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.

Yes that's a fair point

How is it done in many European countries, Australia etc? These are questions that have solutions that already exist. No PhD required there.

How do we figure out the threshold for free prescriptions?

Would we rather 7 million people on the waitlist receiving care after their condition has deteriorated?
Would we rather keep spending money on public health campaigns to attend A&E only when you need to?

Exactly. Interesting that the response was more “Let them eat cake”.

We are already eating the cake. Ask the people waiting 18 months for a hip replacement and unable to work.

And whether you pay directly or it is paid for via tax, you still pay. We all pay. So the £5 you can't afford directly, will be taken from your pay packet anyway and you still don't receive the care you need because both staff and patients alike need a culture change.

So the answer is more funding and a culture change. Not just more funding

As I've said a zillion times before, DH and I at 64 and 63 are still working full-time. We both earn more than £100k. We get free prescriptions. It's bizarre.

Actually a month or so ago I had a minor bacterial infection and needed some ointment. Boots couldn't sell it to me. I had to go to the doctor for it. It would have taken me about 45 minutes on the phone (our GP practice has stopped appointments via the app now) and much frustration for an appointment at an inconvenient time. Let's say 2.5 hours of my time. (hourly rate: £63 x 2.5 = £157.50). However I get on-line GP services through my insurance. I had an appointment with a nurse practitioner at 9.45pm - no time off work, and the prescription was with the pharmacy the following morning. The prescription cost £14.50 and was cheap at the price.

In the context of GDP calculations nobody ever includes the wasted patient/working time that arises from using the NHS.

The answer is definitely more funding and a root and branch review of how the NHS is organised. Not fiddling around the edges taking fivers off people who can’t afford it with admin costs that would exceed the money gained. The reform needs to widespread and radical. This idiotic idea is ideological nonsense.

I agree there needs to be a root and branch reform. More funding depends on the outcome of the reform. There needs to be a sensible discussion of what the NHS can and can’t do. Medicine and healthcare has moved on a lot since the NHS was founded - we simply can’t expect a free to use service to cover everything that is available now. We’d be funding nothing but the NHS.

It isn't nonsense @Blossomtoes. It works perfectly well across Continental Europe, Canada and the Antipodes. I'd suggest a minimum fee for those not on benefits of £25. It would make collecting it more worthwhile .

I collected my dd's contraceptive pills when I went to the pharmacy for my ointment, above. DD is 26, post grad professionally qualified, working full-time, and has private means. Why shouldn't she pay for the contraceptive pill when she choses to pay for tinted Contact lenses and highlights?

@RosesAndHellebores Wasn’t free contraception introduced to make sure women and girls could access contraception regardless of financial situation? I’d be reluctant to put barriers in the way of that particular free-at-the-point of use part of the NHS. Your daughter may well be able to pay her own way, but what if she was in a financially abusive relationship where her partner controlled all the money she earned?

Point taken @Putting but at least give women the agency to sign to say they can and will pay if they can.

I think the American system is appalling. The opioid crisis in the US was as a result of a pharmaceutical company being able to convince doctors that their drug was safe and non addictive with the FDA being partly responsible for the poor wording on the drug (yes I have simplified this). A ventolin inhaler costs over 99 US dollars and that’s with insurance. Americans as a whole are very unhealthy even with their ‘superior’ healthcare. I have heard the Australian system is better but I don’t want to spend more of my money on healthcare with current levels of taxation. I get free private healthcare with my company as a benefit. I would like to see more money spent on educating people on preventive diseases such as type 2 diabetes which costs the NHS millions each year. I have a family history of heart disease and type 2 diabetes and yes eventually I might succumb to them but I will be controlling my weight and diet and exercising so I can live as healthily as possible until that day comes. My mum put her type 2 diabetes into remission and she’s 75 and exercises and eats well. I am not victim blaming but look at Japan. They teach them at school about health and their weight is monitored by their employer. They are one of the healthiest nations.

If only we could get into a Time Machine to when labour was last in. Everything was better then, social care, NHS, getting appointments, dental care …

@taxguru "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."

Nobody here is denying that there have to be changes in the NHS, but the reality is that one reason why millions are being poured into the leaky bucket with no impact is that firstly the holes in the bucket have to be mended.

The NHS is trying to provide a service while being hampered by a lack of staff (over 100,000 vacancies), a lack of facilities, poor and outdated equipment and buildings, poor IT and communications systems. From my own experience as an NHS employee and as a patient, my view is that these account for a huge proportion of the 'holes'. Staff are forever trying, often unsuccessfully, to make do with what they've got, to the detriment of the patients and the well-being of the staff themselves. Nowhere else in the developed world has over 10% of the population waiting for a hospital appointment or treatment.

