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Welcome to Scotsnet - discuss all aspects of life in Scotland, including relocating, schools and local areas.

Original poster

BBC news saying Scotland discussed possibility of wealthy being expected to pay for nhs treatment

256 replies

Ruizy · 21/11/2022 04:12

Feeling a bit horrified at the prospect of this proposal. Surely it would just mean those above a certain wage would have to take out bupa style insurance. But not sure what would happen to emergency care.

OP posts:
PlacidPenelope · 21/11/2022 20:17

and what is expected of us as users and the responsibilities we have towards the system.

antelopevalley · 21/11/2022 21:01

PlacidPenelope · 21/11/2022 20:15

just read the whole thread and what a great debate. So much to think about - really so many big issues we all need to address. The way we live and die is totally different from when the NHS was created.

It has been a great and informative debate, it is just the kind of open debate the country should be having about the NHS. Emotion needs to be taken out of it and things looked at objectively and no reluctance to broach a new idea or different way of doing things, then the pros, cons, benefits and difficulties of that idea can be looked at and discussed. Look at systems in other countries, can we learn from them? You are right, we are living in far, far different times than when the NHS was created and what it was created for then, we need to reassess what we have, what we expect, what we want, what we need and the ins and outs of financing.

The NHS was way better when Labour were in power. But we can't look at that I suppose as that exposes an inconvenient truth.

MarshaBradyo · 21/11/2022 21:10

PlacidPenelope · 21/11/2022 20:15

just read the whole thread and what a great debate. So much to think about - really so many big issues we all need to address. The way we live and die is totally different from when the NHS was created.

It has been a great and informative debate, it is just the kind of open debate the country should be having about the NHS. Emotion needs to be taken out of it and things looked at objectively and no reluctance to broach a new idea or different way of doing things, then the pros, cons, benefits and difficulties of that idea can be looked at and discussed. Look at systems in other countries, can we learn from them? You are right, we are living in far, far different times than when the NHS was created and what it was created for then, we need to reassess what we have, what we expect, what we want, what we need and the ins and outs of financing.

It is possible to have the debate, just. Some good posts in there.

The pp made a good point about care work and the reality of it, as a society we don’t generally do it ourselves either as much as other countries do.

ThighMistress · 21/11/2022 21:11

@antelopevalley - don’t be silly. Do you think there would have been fewer elderly people if Labour had been in power? They would surely have stopped the demographic time bomb. And no one would have taken the mickey, either.

I had several hospital episodes during a Labour govt. can’t say that the experience was wonderful, with masses of nurses in attendance, cleanliness and expertise. Far, far from it.

You could put a billion an hour into the NHS but it wouldn’t address the core problems.

ScotsLassie322 · 21/11/2022 21:13

Perhaps you should change the title op. 'Scotland discussed'?

PlacidPenelope · 21/11/2022 21:26

The pp made a good point about care work and the reality of it, as a society we don’t generally do it ourselves either as much as other countries do.

Definitely a crisis in care for the elderly, there has been for a long time and no-one seems to want to grasp the nettle and solve it or indeed make any attempt to.

Bed blocking and lack of elderly care was just as much an issue under Labour as it is now, plus wasn't it Labour who saddled NHS Trusts with PFI contracts that turned out so expensive that hospitals were closing wards to save money to pay back PFI.

I'm not convinced that any political party has either the ideas or the will to truly address the problems within the NHS and social care, they most they do is apply sticking plasters which is why we need a grown up conversation/debate about the whole system.

Dinoteeth · 21/11/2022 21:38

You could put a billion an hour into the NHS but it wouldn’t address the core problems

What would you say are the core issues and what would you change?

antelopevalley · 21/11/2022 21:58

The main issues are:

  • lack of funding
  • lack of training of staff, so a shortage of staff like GPs
  • lack of migrants to fill in for the shortage of staff
  • lack of carers and money in social care so people get stuck in hospital
  • lack of mental health care so GPs and A and E end up spending lots of time dealing with this
endofthelinefinally · 21/11/2022 22:20

Tony Blair's PFI funding scheme costs the NHS millions every year just in interest payments. I don't think there is any hope of ever paying off the capital. These payments are a massive drain on budgets. I don't know if the interest rates are fixed, but I believe the rates are over 8%.
I spend a lot of time in hospital as a patient and I know there are pockets of excellence everywhere. What seems to be lacking is a co-ordinated effort to identify and reproduce the good practice and improve the bad.
When I was working I used to attend medical conferences regularly and it was interesting to share information and note that some trusts provided great service in a particular specialty and others couldn't get funding at all. A lot seemed to be down to who could fight their corner successfully with the bean counters.

justasking111 · 21/11/2022 22:30

antelopevalley · 21/11/2022 21:01

The NHS was way better when Labour were in power. But we can't look at that I suppose as that exposes an inconvenient truth.

