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.

The lack of communication between different NHS depts, different trusts, between GP and hospital etc is an absolute disgrace and needs to be tackled. It really shouldn't be the responsibility of ill patients to have to act as go-between between the different depts, even moreso when they are so hard to contact, don't answer phone messages, don't pass on messages when you do manage to speak to someone etc.

Looking at top 20 countries for healthcare, no surprise to fin we are nowhere on the list. % rating healthcare

Taiwan (78.72)
South Korea (77.7)
Australia (74.11)
Canada (71.32)
Sweden (70.73)
Ireland (67.99)
Netherlands (65.38)
Germany (64.66)
Norway (64.63)
Israel (61.73)
Belgium (60.16)
Switzerland (59.6)
Japan (59.52)
Singapore (57.96)
United States (56.71)
Austria (54.86)
United Arab Emirates (52.3)
Czech Republic (52.25)
Finland (52.1)
Portugal (51.99)

I am a frequent visitor to Canada and they have great healthcare compared to us- Yes thy do contribute towards it but they really get a lot for their contribution.

Canadian residents pay for Medicare through their taxes, but the medical services are free at the point of use. On average an individual might pay around $5,000 per year which is about £2,800 or so.

I am not advocating we all pay that in UK but perhaps we could have something similar where the amount you contribute, depends on say your income. I know people will say that is the end of NHS, however, let's be honest it is no longer fit for purpose in its current state and something needs to be done to change things.

There have been no new PFI contracts since 2018 - Tory governments were equally fond of them - and they have a duration of 25/30 years. My local hospital has one with just another five years to go and it’s paid for itself in increased workload since it opened.

Fine, 20% and the rest comes from general taxation. The point is, we already pay for it - it’s just not an itemised bill.

You have no idea what you are talking about when comparing to other countries. Yes, PUMA only covers 70%, but most people have additional insurance to cover the 30% if needed. In the US insurance is very expensive, especially for the self employed who foot the whole bill, but for most people employers cover the majority of insurance and taxes are lower.

individuals in both of these countries are exposed to some extent to the cost of the healthcare they consume, but that isn’t a downside- in many cases that is by design as it provides some mechanism for the consumer to understand the implications of their choices. Free at point of care is not the holy grail, but rather the fatal flaw in the system for the nhs - there is a reason no other country has copied it.

and I will reiterate that there is a vast gulf in the quality of care you receive in France or the us vs the uk. We don’t have access to many innovative medicines, diagnostics are often outdated and/or insufficient to meet needs, referral times and waitlists are far outside accepted standards, and no one can count on an ambulance getting to them with any urgency or a hospital bed being available if it does.

in the us the worst case is crippling medical debt, which is awful, but to my mind better than dying a preventable death with insufficient care.

What a bizarre reply, so you would rather have no healthcare than a system that provides universal free healthcare that is ranked in the top 5 in the world.

America has millions of people who can't afford it, and you say it comes free with employment....this only applies to certain jobs. Something like 10 percent of Americans have absolutely no healthcare provision, another 20 percent have inadequate provision.

France doesn't have a better healthcare system than the UK and they pay huge amounts in tax to fund it. They don't have the same cancer care provision...no where near.

Having lived all over the world, the best places have been Australia and Saudi....but again you have to pay into a compulsory scheme and it's not cheap.

Agree. Needs completely reformed. It doesn’t have to be the US system

i find your argumentation nonsensical. Having a partially private system (which is the vast majority of the developed world) is not the same as ‘no healthcare’. I also never claimed that healthcare in the us is ‘free’ with jobs - rather the opposite in that even with great insurance you always pay something and therefore recognise that healthcare has value.

good healthcare costs money, and excellent care cost a great deal more. I want everyone to have good care, but I also think people should be able to pay more for excellent care if they can.

And fwiw, France is generally recognised to have far superior cancer care than the uk.

No, I don’t agree. DH has been a higher rate tax payer for years and barely used the NHS but now he’s sick he needs lots of appointments and is likely to lose his job because of said sickness. Hes already paid his dues… to now have to pay again to see the doctor about pain that’s preventing him working would cause us to really struggle. Much better to get him in, treated and better so he can go back to being a work horse paying his tax!

