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.

As @Overpayment, your fellow poster in favour of such things would no doubt say, that could have been avoided through better planning.

Bit surprised by the absence of biologics under that board, @newmummycwharf1 . Very surprised, in fact, going by the existence of the Biologics Suite at St George's Hospital in the Rheumatology Department.

That has nothing to do with the health care system and more to do with a piss poor run city and ridiculous drug use. When you decriminalize drugs and let lawlessness rule what type of person are you going to attract?

Get out of the California bullshit and go see the rest of America

I have a hip condition. I have been on the waiting list to see a consultent for almost a year and no end in sight. Once I finally get to see someone, they'll be a wait for scans, a wait for results and then an even longer wait for surgery.

I'm on several Facebook groups for this condition. Everyone in the US has surgery within a few months of diagnosis. Yes, they pay for it through insurance but at least they get somewhere. I wish I had private health insurance but of course now it wouldn't cover me as it's a pre exiting condition. When health insurance works, it works.

I have lost all faith in the NHS and don't even bother trying to see a GP any more. I buy medication online.

Going to answer any of the actual questions?

Like all public services, it’s extremely poorly run and its systems and processes are so backwards.

But it’s free at the point of need, and we are lucky in many ways. My DS had an injury a couple of weeks ago, and we were seen by a doctor and x-rayed twice at our local A&E within less than 2 hours. I didn’t even have to pay to park.

For non emergencies, and for adults as opposed to children, it is often diabolical, but that’s when you can choose to go private.

Funnily enough while looking at a really agonising crack in my perineum I started thinking about how sore it must be to mess with this area for that purpose. Personally I'd counsel against it.

We no longer have basic healthcare though?

https://anthonygold.co.uk/latest/blog/impact-of-uk-housing-crisis-on-nhs

Too poor to pay eighty quid for a safer shag when you also pay 'tens of thousands' in tax, so must be a higher earner?

My question was about funding for transgender support, medications and support.

What are your views on that?

@OptimismvsRealism "what are your views on NHS funding for transgender support, medications and surgery?"

The issue is 'basic' may need to be re-defined. There should be universal core funding but should that include fertility treatment, cancer drugs that extend life by 4-6 months, drugs that slow progression of multiple sclerosis by 1 year, diagnosis of debilitating disease 6 years before the person is symptomatic etc etc.

There are now infusions that help prevent development of type 1 diabetes in children at risk. How much is that worth? Is that basic healthcare?

What about gene therapy that cures sickle cell disease? Sickle cell is a life-threatening disease and sufferers often live in intense pain perpetually. The gene therapy to cure them costs circa £1million - it is a complete cure. Declined by NICE

Can’t afford £2.30 a day either, so good luck to them paying co-pays.

I think that the entire funding system should be changed so that people pay a bit, unless they absolutely can't and if they absolutely can't they get what's available (which is probably better than what's currently available for anyone). I don't know if transgender care is essential any more than I know if prostatitis is liveable with.

The waiting lists won't suddenly vanish. There still won't be enough doctors et al. to manage the needs of society.

A lot of private care is provided by NHS doctors on their off days

In many other countries in Europe, you pay a small yearly fee (€100 ish for my family of 5), you then pay your doctor directly and automatically get around half of that back. Most employed people have private insurance (very affordable and often paid for by employer) which then pays the balance. It works well. No waiting lists . Can see a GP pretty much same day. Prescriptions are automatically partly reimbursed. People on very low incomes basically don't have to pay anything. The NHS is amazing in many ways but it is underfunded and overwhelmed. I don't think the UK is ready for this European model as you do have to pay something.

The financial and business model of the NHS should have been ditched decades ago, and most people know this. We need to look at countries like France, Germany, Holland etc and adopt a similar insurance system. Members of the public need to take more responsibility, but it will also put provision on a much more sustainable footing.

The guidelines for the biologics they provide are publicly available. They don't fund the ones they deem expensive. Same for Eye injections proven to save sight.

It isn't a malicious decision - they have to make decisions based on the finances available

I feel really quite astounded at how many Ukrainian people who had to move to the UK due to the war have commented on how shocked they were not to be able to call a doctor and see them same day. Ukraine!

It doesn't add up because it doesn't work like that. My point was that if everybody paid a percentage from their estate (5% in my example of a £300,000 estate) then, nationally, there's enough in the pot to fund everyone - from those with low needs to those who need the highest priced care. It's the same principle as we have now - we all pay tax that funds the NHS. Some of us have conditions that cost hundreds of thousands to treat, and some of us will never use it, but we all pay for it. It's collective responsibility. I just think the same principle should apply to social care as well as medical care, but instead of funding it upfront it should come out of people's estates. So people are still paying for it out of their assets, but sharing the risk across the whole of the society means they would pay a lot less.

I don't think I understand the part about it costing them twice (families who provide care)?

And what? If they're working 5+ days a week now between NHS and private, they'll still be working 5+ days a week in a full private system. The waiting lists will still be there.

It is not possible to fund it properly unless tax increases. A LOT. The premise of the NHS, was need not want, it also belongs to a different time, now we have all the medical advances….its not possible with the demographic that the country has to just ‘fund it properly’.

In your vision for UK healthcare,

How and who would decide what "essential care" is?
Would that be the same as "getting what's available"?
How and who would decide whether people can "pay a bit" or "absolutely can't"?

Why do you think that this problem exists in the UK but not France Germany Netherlands Belgium ?

Do you imagine Denmark is rationing basic healthcare?