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.

Health
1/3 behaviour
1/3 environment
1/3 genetics

At best people can influence a minority of their health outcomes. Much is down to luck.

Indeed. I've just checked. Our local health board has an official, registered charity that manages over 300 funds for equipment, research, treatment and patient care.

No it should not. Free at the point of use.Lets fight to defend that against these shadowy thread starters from god knows where.

100%

The NHS used to work. It doesn't because of increased population caused by immigration. Immigrants need treatment and age. The indigenous population can take the roles. We have home trained medics who are desperately seeking work.

Individuals earning less than £35,000 are not net contributors, low wages caused by flooding the market with cheap labour. The main issue is those receiving a multitude of state benefits which is a massive drain on the economy.

In summary, stop immigration and reduce benefits. Return to a set up that worked.

I think a significant part of the problem for social democracies is how older age cohorts are treated. Elderly people with multiple health conditions, no real quality of life possible and yet multiple inpatient stints are being treated and treated and treated.

I cannot put into words how barbaric a family member’s end of life was due to these policies and one single outlier family member who wanted the person kept alive at all costs.

But the wards she was on when she was an inpatient were filled with other patients in similar circumstances. It is brutal and barbaric but it is happening is hospitals everywhere.

You said the facilities could not have been provided without PFI. I don't believe that is correct and I explained why in my answer.

The NHS used to work has little to do with migrants.

The UK has and aging population of which migrants are generally younger and healthier.

Government policy failure

The increase in long term illnesses cancer, diabetes, dementia and other conditions that would traditionally have killed people.

A lack of personal responsibility, although pplicy hasn't helped

Misinformation and waste in the nhs.

.

I don’t think I said that at all. I said that the PFI payments are covered by the income from the work it generates.

Yeah, alright 🙄 Come back when you have something meaningful to contribute.

In what way was it barbaric exactly? That’s quite a strong word to use.

I have family members who use MN so I will not be detailing the family members trauma here but it was the very definition of barbaric. An A+E doctor has asked that this person go on palliative treatment because he had cared for her a lot previously as she had been in multiple times but he was over ruled by a consultant and one family member was never going to be on board with palliative care so very extreme measures were taken.

This patient was a 36kg adult less than half of her normal weight at this stage and they had multiple very long inpatient stays at the hospital. The A+E doctor was 100% correct she should have been put on palliative care at that point.

End of life is rarely nice, very few fall asleep and die. You can't blame the NHS for how horrible death is....the Liverpool path way was deemed barbaric also truth is other than putting you down it's rarely a quick thing

@paolo2145 on this basis, if it costs an average of £2800 to provide a Canadian standard of healthcare, in the uk you would need to be earning over £41,600 to fund this. To contribute £2,800 to UK health services via National Insurance (NI) in 2025/26, you would need to earn approximately £41,600 per year. This calculation is based on the 8% main rate of NI applied to earnings between £242.01 and £967 per week, for those employed.
MoneyHelper
+1

• Calculation Breakdown: With an annual income of £41,600, your weekly earnings are roughly £800.
• NI Calculation: No NI is paid on the first £242.01/week.
• Taxable Amount: On the remaining
• £558 per week, you pay 8% (
• £44.60 per week).
• Annual Total:
• weeks =
• (Note: To reach exactly £2,800, the earnings would need to be higher, closer to £48,000–£50,000, assuming 8% rate consistently applies).

Note: This focuses on National Insurance (NI), which primarily funds the NHS and other services, and does not include income tax or other potential contributions. MoneyHelper

Average uk earners are contributing much less:

Average UK earners contribute hundreds of pounds annually to the NHS through general taxation and National Insurance, with one estimate suggesting around £792 per year. The NHS is primarily funded by taxes (including income tax, VAT, and NICs), with average annual costs per person reaching over £4,000 in recent years.
Key details on NHS funding and contributions:

• Funding Sources: The NHS is funded by general taxation, National Insurance Contributions (NICs), and other taxes like alcohol and tobacco duty.
• Contribution Estimate: An estimate suggests an average UK taxpayer contributes £792 per year in general taxation towards the NHS.
• Expenditure per Head: In 2024/25, health expenditure per head varied by nation, ranging from £3,462 in England to £3,758 in Wales.
• Cost per Person: The average person costs the NHS approximately £4,188 a year.
• National Insurance: Employee NICs are charged at 8% on earnings between £242 and £967 per week, with a 13.8% employer rate.
• IFS | Institute for Fiscal Studies
• +3

Note: The £792 figure is based on a 2022 calculation, and individual contributions may vary depending on income level and tax paid.

