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Funding the NHS?

(230 Posts)
JessM Mon 31-Mar-14 13:40:02

Lord Warner has written a report that points out the if we want to have an effective NHS we are going to need to get more money for it.
He suggests various things including a £10 a month for using it and levies on gambling, alcohol, tobacco or sugar.
With some drastic cuts in the pipeline under "austerity" - how do you think the NHS can be funded in the face of increasing demand and increasing costs of the latest treatments.

HollyDaze Sat 21-Jun-14 12:38:24

Holly, you need to shop your brother.

As this happened many years ago, there would be little point. Had I known at the time, I most certainly would have done.

HollyDaze Sat 21-Jun-14 12:37:30

Holly, there are two "if"s in your quotation. You said "If you could afford it." That assumes you think I cannot because I would not go private under any circumstances. I stick to my principles. That's why I fight for an NHS still free to everyone at the point of use. When it was set up, I assume they foresaw advances in medication and technology that would benefit everyone, not just those who could afford it

No durhamjen - it was said more as a generic 'you' but that would, of course, also include you and the term itself should read 'finances permitting' but to be honest, however I would have worded it, it would run the risk of being misread.

I'm not sure why you assumed I would be that judgemental as I don't think I have given you cause to think that way.

I support your view that the NHS should remain and remain free at the point of service - I just don't agree with you that the option of private treatment is a negative thing. I had a lump appear at the front of my throat and six months after seeing my GP, our hospital had carried out two tests on the lump (and one they botched so it was useless) - the lump was growing visibly and they had no idea what they were dealing with so, I went privately and was under the knife three or four weeks later - it turned out to be a malignant thyroid tumour. My principles are: if one route isn't working, try another.

janeainsworth Sat 21-Jun-14 12:36:49

Grannytwice There is a blindingly obvious bright idea, to me anyway, and that is to strip out the layers of management with their endless meetings, meetings about meetings, away days to think up more ideas for more meetings, re-organisations etc.
I was talking to someone last night who used to be an NHS hospital manager and who left in frustration. He was actually trained in hospital management - now they prefer accountants.
He said last night that in the NHS there is now the equivalent of one manager for every bed.
I don't think he was joking.

durhamjen Sat 21-Jun-14 12:24:57

nhap.org/mind-gap-2bn-nhs-spending-gap-can-filled/

Holly, you need to shop your brother.

durhamjen Sat 21-Jun-14 12:21:40

Holly, there are two "if"s in your quotation. You said "If you could afford it." That assumes you think I cannot because I would not go private under any circumstances. I stick to my principles. That's why I fight for an NHS still free to everyone at the point of use. When it was set up, I assume they foresaw advances in medication and technology that would benefit everyone, not just those who could afford it.

HollyDaze Sat 21-Jun-14 12:18:42

People often confuse reciprocal agreements with free health care

I am probably a guilty party to that - all very confusing (to me anyway!)

HollyDaze Sat 21-Jun-14 12:17:05

I've just had a quick google Granny and the 'true' cost to the NHS of health tourism seems to be around £2billion per year (once figures enter the equation, I start to struggle - I claim ownership of the term 'numerically dyslexic'!) and then, of course, it's finding a reliable source; I opted for the BBC:

www.bbc.co.uk/news/uk-politics-24616801

It seems a fair bit could be recouped.

GrannyTwice Sat 21-Jun-14 12:16:33

So jane we're back to other bright ideas for the NHS. I don't think extending co-payments is really a goer, is it?

durhamjen Sat 21-Jun-14 12:14:42

nhap.us7.list-manage2.com/track/click?u=937c3e62bc24fa37708920cc9&id=ee65e433e5&e=716bee6853

I hope this is not the way some of you want the NHS to go.

JaneA some people just do not understand what the word taxes means.
This government said in the last election that it was not going to put up VAT, then it immediately did.

janeainsworth Sat 21-Jun-14 12:12:00

I think the received wisdom is that it isn't a big problem and the costs of setting up procedures and implementing them would be far more than any revenue received.

GrannyTwice Sat 21-Jun-14 12:10:59

Re reciprocal agreements - all it means is you get the same treatment as a resident so you almost certainly need insurance- as I do if I go to France. Fir example, to cover repatriation costs or anything else that a normal resident wouldn't get for free. People often confuse reciprocal agreements with free health care confused

HollyDaze Sat 21-Jun-14 12:08:59

GrannyTwice - had I known at the time he was visiting mum, I would have done! It came up in conversation with with my mother a few months after he'd gone back to Australia. My brother and I did speak about it (over the phone) and it ended up a terrible argument; it's something I feel very strongly about.

The link that was put up recently about the young girl needing just £10,000 for surgery that could change her life for the better being denied due to lack of funding, I can't help but think that if the NHS wasn't abused (by people like my brother) then others may not be put in the sad position that that young girl and her family are in.