Show quote history

The fly in the ointment is that labour have always run Wales. Our health board has been in special measures for eight years in N Wales 🤷

MarshaBradyo · 22/11/2022 07:23

Yep Wales and PFI are a good reminder re realities

Dinoteeth · 22/11/2022 07:35

Don't forget SNP have done more than their fair share of PFIs. And they want to build the new Monklands under one too.

OutOfTheFog9 · 22/11/2022 07:42

I expect a U turn over the next few days as SG is currently negotiating the NHS salaries - there will be a deal, some service cuts but no 'official' two tier so a win-win, at least temporarily.

I agree however that as long as we choose to hold on to 'founding values' at all costs and at the expense of dealing with the reality no staff, little resources and colossal demand, nothing will change.

TomTraubertsBlues · 22/11/2022 07:52

OutOfTheFog9 · 22/11/2022 07:42

I expect a U turn over the next few days as SG is currently negotiating the NHS salaries - there will be a deal, some service cuts but no 'official' two tier so a win-win, at least temporarily.

I agree however that as long as we choose to hold on to 'founding values' at all costs and at the expense of dealing with the reality no staff, little resources and colossal demand, nothing will change.

A U turn from what? This isn't a political policy and never was. It was obviously a hypothetical discussion by NHS chief execs, going by the article.

HeBeaverandSheBeaver · 22/11/2022 08:02

I would
Invest in MH clinics like sexual health clinics now. With qualified staff

Anyone in crisis can be directed there instead of a&e and be given specialist help.

It would take money but if every large town had one it would be amazing

TheBelmont · 22/11/2022 08:56

Urgh…posted this on the wrong thread yesterday. I was posting in response to the question of what was a solution.

”I think there are enough staff…they are just incompetently and inefficiently used. (to be clear I am not saying they are incompetent or inefficient…but that they are deployed poorly).

Anecdotal but my last trip to the sick kids….lots of nurses (I counted about 8 in total) looking not very busy chatting away. All very competent and professional individuals…with nothing to do. Hardly any patients.

Then it took 9 working days to get my hands on my daughters prescription because the consultant was not allowed to write the script himself….had to be requested from my local GP who I chased twice and the prescriptions person was off and no cover and then it got lost in the system between person a and b…meanwhile 9 more days of suffering for my daughter. What’s wrong with…consultant hands me the script in the appointment and I nip to the pharmacy on the way home…take maybe an hour. Like it used to. Two people involved. As it was…there were probably about 10 people playing pass the parcel and nobody taking ownership.

The patient is completely ignored as the NHS drowns in ridiculous inefficient procedures. Some patient focused process re-engineering is desperately required.”

OutOfTheFog9 · 22/11/2022 09:26

'This isn't a political policy and never was'

Any decisions to do with the NHS are always political. Ask staff.

ScotsLassie322 · 22/11/2022 12:36

Dinoteeth · 22/11/2022 07:35

Don't forget SNP have done more than their fair share of PFIs. And they want to build the new Monklands under one too.

Really? What hospitals have the SNP built under PFIs? I'm quite sure they were all Labour.

TomTraubertsBlues · 22/11/2022 12:43

OutOfTheFog9 · 22/11/2022 09:26

'This isn't a political policy and never was'

Any decisions to do with the NHS are always political. Ask staff.

That doesn't make this a political policy. The Scottish government (who would be the decision makers here) had zero involvement in this discussion. No decisions have been made or even proposed by anyone with the power to do so.

E.g. If a group of staff talk about hypothetical contract changes, is the content of their discussion official company HR policy? Obviously not.

Honestly, the lack of reading comprehension on here is staggering sometimes.

MarshaBradyo · 22/11/2022 12:48

On PFI it looks good for the party using it - as it did for Labour but it’s not viable. We’re still paying now and we need those funds even more due to demographic changes:

As will the next generation

Dinoteeth · 22/11/2022 13:30

I thought the new Monklands was getting funded via pfi but I now can't see how it's getting funded at all.

justasking111 · 22/11/2022 14:03

I think there's cross party discussion about this left and right in every country within great Britain. The Scottish NHS have broken cover to test the waters. Nudge theory in action

antelopevalley · 22/11/2022 14:33

Everyone is struggling. Charging a lot of the population to use the NHS on top of tax is not going to go down well. How shit do they want peoples lives to be?

KnittedCardi · 22/11/2022 16:14

The patient is completely ignored as the NHS drowns in ridiculous inefficient procedures. Some patient focused process re-engineering is desperately required

It cultural. DH has spent the last 30 years trying to get the NHS to be patient centred. The NHS, (the blob rather than the working units), largely operates for its own preservation.

caroleanboneparte · 23/11/2022 11:25

Surely this already happens?

People who can afford it pay for hip/ knee replacements, IVF, GP appointments, scans/MRIs, autism assessments, counselling, gallbladder removal, hysterectomy, etc.

I don't think many £100k+ households are on NHS waiting lists.