible to converse with you about a subject and ideas when deflection and avoiding the question(s) are deployed by you. Emotional dysregulation and you posting comments that break guidelines also negatively impact the quality of the conversation and tone of the thread. I do appreciate you are in a sticky situation managing health conditions without the support you wish for, which may be reason for some of your conduct and tone, but not an excuse for it. I'm not able to engage further with you on this subject for these reasons as I have limited energy and resources. I do sympathise with you and your predicament and wish you and your family all the best.

And there are others not available or only available after trying 2 or 3 or 4 other options based on cost.

Not sure what your point is. The ICB and NHS England are open about rationing and it is the responsible thing to do given funding constraints

Happy you got your treatment and many of my patients have too but others would have been treated differently if not for funding constraints. That is life

It’s not the model that isnt working. Blaming the model of the NHS is a bit like blaming the model of EV for not working after forgetting to plug it in. It’s the lack of funds and investment into the model that has crippled the NHS. In every study on the causes of the NHS’ problems, it has been highlighted as underfunding and waste on politically driven freebie frauds like £3bn in PPE never delivered on a contract given to an MP’s firm and then written off.

@venusandmars and I agree. Same for me, in fact after several years of successful management of my conditions at very little cost my GP has asked to see me in person.

You might want to check while most of them left. I’ll give you a clue - it begins with B.

And (following your EV model) perhaps we all need to take some individual responsibility for all turning up on Monday morning (or Friday evening at A&E) expecting everything to run smoothly and work perfectly, and then complain that there aren't enough instant chargers.

In 1948, at the founding of the NHS, Nye Bevan said: ‘We shall never have all we need. Expectations will always exceed capacity. The service must always be changing, growing and improving – it must always be inadequate.’

Historically, healthcare spend in the UK has grown at >3.5% per year, but between 2010 and 2019, it grew at a markedly slower rate of <2%

An interesting academic paper on underfunding in the NHS.
https://journals.sagepub.com/doi/full/10.1177/01410768231214340#:~:text=Imbalances%20between%20supply%20and%20demand,dated%20infrastructure%20and%20low%20investment.&text=Achieving%20the%20'right'%20level%20of,75%20years%20of%20the%20NHS.

Sorry but that's exactly how it works. You make an appointment with any specialist directly, you pay your part of the consultation price, etc.
You only see a GP for general health, or for referral, if you have really no idea what specialist you should see.

I’m in France.

Yes, if you have an operation you will generally be given a prescription that you’ll use to collect various medications etc from the pharmacy. Which you will either not pay for or you will be reimbursed for.

DH has a spine operation recently. He went private for this. The total cost to him was around €1000. He had to paya bit more upfront, but a lot was reimbursed. For this price he received:

Choosing the date / time of the operation, at his convenience, with the surgeon of his choice. No waiting at all.
His own en-suite room for the 4 nights he was in hospital, in one of the best private hospitals in our city, literally 5 minutes walk from our home.
Full surgery under general anaesthetic and all follow up nursing care.
Ambulance to bring him home.
All post-operative pain relief and wound care materials - delivered to our home by the pharmacy.
Once home, nurses visiting 3 x per day to give pain relief then change the dressing. This continued for 3 weeks, dropping to 3 then 1 visit per day.

this is stunning value for money. The joy of the French system is that the fully public system is there, free of charge, for those that need / want it. For this who can afford to pay a little, private care is totally affordable. Doh and I are not rich (teacher and admin assistance) but thanks to government reimbursement and our to up insurance (which our employer contributes to) we can access top level medical care at a fraction of the cost in either the UK or the US.

there’s a lot of paperwork but it’s worth it.

For a start because your private insurance / private hospital almost certainly wont cover any serious emergency, or have intensive care facilities.

In fact many won't even cover complications of their own procedures. Hip replacement you had done last week infected or dislocated? Off to A&E with you for the nhs to sort out...

Post op heart attack or stroke, better call an ambulance...

Then you will have to accept things are they are, sadly, and keep gently pushing with the powers that be.

As stated in the quote I shared - indeed. And there is ongoing expectation that more will leave with changes to non-dom and a generally more hostile environment. So best to look in each other's pockets!

@HollyKnight I should add that -as far as I know - the complementary healths insurances you pay for and access through your employer or voluntarily, have a completely different status to health insurance in this country. For example they can't refuse you, or charge you more on the basis of a health condition. They are more akin to the Welsh system of health insurance that pre-existed the NHS.

As for teeth - despite being a big cause of ill-health and also now affecting people's employability - the NHS system is well and truly broken.

As you can't even get a private dentist for many miles round these parts you can now start to tell who the poorer locals are compared to the better teeth of those moving here for a better quality of life (SW England).

And guess who is more likely to be employed for the rare decent jobs that come up?

this is correct. No pre-existing conditions and there are a multitude of different insurances available so they are pretty competitive. In France there are really good value / subsidised ones for specific ‘trades’ - probably a hangover from the strong union movements. So there’s specific ones for teachers / farmers / post office workers / civil servants / administrators etc.

The NHS is broken. I would much rather have a Euro style health insurance system with affordable fees and better access to care.

We also need to finally fund social care properly. Anyone who has been in hospital in the last five years will tell you that wards are often half full of medically fit dementia patients with nowhere to go. It is breaking the NHS.

Tell us you don't understand the theory behind the Laffer curve, without telling us......

Seriously.

What shape is the Curve for the UK economy? Where is the apex? Where are we sitting in comparison?

?

? ?

I’m glad you like the analogy.

And where do you think the money’s going to come from? European countries spend far more than we do on healthcare.

Is that true wait lists, or the 'massaged' wait lists. I started in nhs in 2002, and remember being taught how to adjust the wait lists to make wait times seen shorter. A quick call by a clinical staff member to check a detail on the referral 'stopped the clock' and the patient was moved off the recorded wait list to a 'sub wait list', it looked like their treatment had started when it had not.

@HollyKnight

In France you do just choose your specialist and make a rdv. They are basically all self-employed, they don’t generally work through a referral system. It’s often good to see the GP first as it increases the level of reimbursement that way.

So I had an odd thing on my leg that was like a very weird mole. I went to my GP, showed it to him, he agreed I needed to see a dermatologist. He wrote a letter explaining my situation, and hands it to me. I then got on my trusty Doctolib app, find a rdv with a dermatologist that suits me (place, time, date). I trot along to the rdv at the dermatologist a few days later, hand over my letter, explain my thing. She decides it’s not serious but should be removed and biopsied anyway, so she just does that there in her surgery.

The dermatologue consultation and minor surgery costs €75. I pay upfront. I give my health card to the secretary. With days I am reimbursed the govt amount (about €40) and my mutuelle reimburses the rest.

From users - through social insurance. In addition to current taxes. That is one option....

Most of the countries that spend more are wealthier than the UK (eg Germany and Netherlands. Even France GDP is slightly higher than ours).. We need economic growth and increased productivity to invest more in healthcare or we need to get used to the current level of service.

Also wise to focus on healthier behaviours - which is in our control (for many people) - to reduce likelihood of needing the NHS

From tax basically. We need total reform of the NHS with an absolute hard line on waste (yes rainbow lanyards and endless layers of management) and THEN a lot more cash pumped in.

A focus on primary and preventative care would help too, including massive taxes on junk food and obesity management. Type 2 diabetes is singlehandedly enough to bring down the NHS if it continues to rise.