How to "save" the NHS

Very funny that!

My information is entirely the opposite view is expressed by Americans to the one you write here.

The people I know in the USA point to the NHS with envy when they look at healthcare. And some of those views are recent ones.

In the USA, healthcare is expensive and beyond the means of many who have to rely on charitable sources for a very basic level.

Decent healthcare is mainly affordable to more wealthy people and those who can afford expensive monthly insurance premiums.

Many healthcare insurance schemes also have limits attached to them where once the limit is reached, you have to fork out a fortune for treatment which in many cases might be lifesaving.

For millions of Americans, illness means incurring crippling debt that can take many years to pay off if ever.

Healthcare includes the life preserving medicine that many people have to take on a daily basis. It’s not unknown for pharmaceutical companies to suddenly hike their prices increasing individual medicinal costs from several dollars a month to hundreds of dollars or even thousands of dollars a month.

Millions of Americans dream of a healthcare system like our NHS!

Half truths mixed in with nonsense, I’m afraid.

It is true that millions of Americans dream of a healthcare system like the NHS, yes. However, hundreds of millions of Americans wouldn’t have a healthcare system like the NHS under any circumstances.

Your statement of “decent healthcare mainly affordable to more wealthy people and those who can afford expensive monthly insurance premiums“ is nonsense. The percentage of the US populations that does not have health insurance is 8.5%. 91.5% do have health insurance.

Military veterans can use the VA health system. It is very much like the NHS, and damned-near universally derided. If you have health insurance and have VA eligibility, the VA is a last resort.

The healthcare regime in the US (in terms of the actual care) is absolutely outstanding, in my experience. FAR superior to the NHS.

I have two criticisms of the US regime - 1) better provision could be made for the 8.5%, even making the VA available to them would be a good start. 2) the billing is out of control. If I go to the doctor, it should cost me $20 for an office visit. But it costs $25, and I get a bill every fvcking time for $5 once the claim is processed. When I collapsed and went to the ER, I got about 7 bills, because the people who work in the hospitals are sometimes direct employees, and sometimes indirect contractors. This would be like an agency nurse working in an NHS facility, and the patient being billed a small amount. There’s no way for the hospital to collate all the claims, and present the patient with one bill. The overall bill was small, $300 or so, but considering they saved my life, cheap as chips. I had all manner of tests and imaging done. But then used a ream of paper to tidy up the billing. Not a big deal, but still annoying.

The NHS is ridiculously expensive for the service it provides. Or actually, fails to, in many cases. 9% of salary in NI payments, and this is in some way superior? Hahaha. Fcuk that for a game of soldiers, thank you very much.
 



They already just got that. And nearly half the NHS budget goes on pay already - 1.3 million employees remember. What do they all do?
From my experience 5% nurse, 5% operate, 1% cook and clean and the rest manage the first 11%!
 
Half truths mixed in with nonsense, I’m afraid.

It is true that millions of Americans dream of a healthcare system like the NHS, yes. However, hundreds of millions of Americans wouldn’t have a healthcare system like the NHS under any circumstances.

Your statement of “decent healthcare mainly affordable to more wealthy people and those who can afford expensive monthly insurance premiums“ is nonsense. The percentage of the US populations that does not have health insurance is 8.5%. 91.5% do have health insurance.

Military veterans can use the VA health system. It is very much like the NHS, and damned-near universally derided. If you have health insurance and have VA eligibility, the VA is a last resort.

The healthcare regime in the US (in terms of the actual care) is absolutely outstanding, in my experience. FAR superior to the NHS.

I have two criticisms of the US regime - 1) better provision could be made for the 8.5%, even making the VA available to them would be a good start. 2) the billing is out of control. If I go to the doctor, it should cost me $20 for an office visit. But it costs $25, and I get a bill every fvcking time for $5 once the claim is processed. When I collapsed and went to the ER, I got about 7 bills, because the people who work in the hospitals are sometimes direct employees, and sometimes indirect contractors. This would be like an agency nurse working in an NHS facility, and the patient being billed a small amount. There’s no way for the hospital to collate all the claims, and present the patient with one bill. The overall bill was small, $300 or so, but considering they saved my life, cheap as chips. I had all manner of tests and imaging done. But then used a ream of paper to tidy up the billing. Not a big deal, but still annoying.

The NHS is ridiculously expensive for the service it provides. Or actually, fails to, in many cases. 9% of salary in NI payments, and this is in some way superior? Hahaha. Fcuk that for a game of soldiers, thank you very much.

