To worry about the NHS if Reform get into power?

[Vicjo]

I'm not really a follower of politics tbh but can't help worrying about the future of the NHS if Reform were to get into power.
I've spent most of my career in the NHS and the thought of it being abolished is so depressing.
Do other NHS staff worry about this?

Yes, but given that Farage is up Old Donald’s rectum and is taking many of his ideological positions from him, and given that Trump has mentioned interest in the NHS previously on one or two occasions after Brexit, it doesn’t take a genius to work out what the ultimate goal is as far as reform are concerned, does it? However much he protests, we know he’s got the American health care system in mind for this country, and that’s exactly what would happen eventually.

Singapore, for one.

Same question to you. Have you an example of a successful current working hybrid? Genuinely interested if you do.

So you would rather a failing system that sees endless money pumped into and no return on investment. The ideology of Bevan is no longer sustainable and hasn't been in donkeys' years.

Please explain - I am genuinely interested in how health care is equal amongst everyone in their system.

Well the NHS is pretty much broken now. Cant really get much worse.Patient safety is a big issue at present. I’d be frightened to be a hospital patient as I couldn’t trust the care I’d be given.

Most people in this country can’t afford the astronomical healthcare bills, even the insurance is extortionate and doesn’t cover everything. If you’ve got existing health conditions, you’re buggered. Could you afford it?

It’s a genuine pleasure to do my job. I’ve nursed from being 18 years old. I’m fiercely proud of the NHS and feel incredibly lucky to see the miracles of modern medicine and true kindness of human beings every single day, not just from medical professionals, but patient to patient, relative to relative.

It would be a tragedy if the intended role of the NHS changed.

The NHS and private is already heavily intertwined.
A lot of private health care goes through the NHS as they have the best diagnostic equipment and operating facilities. All the staff in theatre will be NHS, paid at enhanced rates. Then the patient will as soon as possible, be transferred to private facilities to recover.
Reverse is, NHS will send some elective surgery to private hospitals.

My concern is Farage may favour an American system, when it's the French and some Scandi countries who do it a lot better. In health care league tables, the UK comes way higher than the US.

I'm not sure the purpose of your question. Damned it we do have the NHS and damned if we don't. At least a privatised system would get rid of the perpetual scroungers.

Most European countries have some kind of hybrid system, where treatment (at least out-patient and GP visits) is not free at the point of use, or at least where the patient does actually see the bill even if they don't pay it. There is then some arrangement whereby one or more insurance schemes either reimburse you, or pay the bill directly. Sometimes this comes with modest co-payments. Spain is a bit of an exception — its system is very close to the NHS.

To take France as an example: A visit to the GP costs (in most places) €30, a price which is regulated by the state system. The system reimburses 70% of that, minus €2 which is considered to be your "skin in the game", so €19. Most people have top-up insurance via their employer that will reimburse the other €9. (It's actually illegal for an insurer to pay that last €2 back to you — the idea is that people with time on their hands need to be discouraged from visiting 10 GPs until they find one who can be bullied into giving them antibiotics for a cold.) But if you have a very low income and/or chronic conditions then you can get 100% reimbursement. And for major things like hospitalisation, where 30% would still be quite a lot, the system covers pretty much everything. Your top-up insurance might pay for a better room but that's about it.

In some countries there is a mixture of private and public hospitals, in others it's all private but the government regulates prices. Even in Switzerland, which likes its capitalism red in tooth and claw, medicine is private but the government guarantees that everybody, regardless of pre-existing conditions and disabilities, can get insurance at an affordable price.

So if you want examples of systems that I either have experience of or know of people who live there and are happy: France, Germany, Switzerland, Netherlands. Of course, all of those systems have issues, but is none of those countries (or Spain) is health as prominent a political topic as it is in the UK.

Now, how you would go about getting to that situation starting with the NHS model is an interesting (and hard) question. Overnight you would have to put in place billing systems and insurance rules, which would add many billions in overhead themselves, and hope that that would somehow allow people and the state, between them, to spend more (% of GDP) on healthcare, which is the real problem of the NHS. (It reminds me a bit of Universal Basic Income, which may or may not be a good idea, but if it was ever introduced it would be incredibly hard to remove it.)

I don’t now how anyone could realistically favour the US system. Apart from the ethics of it it is massively inefficient - it actually costs the US Government more per capita in public spending than the NHS.

I’ve read good things about the Spanish system and Australian, sure there are others too.

If he's still a great fan of Trump, he's keeping quiet about it. That's because most on the Right in the UK have turned against Trump. Not just his policies but his downright rudeness.
Farage has also drifted more to the centre much to his follower's disgust, but he needs the centrist vote as much as the Right, to secure victory.

