Who hates the NHS

I could never hate the nhs! I’m forever grateful for everything they have done for both myself and my husband

As an American with piss poor health "insurance" I feel a need to weigh in on your health care system in general. You don't even know how good you've got it!! All of your healthcare is "covered" at no additional out of pocket cost. Heart surgery, childbirth, vaccinations, medical exams, bloodwork, chemotherapy, scans, x-rays, etc. You will never know the true value of the NHS until you have to declare bankruptcy and sell your home to afford heart surgery on your newborn daughter. You take for granted that you will be provided with medical care and you, rightfully, expect it to be competent and caring. That is something that only the politicians in the US can demand. The entire rest of the country lives with insanely unaffordable ($50,00 for routine childbirth in a hospital) and routinely incompetent care here. Do not wish away your NHS - seek to improve it, certainly, but never take for granted the care your receive as British citizens. That is something the majority of Americans have been brainwashed to believe they do not deserve and are smart enough to know they will never, ever have. Guard the NHS for the treasure it is, the gluttons who feed on US citizens are looking to privatize the NHS and turn it into a profit center for the obscenely wealthy just like they do here, while providing no actual health care. US healthcare is abysmal and unaffordable at best, don't wish away the good in the system you have.

I think we’ve been gaslighted into thinking the NHS is unworkable. I mean only 7 years ago Brexit was going to save the NHS. Two years ago everybody was clapping for it. How did we get to where we are now? Can you imagine going to A&E and being asked to show your medical insurance before they’ll treat you? Because that’s where it’s going. Yet again I feel that I’m living in a parallel universe.

Remember that we have an election coming up. The NHS will figure large in that, and all sides will be scrutinising the policies of the others to expose any oversights or budgetary concerns.

They know the public care about the NHS - from GP appointments to ambulance waiting times - and all will have policies to make it better.

A cynic might think that running it down to either save it at the last minute, or leave a change of government with huge debts might be deliberate. The chances of an insurance-based scheme being introduced, when that would alienate the demographic that is most likely to vote (and, apparently, most likely to vote Tory) seems unlikely in the extreme. More likely, in the unlikely event of a Tory win, is more privatisation by stealth.

I would agree that anything is better than the US system, but that is not a justification for us accepting a system that is lumbering, inefficient, and a black hole where no matter how much money you put in it, it is never enough.

Ours is not the only free public health system in the world and many European countries have such systems that are better run and more efficient than the NHS.

After 75 years, and immeasurable developments in medical practice, technology and drugs, it seems to me quite reasonable to have a major enquiry into how it works and how to fund it, this doesn't mean replacing the current system with a contributory one. I do not know why people keep going on about that. The system is free and that is not going to change, but perhaps, for example it would work better if it was broken down into smaller completely autonimous regions, or all training was centralise - or spread more widely, Perhaps GPs could work in smaller wider distributed surgeries with a central hub, or only have surgeries in cities.

I am floating ideas good and bad, to try and say, that after 75 years, a root and branch examination of the NHS is needed, to see if major changes are needed to make it work better.

Part of the problem as I see it is that the Nhs is used as a political football. I think a country is more than the sum of its hip replacements. It feels very wrong to have a health system where there’s no overall authority. By this I mean that consultants have in the past blocked an increase in medical places and this is now coming back to bite us. That same union - the Bma is now in direct conflict with the government over pay. Something needs to shift.

I second what grant says. I wish we had it here. Whilst what we have is not as costly as the USA we still have to pay a heck of a lot more than you do in the UK. I think twice before I even go to the doc, it costs $80 for 5 minutes and you only get about $37 back from Medicare. We have to pay for prescriptions,too.

I would agree that anything is better than the US system, but that is not a justification for us accepting a system that is lumbering, inefficient, and a black hole where no matter how much money you put in it, it is never enough.

Extraordinary that you are claiming that 'more money ...is never enough' when people are extolling health systems in Europe which have far more money put into them.

I'd also remind people that under the last Labour government, when funding was increased, the NHS was greatly improved. Not perfect, but greatly improved. It has regressed in the past 13 years because of 'austerity' and cuts in funding. No money 'poured into it' in the past 13 years.