Entirely agree.

Continental European countries spend more on healthcare Roses. You’re comparing apples and oranges. I want all women to have easy and free access to contraception, it’s one of the big feminist achievements of the last 50 years.

Yes it was. 1997 to 2010 was a golden age for the NHS.

@RosesAndHellebores "Actually a month or so ago I had a minor bacterial infection and needed some ointment. Boots couldn't sell it to me. I had to go to the doctor for it. It would have taken me about 45 minutes on the phone (our GP practice has stopped appointments via the app now) and much frustration for an appointment at an inconvenient time. Let's say 2.5 hours of my time. (hourly rate: £63 x 2.5 = £157.50). However I get on-line GP services through my insurance. I had an appointment with a nurse practitioner at 9.45pm - no time off work, and the prescription was with the pharmacy the following morning. The prescription cost £14.50 and was cheap at the price.

In the context of GDP calculations nobody ever includes the wasted patient/working time that arises from using the NHS."

Still the question remains - how the hell did the UK population allow itself to get into this situation? Who voted for successive governments that have underfunded the NHS for decades? Who refuses to face the fact that cutting taxes means cutting public services?

@Putting "There needs to be a sensible discussion of what the NHS can and can’t do. Medicine and healthcare has moved on a lot since the NHS was founded - we simply can’t expect a free to use service to cover everything that is available now. We’d be funding nothing but the NHS."

And yet across most of Europe the situation is completely different. There are different forms of "Health Service" - some are funded and organised in a similar way to the UK, some use the "Krankenkasse" system of funding (which is a compulsory, ringfenced "National Insurance" scheme) but overall there has been a political will (and a demand from the population) that healthcare should be well-organised and prioritised, and woe betide any politician who dares to suggest otherwise. Any Health Minister like Hunt, who cut budgets in real terms, caused an exodus of medical staff and who failed to prepare for the pandemic, would have been booted out and never allowed near Parliament again. In the UK, he was promoted to Chancellor, where he continued to smirk while telling the people that there is no money in the pot to resolve the issues that he himself caused.

Meanwhile, sickness costs UK businesses over £100 billion a year - which suggests that far from not being able to afford to invest in improved healthcare, the country cannot afford not to invest.

For some, probably, for NHS workers, definitely. For patients who died or harmed by neglect, mistakes, "fiddling targets", definitely not.

People need to read Consultant Peter Duffy's book "Whistle in the wind" to see how both patients and staff were treated like crap due to poor management, negligence, incompetence and cover ups, finally resulting in the whistle blower himself being hounded out whilst some of the negligent doctors involved continue to practice. It tells you exactly everything that is wrong with the modern NHS. And no, none of that was due to lack of funding!

Oh 1997-2010 those halcyon days when Blair introduced a very expensive additional layer of bureaucracy called PCTs, escalated PFI funding for bright shiny buildings which is at thenroot of many Trust's financial difficulties, introduced 28 day prescribing and guaranteed all patients a next day appointment, only if they were available to attend on the day they made it, withdrawing the right for those with chronic conditions to book inadvance and around professional commitments that taxpayers have. Notwithstanding the destruction of the GP contract which removed out of hours family doctor services for the general public.

During those same halcyon days my dc were denied grommets and a GP failed to diagnose my father's Acute Myeloid Leukaemia.

Some facts.

https://www.kingsfund.org.uk/insight-and-analysis/reports/high-performing-nhs-review-progress-1997-2010

Waste of time argument as formally removing NHS is never going to happen. It is a political football.
Rather what is happening and will expand is privatisation by stealth with private contractors, some now engaging consultants to become partners, moving in on the several outpatient based specialties and taking on that work (routine ortho, ophthalmology, dermatology etc)

and the flammable cladding would be coming off of flats a lot quicker
Dagenham was yet another near miss. And people still lost all their belongings.

My OM has been waiting five years for a knee replacement He had yet another fall today............on his birthday.

@JenniferBooth I know from previous threads that you are terribly poor and all your family are massively unwell and disadvantaged, and live in appalling SH conditions in dodgy areas. But you are clearly bright and articulate. So why not invest some of your internet time and energy to improving your family's circumstances?

You @JenniferBooth have sometimes called me out quite rightly on points I had not properly considered or known about, for which I thank you. I hope my posts are more measured as a result.

But @JenniferBooth , you clearly live in London, which has more and better opportunities for high quality highly paid employment than any other region. Why are you not pursuing some of the vacancies? Instead of telling me about the need to be at home all the time to keep your social housing. I don't think that occupying social housing and working for a living are mutually exclusive yet.