He could yet end up like Boris Johnson, trying to straddle the centre line, being all things to all people and pleasing no one.
Sorry, went off the NHS topic somewhat.

Reform are mostly very far right ex tories I don't get why people voted for the when they spent the last 12 years fucking up the country

100% this. My fear is if someone doesn’t do something soon, we’ll all be fucked. We have no choice - time to privatise.

Since Reform won the council seats Trump and Elon are coming out of their mouths more. DOGE, sacking DEI workers, banning all flags except for British flags and saying they are going to fly them from every public building smacks of the USA with their excessive national pride and superiority. So, from my perspective, I don’t see that he’s hiding it very well, but we’re all different.

You could move over to the Australian system. We have a Medicare Levy here which is a bit like your national insurance payments. The levy varies according to factors like your income level and whether or not you have private health insurance. If you are low income, you aren't charged.

All emergency and serious illness is free at the point of care in the state hospitals. No one is going to die on the street because they've had a heart attack and have no insurance. We pay for more optional things and receive varying levels of Medicare rebates for those plus private rebates if we have insurance. Again, those on low incomes aren't paying for this. We pay a small amount for prescriptions unless we have a concession card.

This sort of system might be difficult to sell to people who are used to the NHS. I found it difficult to get my head around it when we first moved out here. But it's impossible to deny that we've had much better medical care over here, even if we have quite rightly had to pay for some of it because we earn enough to contribute.

We have a physically and mentally disabled child who requires a huge amount of care. We will never be able to pay into the system everything that child has needed to take out of it. But we are very happy to pay what we can. Both the physical and mental health services have been absolutely outstanding and have saved our child's life several times. Reading some of the stories on mumsnet about the current UK mental health services makes my blood run cold.

Yes but reform would turn it into an insurance system that looks more like the American one than the French one.

My dh has bupa private insurance paid for by his company. Excellent coverage. Dh has claimed around 30k in medical costs this year and copay only £100. But doesn't cover prescription costs. We are paying £700 a month out of pocket for prescription and consultations. We are living the American system and it isn't nice. Yes nhs waiting list is horrible but at least one day the wait would probably end.

We are stopping at one child partly because we don't think if our child inherits dh's conditions, we could afford more than 1. Dh had a vasectomy and it brought us much peace of mind.

It's been purposefully underfunded for years in order to sell it off. It's not a vote winner to privatise the NHS so it's being done by stealth.

I too worry about Reform,apart from his stance on migration precious little is known about taxation nhs etc. I think he is a credible threat though.I would not want him for PM at all.

Singaporeans save 20% of their gross income in a compulsory savings account, of which a portion is allocated to pay for healthcare (insurance premiums and also healthcare treatments). They can do that as most people live with family until they get married can afford to buy a government flat which is also subsidized (though it is approaching london prices but most can still afford it with 2 incomes and years of savings plus the population is very well educated with a huge proportion in professional roles). Far fewer single parents, normal household setup in singapore is singles living with parents, dual income household with 1 or 2 kids (occasionally with elderly parents), or 35 and above single living alone- these family setups in the west are also less likely to be cash strapped and could afford to devote more money to things like healthcare.

They also have low obesity rates, only 11% of population own a car so they walk more, exercise more, older people more likely to live with or near family. Very little binge drinking, vaping banned. National service so men below age of 40 need to pass a physical fitness test every year. The women are extremely weight conscious

All these factors mean healthy life expectancy is the longest in the world so the health system isn't under constant strain. And means health insurance payments can be lower as people less likely to develop chronic illnesses in the first place.

I am singaporean. Health insurance is compulsory but the basic insurance doesn't cover much. So you generally have to buy more comprehensive insurance. However as you are forced to save 20% of your income and employer contributeds16%, you can use that money to buy health insurance.. there are lots of rules on how that money can be used though, aka cap on the money you can withdraw to pay for a hospital room for example, so if insurance doesn't cover 100% you have to pay out of pocket..fortunately if you opt for the cheapest shared room there is as much as a 80% subsidy but this is also income dependent, if you earn a lot you may only get 60% subsidy.

The government also frequently tops up the medisave accounts of poorer and older people as a one off bonus.

I think in singapore it's very much on a case by case basis. It's affordable for many but I wouldn't dare say it's 100% (the very poor do get everything covered). There is an old saying in singapore, in singapore you can afford to die but you can't afford to get sick. That was more applicable 15 years ago when there wasn't compulsory health insurance and not as much subsides for the elderly (plus incomes were much lower then). But I am sure there are still some ' left behind' people.

As I understand it, Farage believes that those who can pay, should. I don't really see anything wrong with that statement.

Anecdotally, the two times (only) my husband and I have needed hospital care, we've had to go private. I don't see this being any different in future, whoever's in charge.

Respectfully, they said that about Brexit...