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.

Do you realise that most EU countries have insurance based models and no one is going bankrupt over there?
I hate how everyone jumps to the US system when someone dares to suggest the NHS should be changed.
For example, in my husband's country, everyone pays insurance out of their salaries, it's compulsory. If you're unemployed, caretaker etc, the government pays it for you.
If you need something extra (ie a private room for postnatal care), you have an option of paying a reasonable amount of money, nothing close to what you'd pay for private maternity in the UK. If you can't/don't want to pay, you still get all the care "for free".

Im a full time carer for my husband who is 74 I live in Braintree Essex not London.

Where the fuck are you getting this from. DH and i live in a social housing flat.
DM has osteoporisis and has lost her hearing. DF has prostate cancer and they own their own home.
DB and his partner also own their own home. Ex council but they bought it together.

Except nobody can afford to self pay for all of the treatment they might need. Something simple like a broken ankle that needs surgery could end up costing £150k if it gets an infection, and needs further surgery.....

So the only option is either a privately, ir publically funded insurance model, with or without copayments.

£185bn is spent on the NHS and £40bn (17% of the total) on private helathcare which makes up around 12% of the healthcare delivered in the uk. Its therefore already less efficient bwfore even taking into account very little of the very expensive unplaned work such as acute or trauma care, intensive care is undertaken in the private sector.

If the £40bn people spent on private healthcare was spent in the nhs overall, more people would benefit.

DM and DF are 88

This.

OP you need to have a look at the private cost of items.

Despite the assumptions being made about me because i live in social housing I wouldnt actually mind paying something towards seeing a doctor

But i will let DF know that me being articulate will massively help his cancer Im sure it will cheer him up no end!

I work in a health system with both public and private arms.

You are insane if you belive a private system will provide better care to more people.

Quite right. As if , given the parlous state of the nhs, milking profits from it will improve the situation!

But obviously the sharks are always circling.

To all those saying NHS needs more funding like that will just fix it. It won’t. There’s absolutely no point in chucking more billions at it. It needs a total overhaul first. Streamlining, middle managers, money wasting & all the rest of the money & time wastage. It just doesn’t work in its current form & that’s not going to be fixed by more money wasting.

No one said self-pay. Co-pay is different to self pay. Co-pay is what happens in other parts of Europe, Australia etc. Even Ireland
It does not preclude investment from the government into healthcare - which is what we see in Germany and France - who invest more in their healthcare than we do and still co-pay!

But in some respects that’s quite damning, if you take your Labour tinted spectacles off. It says despite all that funding the NHS became less productive, that despite having 13 years it failed to do much about the needs of an aging population and, worst of all, public health, especially obesity which is a leading indicator of other illnesses got worse every year from 1997. It’s almost as if they just focussed on the short term, with no thought to the long term term at all. Further evidenced by the corrosive effect of manipulating the spending figures through PFI…

My late husband was a very heavy user of the NHS in that period as a result of chronic long term illness. The KPI focus introduced by inexperienced politicians, and implemented by third rate leaders and managers led to a massive and consistent deterioration in joined up care for him, across several NHS trusts.

The French system is mainly delivered by the private sector and funded by a state insurance scheme. It’s streets ahead of the shabby, shambolic NHS. It’s also recognised as one of the best healthcare systems in the world. It also happens to be a broadly left of centre country, not averse to nationalising things. And yet, it never has for its heath system. Why not learn from one of the best systems? Surely no one would let ideology lead to worse outcome for patients just because ‘NHS’?

ues its time we let the NHS go many will say well if we have part insurance they it can be saved, but then it’s no longer the NHS

we do not want a repeat of huge high interest loans to prop the NHS up, we do not want more years of it slowly being sold to private companies and we need cross party involvement working together towards a better healthcare system becuase what we have now it’s pretty shameful

France and Germany can manage this as do numerous other countries it can be done but it’s a long process we deserve a better healthcare system

Labour have promised NHS reforms I have no doubt we are moving towards insurance based system they need to be brave enough to say this but people are so attached to the NHS it was at one time a fantastic institution those years have long passed and we have to deal with what we have now rather than and that is a broken system

The French government spends more per capita than we do. And has done for a long time.