How can anyone expect an organisation to run effectively when it is kept short of funding? Lots of complaints on this thread about interdepartmental lack of communication but how can it be improved without massive investment in an integrated IT system, or, at the least, more staff to undertake interdepartmental admin co-ordination?

And, talking of money 'poured into' a service, the Public Accounts Committee report published to day appears to be detailing some appalling wastage of health service/covid related £billions in the new UK Health Security Agency over the past 3 years. (though perhaps it deserves a separate thread)

committees.parliament.uk/committee/127/public-accounts-committee/news/196161/uk-health-security-agency-set-up-with-no-formal-governance-and-weak-financial-controls/

Those who ‘hate’ the NHS have the option of taking out private insurance.

One of the problems with the NHS, apart from shortages of staff, disorganisation etc., all well and truly debated here and elsewhere, is that there are very few people still living who remember a time before 1948. Basically, we have been spoilt.

I started work in the NHS in the early sixties and stayed until 2004. In those years the advances in medicine, allied professions, nursing, equipment and the skills and funding required to service them are enormous. I can remember when ambulances were little more than a lift to the hospital, with skilled first aiders, and are now mini A&E departments. I worked on a dialysis unit (albeit in the RAF) where there was one portable dialysis machine, used to transport from war zones, very few permanent machines and such a poor patient survival rate that staff had to take compulsory breaks from the stress. Joint replacements were non-existent, as were organ transplants. I could go on,

All this has to be paid for and the enabling staff given acceptable pay rates and conditions,

Basically, we have been spoilt.

That has to be one of the most extraordinary things I've read on this thread!

Decent healthcare for the whole population is 'spoiling' them?😱

My gast is well and truly flabbered...

MaizieD once you have recovered your gast, why not read and take on board the obviously well thought out comments posted by Tweedle24?

Tweedle24 Those who ‘hate’ the NHS have the option of taking out private insurance.

Agreed.

Not sure why that idea isn't accepted. We could pay as we do for NI.

ronib Thank you.

Norah Except that it would cost a good deal more than NI contributions and a lot of people would not benefit

ronib

MaizieD once you have recovered your gast, why not read and take on board the obviously well thought out comments posted by Tweedle24?

I really don't need your advice, ronib.

I want very much to know what this concept of being 'spoilt' implies.

Norah

Tweedle24 Those who ‘hate’ the NHS have the option of taking out private insurance.

Agreed.

Not sure why that idea isn't accepted. We could pay as we do for NI.

Isn't that what people have been doing for a long, long, time?

It's not exactly a novel idea.

It's a trifle difficult for those who can't afford private health insurance, though..

MaizieD

Norah

Tweedle24 Those who ‘hate’ the NHS have the option of taking out private insurance.

Agreed.

Not sure why that idea isn't accepted. We could pay as we do for NI.

Isn't that what people have been doing for a long, long, time?

It's not exactly a novel idea.

It's a trifle difficult for those who can't afford private health insurance, though..

Of course many pay for private insurance but I still contend it could be paid like NI, allowing money to go straight to healthcare. NHS appears broken, perhaps different funding would help.

How do you think 'different funding' would help? How would it make up for the shortfall in NHS staff, for the outdated and inefficient IT systems, for all the problems people have cited on this thread?

Other, more efficient models cited on this thread have more funding than does the NHS. That's what makes the difference.

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.

I agree that it needs a long hard look at its organisation and infrastructure, but that would be an extremely costly exercise which no government is prepared to do because it wouldn't be popular with the media...

MaizieD

How do you think 'different funding' would help? How would it make up for the shortfall in NHS staff, for the outdated and inefficient IT systems, for all the problems people have cited on this thread?

Other, more efficient models cited on this thread have more funding than does the NHS. That's what makes the difference.

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.

I agree that it needs a long hard look at its organisation and infrastructure, but that would be an extremely costly exercise which no government is prepared to do because it wouldn't be popular with the media...

I think it could work to fund differently, currently funds appear not to be designated to the NHS. If by an insurance scheme, funds were for health/NHS - those funds could be used to add staff, fix infrastructure and IT problems.

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.

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.

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.

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.

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

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.

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."