Who hates the NHS

Apologies ronib on the terminal care issue, it was clear to me the growstuff was joking, I thought your comment meant that you had considered it, but clearly not.

ronib

Growstuff please don’t insult me.

I wasn't.

ronib

Casdon I was told directly by an ambulance driver that only 25 percent of callers actually needed to go to hospital and he implied that they didn’t need to call an ambulance. I prefer the information given to me from the medical staff on the ground. One ambulance driver thought that a lot of older people were living alone and unsupported and that calls to 999 were because of a lack of care in the community. Also because of the vulnerability of the Nhs in that it could be sued for negligence etc, that ambulance staff would always err on the side of caution.
Also Casdon I did not raise the question of terminal care - it was in response to another comment.

It’s a rabbit hole ronib, if you’re really interested all the England Ambulance Service stats are here.
www.england.nhs.uk/statistics/statistical-work-areas/ambulance-quality-indicators/
Just to clarify, the ambulance staff on the ground don’t receive the calls, so somebody will have told him information which he processed and relayed to you, with some of his personal experience playing into the conversation. The information is always open to interpretation - the reality is that people call for an ambulance because they need help. For many of them there is no alternative service, or if there is they don’t know how to access it. Ambulance crews see that as wasting their time, but it’s a sign that peoples needs aren’t being met. That’s why the numbers are increasing. In my experience there are very high numbers of calls from people with mental health issues, some older, but many not. 999 and attending A&E are the only guaranteed services, and therein is the issue.

Growstuff please don’t insult me.

Casdon I was told directly by an ambulance driver that only 25 percent of callers actually needed to go to hospital and he implied that they didn’t need to call an ambulance. I prefer the information given to me from the medical staff on the ground. One ambulance driver thought that a lot of older people were living alone and unsupported and that calls to 999 were because of a lack of care in the community. Also because of the vulnerability of the Nhs in that it could be sued for negligence etc, that ambulance staff would always err on the side of caution.
Also Casdon I did not raise the question of terminal care - it was in response to another comment.

Tweedle24

*Maizie D* What I meant by ‘spoilt’ is purely that the majority of the population has not experienced life without the NHS. It is now taken for granted that the care will be there without having to worry about being able to afford it. It was not meant in any derogatory way.

I am very aware that there are problems now and I have tried to explain some of the reasons.

It did sound so shocking, Tweedle24. As though we didn't deserve it and needed a dose of tough love..

Thanks for explaining.

I would never want to revert to pre NHS conditions, nor would I want it for my children and grandchildren.

I was treated by a paramedic when I fell and fractured shoulder and arm. I was seen in our local Minor Injuries Unit, having been taken there by a friend. I did not need an ambulance to take me there, but I did need the paramedic’s help with the pain.

I have worked in A&E and know that not all patients need hospital admission, but do need urgent help. Unfortunately, it seems that difficulty in getting a GP appointment is driving some, who strictly speaking should not need the hospital, there. I hear people complaining about the NHS and are surprised when it is suggested they speak to their pharmacist or ring 111. Maybe an information campaign would help?

Life expectancy in 1948 was between 60 and 65. Death in childbirth and the death of young children was still quite common. Is that what you want ronib?

growstuff

How much per year does the NHS spend on breast implants and gender reassignment?

I've also been told that many (don't know what percentage) of people ringing 999 don't need to be admitted to hospital, but that's because many people can be treated by paramedics in the ambulance or in A&E. How much do time-wasters cost?

Personally, I think the idea of killing off premature babies and oldies would save more.

PS. Playing Devil's Advocate again - not serious.

I’ve said it before growstuff if some people get their way we can rename the NHS Logan’s Run.

I should have said there’s a call handling process employed by Ambulance Control, and these days they will often send a paramedic or accord a low priority, or refuse to transport people to hospital based on what the caller tells them. The service is abused, but both 999 and A&E are the last recourse for people who are vulnerable - a lot could be avoided if there was more funding of or other supporting services.

I’m amazed you would even consider that terminal care could be on the table ronib, it’s always been one of the fundamental things the NHS does.
Other treatments which are non life changing are always valid to consider for NHS funding, and there are already processes in place to do that, based on both political funding and clinical decisions.
Your point about A&E is erroneous. Of course, there is a level of abuse of the system - but A&E is not, and was never intended to be the gateway for hospital admission. The vast majority of admissions are organised between GPs and the relevant hospital clinical team. People who are involved in traumatic or emergency events go to A&E. you don’t need to be admitted to hospital if you have broken your wrist, or have a saucepan stuck on your head, or you’ve burned your arm on the iron, or whatever, you might if you have collapsed in the street, but after assessment you might not - that’s what A&E departments do, the clue is in the name.

How much per year does the NHS spend on breast implants and gender reassignment?

I've also been told that many (don't know what percentage) of people ringing 999 don't need to be admitted to hospital, but that's because many people can be treated by paramedics in the ambulance or in A&E. How much do time-wasters cost?

Personally, I think the idea of killing off premature babies and oldies would save more.

PS. Playing Devil's Advocate again - not serious.

In general there’s been a revision of medication and treatment once available for free. The list of conditions is available online.
Terminal illness is an interesting one - by definition there’s no cure and it remains for the disease to be managed and made less painful. This is both reasonable and desirable.
Do patients need breast implants/enlargement surgery? Does the Nhs need to perform gender reassignment on young people? I think there’s a conversation to be had about how patients use 999 as I was reliably informed that only 25 percent of people ringing it need to be admitted to hospital. I doubt that the Nhs in 1948 suffered from this problem. There are many conversations to be had!

