Funding the NHS?

I suspect that within the NHS a lot of the costs are related to the layers of management staff , their huge salaries and bonuses!

I keep mentioning that Jane she said with feeling!!

Interesting article here though. NHS is rated the best health service in the world.
www.theguardian.com/society/2014/jun/17/nhs-health

It did say this though:
"The only serious black mark against the NHS was its poor record on keeping people alive. On a composite "healthy lives" score, which includes deaths among infants and patients who would have survived had they received timely and effective healthcare, the UK came 10th"

The trouble with studies like this is that the results depend on what criteria are selected and how much weight and importance is given to each one in calculating the final position.
I would have thought infant mortality and patients who would have survived if their care had been timely were rather important indicators.

Quite! Great service, just doesn't do what it's supposed to do very well...

jane If you had to pay for your treatment in the US, presumably that means you didn't have medical insurance. I'd be very nervous to do that.

We did have insurance Eloethan, but the cheapest we could get was around £300 to cover DH and me for 3 months.
We could have claimed but decided not to, in case the premium was raised next time we go. We're planning to go to the US for 3-4 months at a time for the next 3-4 years, so it is quite an expense already.

Jane - are you sure your figures aren't mixing attendances and admissions at a and e? The average costs would be very different

I think it is time that the Nation had a major discussion as to what we want from the NHS and how we want to pay for it. This will almost certainly mean higher taxes and if people are not happy about that perhaps we should also be told what it would cost for private health care and what might be excluded given an individuals heath history age etc.
A referendum would be good

A very good and sensible idea, Whitewave, long overdue. We must not loose our NHS, especially as a result of the activities of slippery, devious politicians and others.

Perhaps we should start a nation wide petition?

Grannytwice My apologies.
That was the figure given to me by a PCT person several years ago, during negotiations over the provision of cover for patients attending A&E with toothache and who weren't registered with a dentist.

Having done some googling it would appear that the cost of assessment at A&E is around £90.

So about the same as in America, and not a great deal less as AAA implied.

Funding the NHS - was the original subject.
It is obvious that more finance is required and I think quite a few would agree that this should come from raised taxes. How about an NHS Lottery. I would think that more would contribute to this good cause than the causes benefitting from the National Lottery.
No reorganisation of the NHS appears to reduce costs. It has to be imperative that the many layers of management are reduced and that as many positions as possible should be filled by persons who understand clinical processes. Has anyone heard of 'LEAN'?. My son is a Lean Process Consultant and goes into large companies to clean out the unnecessaries and streamline the operation. This is what's needed.

Yes but I still think we need a major debate and subsequent referendum, this would then have the strength of a mandate by the Nation and would stop all the fiddling around by the government - at least for a while - that is if we choose to keep the NHS

Assuming (after our referendum) that we agree that the NHS should be kept, I suggest that the first thing to do is to get it out of the hands of politicians as regards day-to-day tinkering as soon as possible. I would set up a small but powerful Trust with wide powers, staffed by dedicated professionals, medical and administrative, charged with (a) taking over control of the whole NHS as is, and (b) setting up and completing a no-holds barred cost/benefit analysis of the whole thing within a year. Then (c), the Trust would recommend action to government and people, for their endorsement. That should all take no longer than two years, and leave the country with an independent, dedicated NHS with a proper remit, properly financed. Hard decisions would have to be taken, perhaps even the end of the 'free at the point of use' concept, and the rigidly controlled involvement of the private medical sector. What do you think?

papaoscar Wed 18-Jun-14 20:51:33
Assuming (after our referendum) that we agree that the NHS should be kept, ... get it out of the hands of politicians....Set up a small but powerful Trust with wide powers, staffed by dedicated professionals, medical and administrative,...
1)...Sounds suspiciously Socialist to me?
2)...The introduction of local 'Trusts', in a move towards Subsidiarity has fragmented the NHS [ Mr Blair's vision of an 'Internal Market' ] It will cost 'Lots' to put it back together - more redundancy pay-offs?
3)...How will the intervention of Big Pharma; Health Insurance S'Vogels; etc with oodles of cash to press for abolition be avoided?
4)...If the NHS is to be abolished, what then? ? The rape and pillage of the Russian economy by the oligarchs [Thieves and looters] will seem like naught compared to what will happen in England [NOT Scotland, Wales and parts of the island of Ireland.]
5)...Whichever way the referendum went, it's not binding on Parliament which would have to vote on the move - if the result ever made it to Westminster
6)...However, I agree that the NHS should be controlled centrally, with a Board and national ''Directors of..'' as you suggest - and you and I as joint CEO/Chair.

There already is a "Health Lottery", although its income is not for use towards services that are covered by existing NHS funding.

