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.

The GDP per capita of France is very similar to that of the UK (according to the World Bank it is actually lower than the UK) but France invests 25% more per capita in healthcare than the UK does.

So, let's presume that more money for the NHS would help.
Where does this money come from?

Governments have three options:

(1) Higher taxes
(2) Spending cuts elsewhere
(3) Higher government borrowing

Which would you choose, and why?

@ExpressCheckout if I pay more tax for the NHS then I expect to see a direct correlation with improved standards. We have a second home in France. Frankly the difference in attitude of medical staff in France is extraordinary notwithstanding better clinical standards.

NHS staff do not do the public a favour, they provide services which are free only at the point of delivery. The attitudes would not be tolerated elsewhere.

In many respects, the Britiah oylubkic have the service they deserve due to decades of misplaced gratitude on the basis of receiving free treatment.

NHS expenditure increased significantly over the last 14 years.

Thanks @RosesAndHellebores (great name) I agree with every point you are making here.

I have worked for the NHS all my life, and now at an age when I need to use it far more than I'd like to. The attitudes of some (obviously not all) NHS staff are terrible, as if - as you imply - they are doing me a favour.

Thing is, people don't want to pay more tax, and I do understand many people can't. However, the majority can - but they might need to sacrifice their Netflix, Amazon Prime, foreign holiday, pricey phones and one or two luxuries.

More money is needed. That should be via taxes and personal contributions. Taxes distances the user - and it is seen as free and abused - both by users and staff.

I maintain that there has to be a system where people can pay a small amount- £5, £10 towards their appointments. Apart from raising revenue, it changes the relationship/contract.

@ExpressCheckout to be fair, we pay significant amounts of tax and will Co tinge to do so into retirement My AXA premium is about £3,200 and it affords me better value and better peace of mind.

And removes the basic tenet on which the NHS is founded. It will simplify prevent those who need healthcare most from accessing it. £5 or £10 isn’t a small amount to many people.

Yep @newmummycwharf1 I agree with you too.

Paying even a small amount for an appointment would make people think twice before cancelling. Problem is that GP practices won't want or be able to police it and so it would need to be done via the NHS app or similar.

Obviously adults in receipt of certain benefits would be exempt, e.g. PIP, etc.

I too think we have reached a pass where money has to change hands, where it can, to redress the power balance.

If people pay for a GP appointment they will expect to be seen on time Ditto if its a telephone appointment. They will expect an actual time not AM or PM. Which is already ridiculous anyway

But people are already being prevented from accessing it as there aren’t the services available.

There could be some exemptions for people who genuinely can’t afford it. But someone was saying upthread people could afford to pay more tax if they gave up Amazon Prime, Netflix etc - people would have to do the same for healthcare.

I get private healthcare paid for by my work, as to many many private sector workers. Make all employers pay the UK government and in return those employees will have guaranteed, immediate healthcare. Is that not what they do overseas? Australia for instance? If you have no private healthcare there is a more basic state paid for system. The same thing happens in many European countries.

That is what needs to change - the idea that we are comfortable with being a rich country yet supposedly many people cannot pay £5 for an appointment to maintain their health.

Economic growth but also prioritisation. I would rather use my £5 to do something else as would many of us - but there are similar countries to the UK, where this is standard practice and they have better health outcomes.

Without changing the culture - more money into the NHS will not change outcomes. For many reasons that go beyond just funding.

I mean, are we saying people in France, Netherlands, Germany- countries that are richer or just as rich - are somehow more able to pay small amounts towards their healthcare and we can't? British exceptionality

They invest more - we need to invest more. They also co-pay, let's try that too

@newmummycwharf1 Without changing the culture - more money into the NHS will not change outcomes. For many reasons that go beyond just funding.

Yes, the culture needs to change. I think this is starting to happen, e.g. recent discussion/criticism of the NHS being seen as a national religion.

@Sunsgoingtokeepshining Make all employers pay the UK government and in return those employees will have guaranteed, immediate healthcare.

Yes, this would be logical. But again it needs a big cultural shift. But I do think it would drive better use of the system and create a bit more accountability.

Again, you keep coming with the 'whys, wherefores and what ifs'. I am talking based on my own personal experience, which you know absolutely NOTHING about beyond what I've said here.

But taking the staff as an example: For my first visit to A&E, it was actually unusually quiet. I still couldn't have encountered a more unhelpful triage nurse. Absolutely nothing to do with funding, cuts or inadequate services and everything to do with the fact that she was grumpy, uncaring and unprofessional!

I will always pay for private healthcare, whether it's through work, or I take out a personal plan. I wouldn't be without it. As I've said repeatedly, my issue isn't with paying for PHC - it's with having to pay TWICE for healthcare with one of those payments being for a service I can't use.

"In many respects, the Britiah public have the service they deserve due to decades of misplaced gratitude on the basis of receiving free treatment."

The British public have the service they deserve because they believed the lie that it is possible to have high quality public services but only pay low taxes. They also allowed policies regarding public services in general to be largely decided by people who do not use these services - if politicians were forced to use public transport, the NHS, send their kids to the same schools as everyone else and live in Housing Association houses then there would be instant improvements in all of these.

"NHS expenditure increased significantly over the last 14 years."

Not in real terms. Not in relation to expenditure in other countries which spend more per capita. "Spending more" might still be "still not enough" - as evidenced by the ever-increasing treatment waiting lists, waiting times for ambulances, inability to see a GP, impossibility of finding an NHS dentist, hundreds of thousands of unfilled vacancies in the NHS...

We pay enough tax. Our money just needs to be spent more wisely. That's the issue.

A charge at that level is definitely modest. If you can find money for a pint or a pack of cigarettes, and looking around our local area, most of them can and do, then expecting a contribution to the healthcare/treatment they are seeking hardly seems a huge ask. Plus as was pointed out above: once you pay for something, you expect to get it.

And so we SHOULD patient blame!!!!!

The amount of time i have looked at the ED screens at work and people are coming in for stupid reasons is beyond me!

Chapped lips (yes - I'm being serious, they didn't want to buy Vaseline so hoped we had some for free)
Prescriptions (A&E is closer than their local pharmacy apparently)
Dry Itchy Scalp (Advised head & shoulders because what even the fuck?)

@ExpressCheckout

Obviously adults in receipt of certain benefits would be exempt, e.g. PIP, etc.

That's where the idea fails. The people who are exempt won't bother about missed appointments etc., because it won't affect them. I'd hazard a guess (because stats aren't available) that most of the FTA appointments are from people who'd be exempt, i.e. disabled, OAPs, etc., so it would end up just yet another tax on workers!

If we just keep chucking more money at the NHS it will end up costing more and more. I'm all for increasing funding, but I was to see massive reform. We can't keep chucking billions into the leaking bucket.

What about people who can’t find that money? I remember when I couldn’t have found it, I was looking down the back of the sofa to buy bread and milk. I’m so grateful I had that experience because it saves me from the “Let them eat cake” attitude so many people have.

Then they are exempt. Even in the horrible YS system - the really poor get access to free healthcare.
And we should not tolerate a country where significant percentages are desperately poor for prolonged periods of time.
We have FSM, out of work benefits etx, payment for NHS prescriptions with exemptions - means testing is already part of how the country is run

Then you're going to have someone £1 over the threshold who can't afford to pay.

And whose going to go after these payments and how much money will this waste?