Well the NHS would have saved your life and you wouldn’t have got a bill because the costs come out of the taxes you pay. The NHS would also have saved the lives of the 8.5% of people who can’t afford healthcare insurance.

Bear in mind that they also do actually pay taxes both directly if they are employed but also indirectly through indirect taxes.

Just out of interest, how many milllions of people is 8.5% of the population?

The NHS isn’t perfect. There’s always room for improvement but it is the envy of most of those around the world who don’t have access to healthcare services both for routine treatment and emergency lifesaving treatment.

Don’t confuse the deliberate underfunding of some parts of the NHS and the deliberate poor service levels provided to the public in some instances by the NHS which are deliberately put in place by a regime and it‘s supporters that promotes private healthcare as a better alternative because they have associates who want to turn it into a multi trillion pound cash cow similar to the American model.
 
The NHS is ridiculously expensive for the service it provides. Or actually, fails to, in many cases. 9% of salary in NI payments, and this is in some way superior? Hahaha. Fcuk that for a game of soldiers, thank you very much.

The NHS seems to genuinely believe itself to be "the envy of the world" but to the rest of the developed world at least, it's a shining example of how NOT to run a healthcare system. Foreign co-workers and friends, if they need anything more complicated than a signature for a prescription for themselves or their kids, will return to their homelands for it. And I don't just mean French and Germans, but Romanians and Egyptians too. It will NEVER get better while it clings to this belief, unfortunately it is dragging all of us down with it.

Even the Guardian gives its staff private healthcare...
 
The NHS seems to genuinely believe itself to be "the envy of the world" but to the rest of the developed world at least, it's a shining example of how NOT to run a healthcare system. Foreign co-workers and friends, if they need anything more complicated than a signature for a prescription for themselves or their kids, will return to their homelands for it. And I don't just mean French and Germans, but Romanians and Egyptians too. It will NEVER get better while it clings to this belief, unfortunately it is dragging all of us down with it.

Even the Guardian gives its staff private healthcare...

Private healthcare does mean a faster service. That’s because the NHS is financed at a level that means we all have to wait. That’s not the fault of the NHS. That’s the fault of the government who decide the level of funding and the level of corresponding service.

The NHS could provide a faster service if it was properly funded.

The joke is that private healthcare is largely carried out using highly trained medical staff who mostly work in the NHS and private medical care largely relies on NHS facilities including the equipment used in complex procedures.
 
Well the NHS would have saved your life and you wouldn’t have got a bill because the costs come out of the taxes you pay. The NHS would also have saved the lives of the 8.5% of people who can’t afford healthcare insurance.

Bear in mind that they also do actually pay taxes both directly if they are employed but also indirectly through indirect taxes.

Just out of interest, how many milllions of people is 8.5% of the population?

The NHS isn’t perfect. There’s always room for improvement but it is the envy of most of those around the world who don’t have access to healthcare services both for routine treatment and emergency lifesaving treatment.

Don’t confuse the deliberate underfunding of some parts of the NHS and the deliberate poor service levels provided to the public in some instances by the NHS which are deliberately put in place by a regime and it‘s supporters that promotes private healthcare as a better alternative because they have associates who want to turn it into a multi trillion pound cash cow similar to the American model.

I just don’t agree with you that it is the envy of the world; see @Bob65’s post below.

As for not getting a bill, that’s because you’ve already paid for the NHS with your NI contributions. And done so through the nose.

The term “socialized medicine” is every bit as toxic to most Americans as “drink driving”. Something to be avoided at all costs. But as I say, the paperwork and lack of universal coverage needs to be fixed.
 

FORMER_FYRDMAN

LE
Book Reviewer
Well the NHS would have saved your life and you wouldn’t have got a bill because the costs come out of the taxes you pay. The NHS would also have saved the lives of the 8.5% of people who can’t afford healthcare insurance.

Bear in mind that they also do actually pay taxes both directly if they are employed but also indirectly through indirect taxes.

Just out of interest, how many milllions of people is 8.5% of the population?

The NHS isn’t perfect. There’s always room for improvement but it is the envy of most of those around the world who don’t have access to healthcare services both for routine treatment and emergency lifesaving treatment.

Don’t confuse the deliberate underfunding of some parts of the NHS and the deliberate poor service levels provided to the public in some instances by the NHS which are deliberately put in place by a regime and it‘s supporters that promotes private healthcare as a better alternative because they have associates who want to turn it into a multi trillion pound cash cow similar to the American model.