"To match French health expenditure (in PPP-adjusted terms), the UK would have to spend roughly 21% more per person according to the latest OECD data, or £58 billion."

They also have more doctors, more beds, more scanners & better infrastructure.

www.nuffieldtrust.org.uk/news-item/is-french-style-health-care-the-answer-why-we-should-stop-idealising-other-health-systems

You didn’t read the report, did you? You just read the covering page. it doesn’t say the NHS became less productive, you made that up. It says that the needs of an ageing population continue to be an issue that needs to be addressed and that obesity and smoking present an ongoing challenge.

If you take your heavily biased anti NHS spectacles off you’ll see that by just about every metric the NHS was performing better than at any time before or since. Data is what’s relevant here, not anecdote.

And yet -despite all that they spend (typically 25% more), there is also insurance based contributions made in addition. No wonder we struggle here. Even if we matched their spending, we would still be short of funds to deliver the high quality healthcare expected in a G7 country.

@newmummycwharf1 "And yet -despite all that they spend (typically 25% more), there is also insurance based contributions made in addition. No wonder we struggle here."

The figues for GDP spend on healthcare include the insurance-based contributions.

Where I live in Europe, we have compulsory health insurance. But this is not private health insurance, it is a form of National Insurance that is administered by public health insurance funds (Krankenkasse) which operate largely independently of the government. This National Insurance is collected through payroll so it is very similar to paying tax (and it is compulsory), it is progressive (i.e. a % of salary, so the more you earn, the more you pay) and appears a separate deduction on my payslip.

Great. The French system is also a statutory insurance and covers most things and on top of that, there are small out of pocket payments to be made. Detailed more eloquently in various posts on here. This is despite them spending more than 25% than us on healthcare.

My point is small co-pays, if administrated properly, not only raise revenue but more importantly change behaviour positively.

Someone will come along and say most people cannot afford to make small co-pays and I beg to differ. Some cannot and they will be exempt but the vast majority will benefit from being empowered around their own healthcare. And for now - money is the currency by which society ascribed value to a service. We pay via tax and we need to pay more via tax but it won't be enough. True reform will be needed to get out of this rut

And the NHS was expecting significant strain as the golden Blair years that people remember fondly were coming to an end - as population exploded and the ageing population increased. Any party would have struggled

The NHS was certainly performing better but that was 15 years ago it is not relevant now, that time has passed

The pressure on the NHS is far greater now, we have had years of mis management, years of underinvestment, years of privatising areas of the NHS, years of staff leaving in high numbers and on top of what the Tories have done we also have that Labour took out huge loans and were short sighted in how they managed the NHS

We deserve better my colleagues are leaving in large numbers, many are off with stress, we struggle to be able to give the service we should be giving and too often we are not giving the care that should be absolutely expected, not because we are not wanting to but we can only be stretched in our work so far.

Labour need to be honest they need to not fear the publics response of a full reform of the NHS we do not need to follow a US model there are other models that work far better but that means on average we shall pay more and the government certainly need to pay more

I don’t disagree with any of that. Reform is essential and I’m really looking forward to Lord Dharzi’s report. That doesn’t mean a new funding model and I can’t imagine for a second that the NHS won’t remain free at the point of delivery. Anything else would be political suicide.

One thing I really hope , now Labour is in power, is if I politely note that my appointment is 90 minutes late or my GP takes 35 minutes to answer the phone, that NHS and associated staff will refrain from telling me it's the government's fault. In fact next time I suffer severe delays for which there is no apology I may go as far as to comment, "how interesting you are still running 90 minutes behind, despite a Labour government. 😀

I have read the report, and for brevity quoted from the summary. The summary conclusion is based on the data. As you say, it says the needs of an aging population need addressing, as do obesity and smoking, and that they were not addressed in that 13 year period. That's a fact. You might not like that, but I can't help that.

13 years was plenty of time to implement things that improved the health of the nation for the long term. But instead they focussed on short term metrics. As anyone who has run a complex organisation know, the only things that get managed effectively are things that get measured. KPIs can be good, but the wrong KPIs drive the wrong behaviour and that was a problem during that period.

I am not biased against the NHS - it achieves a lot. I am biased in favour of patient and long term health outcomes, and I make no aplogies for that. Other systems and countries do it better.