Maizie D What I meant by ‘spoilt’ is purely that the majority of the population has not experienced life without the NHS. It is now taken for granted that the care will be there without having to worry about being able to afford it. It was not meant in any derogatory way.

I am very aware that there are problems now and I have tried to explain some of the reasons.

growstuff

ronib

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

Well, we could stop trying to save premature babies, people with dementia and terminal illnesses. In fact, there's not much point treating anybody who's economically inactive. That would save the NHS a few pounds!

PS. I'm not serious (in case anybody thought I was).

Perhaps ronib thinks we're 'spoilt', too...

ronib

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

Well, we could stop trying to save premature babies, people with dementia and terminal illnesses. In fact, there's not much point treating anybody who's economically inactive. That would save the NHS a few pounds!

PS. I'm not serious (in case anybody thought I was).

Norah

MaizieD

I stated facts as well.

No one is doubting that you have stated facts Norah. All that growstuff and I are saying is that it's not the method of funding that is significant, it's the amount of funding that is key.

And I am saying, which is also a fact, that taxation doesn't have to precede spending.

Good. We agree.

Let's try to fund by spending well on an insurance scheme. As you note "taxation doesn't have to precede spending."

I don't really see why a change to an insurance scheme is needed. It costs more to administer and the transition would cost billions and cause massive disruption to the systems already in place. It wouldn't deliver better outcomes anyway, unless there were a commitment to spending more.

ronib

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

What exactly do you mean ronib, as I presume you aren’t suggesting we only have procedures that were available in 1948 done by the NHS? Do you have specific treatments in mind that you think the NHS shouldn’t fund?

Maizie D no advice intended. Just wondering why you and other posters refuse to take on board the huge increase in procedures available on the Nhs which were not approved or even considered at the time of its inception.
Maybe it’s time to take stock?

MaizieD

^I stated facts as well.^

No one is doubting that you have stated facts Norah. All that growstuff and I are saying is that it's not the method of funding that is significant, it's the amount of funding that is key.

And I am saying, which is also a fact, that taxation doesn't have to precede spending.

Good. We agree.

Let's try to fund by spending well on an insurance scheme. As you note "taxation doesn't have to precede spending."

I stated facts as well.

No one is doubting that you have stated facts Norah. All that growstuff and I are saying is that it's not the method of funding that is significant, it's the amount of funding that is key.

And I am saying, which is also a fact, that taxation doesn't have to precede spending.

growstuff

But Norah, it's not the payment method which is important - it's the fact that Germans pay more for healthcare. The US is different because people pay to private healthcare companies and millions of people can't afford to pay, so Americans get some of the best treatment in the world and the worst.

PS. I haven't given an opinion. I've stated facts.

I stated facts as well.

Germans pay more and receive more. Americans pay, and those who do pay more receive excellent care. I assume the US will sort their healthcare for every persons benefit soon.

US President Obama tried, gained many million more people insured.

Quote: "Since its enactment on March 23, 2010, the Affordable Care Act has led to an historic advancement of health equity in the United States. This landmark law improved the health of all Americans, including women and families, kids, older adults, people with disabilities, LGBTQI+ and communities of color."
Mar 18, 2022

But this is the bit that is being ignored

There is no reason at all, apart from 'small state' ideology, why the government can't put more money into the NHS. The government creates our money. It doesn't need to wait for tax receipts, it can put in as much as the NHS needs. That would not only help the NHS but it would help the economy.

The corollary is that most of what the government spends on the NHS (on any public service) comes back to it via taxation. What doesn't come back via taxation is money spent on goods and services from other countries and money that people save.

But while it is circulating in the domestic economy, before it returns to the government, it is enabling economic activity. In the case of the NHS is it reckoned that every £1 that the government puts in generates £2.50 worth of economic activity.

But Norah, it's not the payment method which is important - it's the fact that Germans pay more for healthcare. The US is different because people pay to private healthcare companies and millions of people can't afford to pay, so Americans get some of the best treatment in the world and the worst.

PS. I haven't given an opinion. I've stated facts.

growstuff

I don't really understand what you mean Norah.

An insurance scheme wouldn't be that different from people paying taxes and NI. The only difference would be that different groups would pay different amounts.

Germany has an insurance model. People pay a set amount of their income, including pensioners. There are some exclusions, such as those who are too disabled to work and children. Unlike NI, it's not capped, so people on high incomes pay much more.

However, the method of funding itself doesn't result in better outcomes. Better outcomes are achieved because Germans spend considerably more per capita on healthcare than in the UK. Even Germany has a private top-up scheme for people who aren't satisfied with the service offered by social insurance.

Incidentally, the German model means that more is spent on admin, collecting the contributions, checking people have paid and reimbursing doctors and hospitals, etc.

Precisely what I mean. Thank you.

Germany and US (on over 65 medicare) pay the schemes by income. Fine, same as taxes. And in Germany they spend more to get more. Same with the US system of medicare (for over 65s and some disabled etc).

I can't see a thing wrong with any of that. Yes, I understand how it works, yes I think it's a good idea. Your opinion is no more valid than mine.