@dwordle your arguments only make sense if we swap ‘better’ with ‘cheaper at point of use’.

for me a ‘better’ means access to innovative medicines, timely treatment, basic dignity in care - and ultimately better outcomes. All of which are have rapidly deteriorated in the uk relative to other countries with different funding models.

I agree that throwing endless resources at the old is impacting the young. Many people (esp on Mumsnet) aren’t brave enough to have the honest conversation about how much our younger generations have been bloody shafted! Apparently we have a birth rate crisis, but fertility waiting lists are huge, not to mention how poor maternity care is. That’s an area that needs proper funding. As does mental health.

it’s paid for itself in increased workload since it opened

I don't understand what this sentence means.

The only way to judge the value of that PFI contract would be to work out how much it would have cost to provide the same thing without a PFI deal.

The early PFI deals were poorly negotiated and ended up with basic maintenance tasks costing an arm and a leg. Negotiators got wiser with the later ones and I would really like to see the figures for the last few.

It means that the volume of income generating work is equivalent to or greater than the PFI payments. In my local trust the volume and range of provision wouldn’t be possible without the PFI provision so your assessment falls at the first fence.

Your last paragraph is entirely correct.

France doesn't have a better healthcare system than the UK and they pay huge amounts in tax to fund it. They don't have the same cancer care provision...no where near.

And yet they have some of the best survival rates in Europe, quite a lot better than the UK.

It still needs to be funded, the NHS is massively underfunded. I'm a higher rate tax payer but I can still recognise a system that offers exceptional value.

The innovation medicine term phrased relies in previous posts relies on being able to pay for it. Germany is a good example of this and one particular clinic offers state of the art kidney cancer treatment....the cost is 1.4 million euros per patient. No insurance scheme is going to fund that and in comparison the NHS is adopting it, albeit slowly, at no cost to the patient. In the real world which seems to be void from many posts, is it's the NHS that is a world leader in researching such treatments.

If people want better healthcare tell your MP you want to pay 30% tax like in France. The thing about British people is that that can't seem to relate how much healthcare actually costs and how much it costs them. If you are earning less than 35k you won't be contributing towards anything....you are a net burden to the state, if that's not an argument for tax increases to fund things then I'm lost. So if people want better healthcare changing the funding model will do nothing because the money isn't there to pay for it.

I don't think this is correct. The PFI deals are only an alternative way to borrow money rather than do it through the Treasury. Anything that was bought with PFI money could have been bought by raising National Debt but governments preferred not to do it that way at the time.

Have you seen the numbers being treated for cancer in the UK, I think you'll find that the system is being overwhelmed. Cancer treatment often lasts years...if not a lifetime. Surgery, chemotherapy and then hormonal suppression drugs etc. ...you are never truly cured....in remission yes....cure is something doctors rarely use for cancer.

In what way is it incorrect? The figures are there in the trust’s annual report every year.

This

@paolo2145 Could I ask where you got those stats for healthcare please? There are some surprising statistics there (to me!) Thanks.

More emphasis needs placed on people
taking more ownership for their health from childhood to the grave. The waste that is strangling the NHS should not only be considered from.the perspective of money being spent by the government or mismanaged resources.

This!
Am astonished at the number of people wi just ‘give up’ and some that from the age of 40 itbud an inevitable decline so funny bother bc with nutrition or exercise and csee it as ‘normal’ to have multiple hospital appointments.

I understand the importance of having a healthcare system like the NHS that supports everyone, especially those facing conditions they cannot control, such as cancer or certain disabilities. I struggle with the idea that people should contribute more purely because they earn more. In many cases, how healthy someone is as an able-bodied person can be influenced by personal choices and lifestyle. While not every condition is preventable, some healthcare costs diwn to individual responsibility. It seems reasonable to question whether contribution should be based on income, rather than also reflecting personal accountability. We have enough taxes which reward lack of personal responsibility whilst pubishing productivity.

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Most hospitals have charitable fund. Pay aDD to your local one then.