NHS should be a co-pay system.

[PeonyPatch]

Who agrees? Other countries who use this model include France, Germany and the Netherlands and they are some of the highest ranked healthcare systems in the world. The NHS is no longer fit for purpose, and it hasn’t been for a long time. I am proud that we have a free at point of access system here but it’s no longer sustainable and has been mismanaged and inadequately funded for a very long time. The only way I think it could improve is by gradually making it co-pay - perhaps capping it like Germany does.

Not sure what it would achieve apart from those of us who already pay into the system will pay again and anyone else who doesn't contribute will still get it free. What governments need to do is stop wasting tax payers money and distribute it more sensibly then maybe services like the nhs wouldn't be in such a state

Again, but you’ll get the posters like Nige who’ll say “oh but I’m just sooo happpy to pay more and more of my salary to and so should everyone else who works!”

In France all cancer treatment is 100% covered. I have never heard their system called a “co-pay” system.

I'd happily co-pay of it meant being able to get an appointment. I've been trying to get a GP appointment for months.

No sorry OP I dont think this would help at all. It will just give them more money to piss up the wall. The reason the NHS is on its knees is because of years of chronic mismanagement. No extra money put in to it will filter down to patient facing services. It'll line the pockets of unnecessary big-wigs at the top.

Yes, the French system I have heard that instead of NICs, employees and employers pay cotisations sécurité sociale. Employees pay 20-25% of their gross wages and Employers pay 40-45% of gross salary. There is also a levy on passive income of 7.5% including pensions.

The UK NIC rates are well below this.
The French pay a lot more in taxes for their healthcare.

i don’t think we just need to throw more money at it. I’ve got a friend who’s worked in the nhs for 20 years and they think it’s where it is simply due to lack of investment. I personally think it’s lack of investment PLUS mismanagement. To be perfectly honest, I really do not know what the answer is :(

We already have it with people with funds going private. I feel very uncomfortable about it.

But we can't keep pumping money into a system where, today, i was having to tell the registrar dealing with my emergency referral for sky high eye pressure my medical history because she didn't even have access to the dates my cataracts were done or the medications I've been on. We wasted probably 20 minutes with her making notes on her system which should already have been there, during which time it came out that i should never, ever, have been prescribed a steroid inhaler while taking a beta blocker eye drop.

It's 2026, FFS, this level of waste and incompetenceis quite ridiculous.

No not co- pay. We need a viable private alternative where you get better service, that is affordable.

I want flexible accessible affordable healthcare that I can fit around my job.

current I have none of that and I have suffered for the past 10 years. It is truly awful.

I have previously worked in the NHS and Civil service. Currently in another branch of the public sector. Money is wasted left, right and centre through laziness, incompentence, mismanagement and corruption. These all need fixed first before we bleed anymore money into it.

The people who use the NHS the most wouldn’t have to pay - elderly, kids, those on benefits, etc .

It’s a shit idea. Why should working people continually have to fund others whilst the usual suspects get their paracetamol on prescription to avoid paying anything.

You have to invest money into management to get good management. Wes Streeting cutting back office jobs contributed to there being fewer managers to manage it well. For example, the NHS can’t spend its funds wisely on supplies and services with no one in the back office to write, negotiate and oversee the contracts. The NHS can’t hire qualified staff with no one in the back office to fill vacant posts quickly.

eye appointments and glasses are also not free at point of access and the NHS isn’t free - we the workforce pay for it. If we want to move to European models then we need to be taxed less and wages need to increase like other countries

Most European systems have a process whereby if you are a student or unemployed you don't actually pay to see a doctor. So there isn't a situation where you are put off seeing a doctor because you think you won't be able to afford it.

I think my reservation about that would be that it's always people who were just above the poverty line who get hit really hard by costs which people below the poverty line get for free. There's this whole pretense that if you aren't on certain benefits you do have enough money to do basic stuff like by school dinners etc but it's not true.

No system is perfect. But I think the taboo around discussing better ways of financing and running the NHS is really not helpful in delivering a good service. I hope people will continue to calmly discuss this usually there's massive Hysteria if you even suggest that there might be a better way of doing things.

European models tax more not less.

I know my UK student abroad in the Netherlands pays into their health system and pays to see a doctor? In fact, to get her student visa she had to prove she had sufficient funds to support herself even if she couldn’t find a job (students can work part time on a student visa) and part of that figure included costs for healthcare.

Just like the UK then. My MIL spent 48 hours on a trolley in an A&E corridor before finally being admitted to a ward where she died because she'd not had any treatment during those 48 hours.

I pressed go to soon! They do in a lot of countries yes, but my point more being we need higher wages and higher contributions from businesses to be able to fund into healthcare. We can’t just lift one element from models that operate better and ignore the rest of the social construct. We have a cost of living crisis and taking more money from those who are squeezed pushes more below the poverty line than we have already - I’m not sure we have a solution but it doesn’t feel like spending more when we’re already taxed

Yup, waste, inefficiency and duplication are rife. My DH has cancer and when first diagnosed had loads of test, i.e. full skeletal x-ray, MRI scans, CT scans, and bone marrow testing. The first haematologist referred him to a specialist in a town an hour away, and at the first consultation with the specialist, he had no test results at all - just a 2 paragraph referral letter with no data on it besides the diagnosis, so a complete waste of the appointment and then the consultant said he'd arrange for his own tests, i.e. full skeletal x-ray, MRI scan, CT scan, bone marrow testing as it was "easier" just to order them again than chase the first hospital to send the results! Utterly bonkers!

No

Because everyone on benefits would get it for free anyway which is half the country.

The tier system in this country is awful and it does absolutely no one any good.

I’d rather see a tax increase than co pay. The rich would be fine, so would the people on benefits because it’d be free for them. The people who would be squeezed would be people who work and are over the threshold for benefits but are still not earning a living wage. The ever shrinking middle class would be squeezed too. We need NHS reform, but not this way.

Nail on the head there. Like the idea of paying for GP appointments. Half the population would be exempt, so it's just another tax on workers, who are already taxed more than enough.

There will be no political will to implement this without a hard left wing government like Corbyn.

Instead the NHS will get worse and more and more people will go private to avoid waiting 12 months for simple procedures.

£10 charge for any NHS appt you booked but don't attend.

Regardless of income or being in receipt of benefits.

People might take it more seriously then and the hundreds of thousands of DNAs in the NHS each month would add to the pot.

Exactly.

9 EU states spend more public money per head on health than the UK. Germany spends a whopping 55% more.

And in France, the system I'm most familiar with, the state only covers 70% to 80% of your health costs, you usually pay for a mutuelle (complementary health insurance) policy, at anywhere between 30 and 150 euros per person per month last time I looked. Anything not covered by your policy, you'll have to pay the 20% or 30% yourself.