The Health Lottery's website states that "20p of every £1 goes directly to local health-related good causes." That doesn't sound an awful lot to me. Apparently the Health Lottery ELM Ltd operates as an external lottery manager to oversee the society lotteries. The ELM charges a management fee of 0.5p in every pound, which provides the profit for the lottery owners. I think the key word here is "profit".

There is an increasing tendency to try and fund various services through national or local lotteries. There are now hundreds of lottery schemes of different sizes and for different causes, and it must be difficult to oversee the way they are being run. I think it's a bad idea to look to lotteries playing any part at all in funding the NHS.

An international panel of respected experts has recently rated our NHS as the world's best healthcare system in terms of quality, access, efficiency and cost. It would appear that the NHS "crisis" that we keep hearing about is mostly one dreamed up by private investors who can't wait to get their hands on the very lucrative rewards that healthcare services could bring them. They are, of course, only interested in "cherry picking" acute health care, which offers quick profits. The cost of care for people with long term, complex - and consequently more costly - needs will presumably continue to be picked up by the taxpayer.

Eloethan I don't think we can be complacent.
Cancer survival rates in Britain lag behind those of other developed countries:
www.nhs.uk/news/2010/12December/Pages/cancer-survival-rates-compared.aspx

"The researchers say their analysis shows increases in survival rates for these four cancers, but also persistent differences between countries. Overall, the largest gains in survival were recorded for bowel cancer and the smallest for lung and ovarian cancer.
They say that the quality of cancer registrations in the different countries is high and that poor quality data is unlikely to be the explanation for the lower survival rates found in the UK. They suggest that the differences could be due to treatment delays and later diagnosis, especially in older and less affluent groups. They say that large variations in diagnostic and surgical practice might also contribute, in particular in breast cancer treatment, especially for women aged 65 and older."
This is the NHS's own report.

Another way in which the NHS could improve is in the treatment of its own employees. I think there is a lot of dissatisfaction, and staff who provide a good service to patients do so despite the system and not because of it.

Eloethan Thu 19-Jun-14 18:30:51
If I may mangle my metaphors in my fulsome praise of your posting :
You have bagged ''Two kites with one 'mail.''
AAA

From The Patients Association e-Newsletter :
In an exclusive interview with the Telegraph, the new President of the Patients Association, Robert Francis QC: (The man behind the NHS Mid Staffs report) credits Jeremy Hunt, the Health Secretary, for a “refreshing change” of approach in standing up for patients, suggesting that his predecessors — from both parties — tended instead to act “as a spokesman for the NHS”. Mr Francis suggests that deference to medical professionals — “allowing them a God-like status” — and pride in the NHS have stifled political debate about its failings.
The P A is now running a survey of its members :
We would like to hear your views. Do you think we allow doctors to have a “God-like” status?
That's where many of the bottlenecks are in treatment for all manner of illnesses, including cancer.
AND
Challenge 'God', and you'll find yourself thrown out of the practice on 8 days notice. Try to record your consultation so that you can absorb it fully later. You'll be ordered to desist, or the consultation will be terminated - and so will your membership of that practice.
Some GPs have introduced a ''One appointment - One Ailment'' policy. (Shock & horror. Holistics, wherefore art thou?
All this, and more, is available as a Podcast from the BBC, and 'Listen Again'' if you're quick.
[I went to see my GP about a crippling pain in my back and leg - I was crying with it - I was sent away with a WWW address.
As Yosser said ''I can do that. Gizza job.]

Yes Jane it's difficult to accept the report Eloethan mentioned when we lag so far behind in diagnosis and treatment of illnesses such as cancer,

“Cancer survival rates in Britain still lag behind those in comparable Western countries,” reported The Daily Telegraph.
The Daily ToryGraph? ? THE biggest supporter of Socialist anything, outside the swivel eyed T Party faction of the USA's neo-Liberal, Reds-under-the-bed; Obama is a Muslim; Guns-R-Uz, Republicans.
''They would say that, wouldn't they.''
Personally, I'd stick with the balanced and even handed analysis from the ''Daily Wail'' -> Our cancer shame: Survival rates in UK are the worst among leading nations.
THAT explains why the NHS is flooded by ''Health Tourists''.
Makes yer fink, eh?

You've obviously thought that through papaoscar I agree that hard choices need to be made.

janeainsworth Thu 19-Jun-14 19:34:48......This is the NHS's own report.
Are you really, really sure of that, j a ?
If you read a little further, the article continues :
Where did the story come from?
The study was carried out by researchers from a number of institutions in the six countries that were the focus of the study. It was funded by Cancer Research UK and the Department of Health, England. The study was published in the peer-reviewed medical journal The Lancet.
This is the NHS's own report. Are you really, really sure of that?

AAA if you look at the link I provided you will see that it is from the NHS Choices website.

When I said NHS report, I meant the NHS report of the research project, ie the NHS's interpretation, as opposed to the Daily Telegraph's.

Got that?