Your last paragraph is simply paranoid rubbish - do you have any evidence whatsoever that a Tory health minister has starved an area of funding to let mates in the private sector access it? Javid's been in post since June, do you believe he did a ring round on his appointment to see which areas to starve? Mental health provision for teenagers is utter cr@p but I can't see a stampede of private interests rushing to fill the vacuum.

It's Labour Party fantasy, just like your reflexive assumption that the only alternative to the NHS has to be the US system.
 
Private healthcare does mean a faster service. That’s because the NHS is financed at a level that means we all have to wait. That’s not the fault of the NHS. That’s the fault of the government who decide the level of funding and the level of corresponding service.

The NHS could provide a faster service if it was properly funded.

The joke is that private healthcare is largely carried out using highly trained medical staff who mostly work in the NHS and private medical care largely relies on NHS facilities including the equipment used in complex procedures.
Doesn't the NHS charge for use of it's equipment and facilities ?
 
I believe a lot of the service quality depends on the particular Trust. Wifey and I have been treated at Bath RUH. Staff are courteous, professional and very funny. The hospital is clean, food (patient and cafeteria ) is good. and there is a calm and professional atmosphere. When you are given a tablet the nurse watches you take it. When you are given food, packets are opend with scissors to make it easy. Generally, if you have to go, it's a good place to go.

Our two mothers, Wifey and late father in law have been treated at Swindon Great Western Hospital. Recently they introduced an electronic prescription system. In August mum's consultant told me he keeps a pad of paper prescriptions locked in a drawer and uses those because the electronic system doesn't work. I took mother in law there this week. Her doctor asked me to return tomorrow for the cancer cream prescription because the electronic prescription system wouldn't allow her to log on. The nurse told me the management have confiscated all paper prescription pads because the staff "MUST" use the new and expensive electronic system despite the chaos. I have seen nurses drop pills on the floor, pick them up and put them back in the pots on the patients trays. I have seen tablets left on patients trays and the patients put the tablets in their locker. Prepacked sandwiches given to elderly infirm patients. after an hour the sandwiches are taken away unopened with the nurse commenting about the patient not being hungry. No thought that the patients are too infirm to open the packets without scissors or their own teeth. Wifey and I have had to open packets and feed patients. when we've visited our mothers. One of the best: late father in law in Swindon for cancer treatment fell out of bed because the safety bars were left down and he broke a hip. Took a week to operate! Wifey visited and poor old guy said he was lovely and warm for the first time in ages. Nurse came to take blood pressure with a big wheeled monitor which gave a zero reading on blood but a heart rate. Nurse muttered about faulty kit and got another monitor which also gave a zero reading and a heart rate. Nurse went to get a third monitor. Father in law said he felt really warm. Wifey took his hand and saw blood. Pulled back the covers. The wound from his hip op was pissing blood in to the bed. No wonder there was no blood pressure. Crash team called. Father in law later passed away. The enquiry into his fall out of bed, loss of blood and malnutrition was a travesty.

Like all places there are good staff and bad staff, it's just that there seems to be a poor culture in some places.
 

endure

GCM
Doesn't the NHS charge for use of it's equipment and facilities ?
Yes it does. I had a little private op done by one of the local NHS hospital's surgeons.
He used an operating theatre at the NHS hospital.
I turned up an hour before he started his NHS list and was out in 40 minutes.
I got a bill from him and a separate one from the hospital for the use of their facilities and the dressings he used.
 
Here in the US if someone doesn't have health insurance the State usually picks up the Bill. Think of the single mother who say has four kids by different long gone fathers. The single mother is usually already being supported by the State financially and a healthcare bill is just one more bill the State will pay.

The last hospital herself worked at was a charity hospital, no insurance, no problem, the State gets billed.
 

skeetstar

War Hero
An acquaintance was a senior civil servant in the cabinet office. The prime minister asked him to do report on the largest problems faced by the NHS. His report said that the biggest problem it faced was productivity.. too many people delivering too little. Blair threw the report in the bin.
 
How to save the NHS? Zyklon B on enforced prescription.
 

ancienturion

LE
Book Reviewer
The NHS could provide a faster service if it was properly funded.

The NHS could provide a faster service if it was properly managed - not funded. Where funding is concerned so called managers will ensure that the "Civil Service" game is played and there would be no real improvement because the wrong sort of people are the upper echelon making decisions.
I have experienced the incompetence of those who like to call themselves managers within the NHS which is not really affected by which political party likes to pretend it is governing.
It is also feasible to recoup by presenting bills to the "doorstep" type of medical migrant.
 