GrannyTwice Sat 21-Jun-14 12:07:51

But seriously - Holly, you are right. The GPs surgery is the place to start. Am I right that GPs can ask for proof of residence and identity before registering a new patient? If you are being treated as a temporary resident, I don't think that happens. Some people though will access the NHS through A&E and then trusts are supposed to have procedures in place for those who should pay, obviously if someone has had an accident you treat first but if it's discovered you have a serious long term problem that doesn't require emergency treatment, then procedures should be followed. But I have no idea if the problem is so large it's worth dealing with and how much difference it would make to NHS finances overall

HollyDaze Sat 21-Jun-14 12:04:50

GrannyTwice - although there was a fair bit in the local media about the reciprocal agreement at the time the UK made it's intentions known, I haven't heard much about it since (I rarely travel to the UK so it's something I haven't kept up to date on) but we were advised to take out travel insurance when visiting the UK:

www.visitisleofman.com/attractions/viewnews.gov?page=lib/news/dhss/ministerwarnsoff.xml

but I don't know if UK residents were given the same advice or not.

GrannyTwice Sat 21-Jun-14 11:59:00

Relatives could shop them for starters grin

HollyDaze Sat 21-Jun-14 11:55:56

Holly - having a British passport is nothing to do with entitlement to the NHS - it's basically a residence test. However, it's well known that people like your brother come over, give a relatives address and cheat the system. They get away with it easily I dare say being white. I'd like to see the figures from those Trusts which are more proactive on checking peoples entitlement to NHS care- what it costs and what the yield is

My mistake, I thought just having the passport had been enough so, thank you for the info, it's appreciated.

I wonder if there is a way, with computer usage that each GP as, if there is something that can be checked to see whether or not someone actually is a resident of the UK before giving out prescriptions/treatments (I'm thinking of people like my brother and sister in law).

GrannyTwice Sat 21-Jun-14 11:48:08

Holly - the agreement with the IOM is reciprocal if a visitor but if an IOM resident is referred to the UK then the IOM pay ( as you said)

HollyDaze Sat 21-Jun-14 11:47:22

What on earth....

Wrong location I think Ariadne wink

HollyDaze Sat 21-Jun-14 11:44:27

^Well said, Jen, and restrained with ''Verging'.
After all Ana, you do have a record of Troll-ish postings, don't you dear? Z, Z, Z^

That's rather rude. The way I read Ana's post it was posted as a question to be answered once someone had made a statement. Or do you feel that only posts that reflect your own ideals and experience should be classed as non-'trollish'?

GrannyTwice Sat 21-Jun-14 11:42:25

There's no earmarked or hypothecated taxes ( although some think there should be) for paying for the NHS. The NHS is paid for primarily out of government revenues of which roughly 26% comes from income tax, 18% from NIC, 17% from VAT, 4% from fuel duty, 4% from council tax and just under 2% each from tobacco and alcohol duties. There are other bits and pieces of course. Holly - having a British passport is nothing to do with entitlement to the NHS - it's basically a residence test. However, it's well known that people like your brother come over, give a relatives address and cheat the system. They get away with it easily I dare say being white. I'd like to see the figures from those Trusts which are more proactive on checking peoples entitlement to NHS care- what it costs and what the yield is.

HollyDaze Sat 21-Jun-14 11:38:34

Private hospitals do not do lifesaving.

That is untrue. They may not have A&E departments but to say they don't save lives just isn't true - the fact that I am here conversing on this forum is down to the private sector (and also the NHS in earlier years).

HollyDaze Sat 21-Jun-14 11:35:05

durhamjen - I'm not sure what you've taken exception to in that particular post that you are referring to, I said:

Of course I'm prepared to pay what the ask if the circumstances demand it - are you telling me you wouldn't if you could afford it and your treatment, actually diagnosis, had taken 6 months with no diagnosis in sight? Of course you'd go private under those circumstances as would anyone if they could get the money.

Why do think I'm assuming anything about your financial circumstances? Don't put the wrong emphasis on the word 'if' (which is what I'm assuming you disliked about my post - the 'if' isn't questioning in that sense).

HollyDaze Sat 21-Jun-14 11:31:10

^ time-wasters and free-loaders, by applying a small front-end charge for basic medical services, with a corresponding reduction in NH charges on the employed^

I do think that is something that should be considered. Before my brother took his Australian citizenship (he'd lived there for about 25 years before taking it), he and his wife would visit the UK and 'stock up on treatments to take back' (their words, not mine) all paid for by the UK taxpayer for people who hadn't contributed one penny. As they both still held their British passports, they got what they asked for; so unfair.

HollyDaze Sat 21-Jun-14 11:25:09

^ I don't think that necessarily means that basic care is better across the board. Many of the current private providers only carry out certain "routine" procedures, rather than treat more complex/chronic conditions,^

In my experience, that isn't true - it will depend, I suppose, on which type of private hospital you go to. I have had cancer treatment privately (surgery and after treatment) in the UK and I wouldn't be able to fault them. Emergency doctors are on call just the same as in the NHS - my particular surgeon lived less than 5 minutes away.

I think there are a lot of myths surrounding private healthcare.

Lilygran Sat 21-Jun-14 11:20:12

Experigran the NI contributions don't cover the cost of the NHS let alone the other expenditure that comes under the NI list. I don't know if they ever did. The fact is that not only are we making more claims on the NHS but there is much more medical science can do for us. Many more procedures can be carried out every year, new drugs are developed every year and more conditions can be treated. And it is nearly all paid for out of taxes. As other posters have said, we need a national and informed debate on how we deal with it.