So… really, our wages need to be increased.

That's not what you said, this is what you said that my answer referred to.

" 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."

It was all done on borrowed money and could have been done on National Debt if it had not been done on PFI

Luck is an excuse used by the lazy and those who are not prepared to do what they can.

What utter bollocks. Life threatening diseases are a lottery.

Not if you have the misfortune (bad luck) to be born with health conditions that predispose you to certain health issues. And I'm not sure you can do much to control whether you develop autoimmune conditions - and once you develop one, they are more likely to come in clusters...

You can of course eat well and keep as fit and active as possible to try and mitigate risks, but the rest is down to luck.

Sorry @BIossomtoes, I didn't mean to quote you, although I was indeed posting in a very similar vein to you!

No problem. It bears saying twice!

@BIossomtoes
@ThingsAreNotWhatTheyWere

Peer reviewed research exists on pessimism, luck and motivation. There is also a lot of research on learned helplessness.

As for What utter bollocks. Life threatening diseases are a lottery.

Not every life threatening illness is a lottery. Some are. Some aren’t. Trying to point score by pretending they are all the same is bollocks as is say the major fact is luck.

There are plenty of life-threatening conditions where people can make changes that improve both their quality of life and the cost of their care. A person with coeliac disease didn’t choose it, but managing their diet makes a huge difference to their quality of life and their cost to the NHS. On the other hand, a heavy smoker who develops asthma or even lung cancer but keeps smoking is likely to cost the NHS far more than someone who doesn't smoke or is who supported to stop. Money, time and resources that could have been used elsewhere. That's something to be mad about, not someone who works hard but earns more than you.

People who find solutions don't have a binary way of thinking nor do they try to derail conversation with extremes. They recognise that there will always be things outside people’s control and that there is also often a lot within it. Many, not all, NHS patients could improve outcomes and reduce avoidable strain on the system by managing their health more proactively.

If we are looking at fairness when it comes to funding the NHS then we have to have the uncomfortable conversations about users of the NHS pulling their weight where they can, as well as waste and inefficiency in the system.

I'm not trying to point score, I'm actually trying to point out how offensive it is to someone who's needed lifetime care under multiple hospitals that if only I did X, Y, Z all my problems would magically disappear. I've never smoked or taken drugs, pnly drink in moderation, was pretty active until my stroke, but still try to do as much as I can, and I do eat healthily. And as someone with Coeliac disease I can tell you that the vast, majority of sufferers will stop eating stuff that makes them ill!

ETA I certainly do nuance, but I don't like being made to feel like a burden to the NHS by strangers when I'm already well aware of the fact.

On the other hand, a heavy smoker who develops asthma or even lung cancer but keeps smoking is likely to cost the NHS far more than someone who doesn't smoke or is who supported to stop.

A heavy smoker who develops lung cancer and keeps smoking is likely to cost the NHS considerably less because they’ll die much sooner. Of course there’s also the small matter that the Treasury gains £12 billion annually from tobacco tax and VAT on smoking products yet the cost to the NHS of smoking related diseases is £1.8 billion.

It’s quite absurd to assert that health isn’t a lottery because it is. I may inherit my dad’s genes and be sharp as a needle to my dying breath at 99 like him. Or I may inherit my mum’s from a family riddled with dementia and end my life away with the fairies. Either way there’s little I can do about it. It’s in the lap of the gods. Or, of course, I might get diagnosed with cancer tomorrow, who knows?