It's Labour Party fantasy, just like your reflexive assumption that the only alternative to the NHS has to be the US system.
Anyone comparing the NHS to the US healthcare system in a manner to solicit fear and foreboding should be six packed, kerb stomped and kicked in the kidneys until they are pissing blood. Then using a private air ambulance flown to the most expensive clinic in Beverley Hills bearing a sign on their chest saying ‘all anaesthesiologists* are @@@@’ as an example to the rest of them.

There are dozens of health care systems throughout the world that perform a f*** ton better than the NHS - AND cost less per person.

These comparisons are usually done by the politically motivated and repeated by the hard of thinking.

* I chose that branch of medicine because that way the treatment would hurt more
 
Very funny that!

My information is entirely the opposite view is expressed by Americans to the one you write here.

The people I know in the USA point to the NHS with envy when they look at healthcare. And some of those views are recent ones.

In the USA, healthcare is expensive and beyond the means of many who have to rely on charitable sources for a very basic level.

Decent healthcare is mainly affordable to more wealthy people and those who can afford expensive monthly insurance premiums.

Many healthcare insurance schemes also have limits attached to them where once the limit is reached, you have to fork out a fortune for treatment which in many cases might be lifesaving.

For millions of Americans, illness means incurring crippling debt that can take many years to pay off if ever.

Healthcare includes the life preserving medicine that many people have to take on a daily basis. It’s not unknown for pharmaceutical companies to suddenly hike their prices increasing individual medicinal costs from several dollars a month to hundreds of dollars or even thousands of dollars a month.

Millions of Americans dream of a healthcare system like our NHS!


My bold agreed BUT, in the days gone past you could turn up at a surgery and see a doc if you were prepared to wait a bit AND if you were really ill they would come to your house. The last time a doc came to my house to see me was about 16 years ago and you have to call an ambulance to get you to A&E now and wait with dozens to see one if you are lucky!
due to the pandemic there are 4.7 MILLION people waiting for routine operations, nearly 400,000 have waited for over 12 months.
NHS waiting list hits 14 year record high of 4.7 million people

The good thing still is that we don't have to pay!! But it pisses me off when idiots go for elective surgery like breast enlargements etc. they should pay for that themselves. Also the very large number of foreigners, most of whom have never paid tax or NI here getting all treatment free because the NHS management wont check if they are entitled.
IMHO ALL inncomers should be forced to have compulsoryt health insurance before they are allowed in and be entitled to free NHS services AFTER they have paid tax & NI for 3-5 years. That would bring in £billions to the NHS.
 
My bold agreed BUT, in the days gone past you could turn up at a surgery and see a doc if you were prepared to wait a bit AND if you were really ill they would come to your house. The last time a doc came to my house to see me was about 16 years ago and you have to call an ambulance to get you to A&E now and wait with dozens to see one if you are lucky!
due to the pandemic there are 4.7 MILLION people waiting for routine operations, nearly 400,000 have waited for over 12 months.
NHS waiting list hits 14 year record high of 4.7 million people

The good thing still is that we don't have to pay!! But it pisses me off when idiots go for elective surgery like breast enlargements etc. they should pay for that themselves. Also the very large number of foreigners, most of whom have never paid tax or NI here getting all treatment free because the NHS management wont check if they are entitled.
IMHO ALL inncomers should be forced to have compulsoryt health insurance before they are allowed in and be entitled to free NHS services AFTER they have paid tax & NI for 3-5 years. That would bring in £billions to the NHS.

You DO pay for the NHS, just not at the point of delivery. Between employee and employer NI contributions, it’s ~25% of salary. Granted, pensioners and the young will not pay that, but the majority of the workforce and their employers will be paying 25% of salary in NI contributions. And still the system faces challenges.

Other than universal coverage, I just fail to see why in the modern era, that is something to be envious of. In 1948, I would agree; it probably was the envy of the world. 1948 was 73 years ago though, and while the universal coverage is there, and some parts of it are excellent, saving lives every day, other parts of it are not fit for purpose, and therefore the system as a whole is compromised. The teaching/training of medical staff has been hollowed out for decades. The ambulance service apparently needs the military to help, the waiting times are ludicrous at A&E when you eventually get there. About 8% of the population waiting for procedures?

Yet there are times when individual departments in individual hospitals and primary care trusts provide sterling service, saving lives, enriching the quality of life of those with chronic conditions etc. These are rightly held up as being triumphs of the system. I just wish those triumphs were representative of the system as a whole.
 

endure

GCM
My bold agreed BUT, in the days gone past you could turn up at a surgery and see a doc if you were prepared to wait a bit AND if you were really ill they would come to your house. The last time a doc came to my house to see me was about 16 years ago and you have to call an ambulance to get you to A&E now and wait with dozens to see one if you are lucky!
due to the pandemic there are 4.7 MILLION people waiting for routine operations, nearly 400,000 have waited for over 12 months.
NHS waiting list hits 14 year record high of 4.7 million people

The good thing still is that we don't have to pay!! But it pisses me off when idiots go for elective surgery like breast enlargements etc. they should pay for that themselves. Also the very large number of foreigners, most of whom have never paid tax or NI here getting all treatment free because the NHS management wont check if they are entitled.
IMHO ALL inncomers should be forced to have compulsoryt health insurance before they are allowed in and be entitled to free NHS services AFTER they have paid tax & NI for 3-5 years. That would bring in £billions to the NHS.
Visa/immigration applicants have to pay a health surcharge when they apply for a visa of between £450 and £700 a year.
 
You DO pay for the NHS, just not at the point of delivery. Between employee and employer NI contributions, it’s ~25% of salary. Granted, pensioners and the young will not pay that, but the majority of the workforce and their employers will be paying 25% of salary in NI contributions. And still the system faces challenges.

Other than universal coverage, I just fail to see why in the modern era, that is something to be envious of. In 1948, I would agree; it probably was the envy of the world. 1948 was 73 years ago though, and while the universal coverage is there, and some parts of it are excellent, saving lives every day, other parts of it are not fit for purpose, and therefore the system as a whole is compromised. The teaching/training of medical staff has been hollowed out for decades. The ambulance service apparently needs the military to help, the waiting times are ludicrous at A&E when you eventually get there. About 8% of the population waiting for procedures?

Yet there are times when individual departments in individual hospitals and primary care trusts provide sterling service, saving lives, enriching the quality of life of those with chronic conditions etc. These are rightly held up as being triumphs of the system. I just wish those triumphs were representative of the system as a whole.

You criticise waiting times and the often poor service provided by the NHS. I absolutely agree with you that the service can be poor.

You are also absolutely right that the NHS isn’t a free service. Everybody in the UK pays for it. Even those not working still pay indirect taxes which fund the NHS as well as direct taxation does.

The problem with the NHS though isn’t that it can only provide a sometimes mediocre service. The problem is what the government want it to provide.

The government collects the tax and the government decides what it wants the NHS to do and it also decides what level of service it wants the NHS to provide.

We can say for the taxes we pay, we should be getting first class medical care as needed with no delay. If the government doesn’t fund that level of care though, the NHS can’t provide the resources to function at that standard of service.

So in terms of level of service, it’s not the NHS that is letting the public down. It‘s the government that’s not funding the proper level of service that’s letting the public down.

There’s also the politics. This government has many supporters both in the government itself and among it’s backbenchers in Parliament that would like to abolish the NHS and see a health insurance scheme funded service replace the NHS.

The only reason that hasn’t happened is because it would be a huge vote loser. The Conservative party opposed the formation of the NHS in the postwar years and it’s support over the years since then has been lukewarm because it would prefer to turn UK healthcare into a free for all market to create opportunities for making more money.

It suits the Conservatives to starve the NHS of the funding it would need to provide instant on demand healthcare at the drop of a hat because that would disable their own argument that the private sector can do a better job.

In a nutshell, the British public pay for something we aren’t actually getting because of the politics of members of the government and their supporters in Parliament. They just will never admit that it’s their policy to anybody other than themselves.
 
Last edited:

endure

GCM
You DO pay for the NHS, just not at the point of delivery. Between employee and employer NI contributions, it’s ~25% of salary. Granted, pensioners and the young will not pay that, but the majority of the workforce and their employers will be paying 25% of salary in NI contributions. And still the system faces challenges.

Other than universal coverage, I just fail to see why in the modern era, that is something to be envious of. In 1948, I would agree; it probably was the envy of the world. 1948 was 73 years ago though, and while the universal coverage is there, and some parts of it are excellent, saving lives every day, other parts of it are not fit for purpose, and therefore the system as a whole is compromised. The teaching/training of medical staff has been hollowed out for decades. The ambulance service apparently needs the military to help, the waiting times are ludicrous at A&E when you eventually get there. About 8% of the population waiting for procedures?

Yet there are times when individual departments in individual hospitals and primary care trusts provide sterling service, saving lives, enriching the quality of life of those with chronic conditions etc. These are rightly held up as being triumphs of the system. I just wish those triumphs were representative of the system as a whole.
How do people with poor/no health insurance and chronic illnesses that require regular medication manage?
 

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