Funding the NHS?

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

Holly, you need to shop your brother.

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.

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.

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.

durhamjen, I am sure that when the NHS was set up no-one foresaw the huge leaps in medical treatment nor the 'extra' time people would be using the NHS because of those advances.

It is just impossible for the NHS to continue as it is - it cannot be all thing to everybody and it is top heavy. There was a great article by a surgeon in the DM the other day. I will try and find the link.

DH, with over 45 years experience (exclusively in the NHS), is 'line managed' by a (extremely!) young woman who talks to him in terms of 'units of activity' but seems confused if he talks in terms of old and sick patients requiring prompt treatment. There is no hope if the 'managers' behave like that.

Holly my Bil and his exwife used to come to the UK in the summer for a couple of months to visit family and have dental checks and treatments, eyetests and, on one occasion, a new hip. Thankfully they stopped a few years ago but it made me very uncomfortable. It is a difficult position to be in.

It's so frustrating isn't it kitty - although I'd have had no qualms about shopping my brother! I am a firm believer that if you don't contribute then don't try to take anything out. During the argument on the telephone (he was moaning about the cost of healthcare in Australia) I said 'well if you feel so strongly, move back to the UK' and he replied 'I wish I could but my standard of living would fall too much'

Not knowing much about NHS financing, I checked the NHS statistics site, which is very illuminating. A forecast overspend of £2bn sounds vast, but is indeed only about 2% of budgeted expenditure at the moment, so no room for complacency, but no need for panic either. Common sense suggests that expenditure and waste can, should and must be reduced as far as possible and that should be the duty of those in authority now without further ado.

As regards the future, there is no doubt that increasing longevity and weight-related problems will continue to put up health costs. So I would shout at the governments, indeed all governments, why are you letting the food and drink industries stuff our foods with many of the wrong things and encourage us all to consume them with little restraint? Self-regulation is a farce, so make those industries do what they should, and put an immediate higher rate of tax on all the bad things, as has already been done with tobacco. I'm sure that by doing so the 2% overspend would be substantially reduced.

Yes, papaoscar, that was the link I put at the top of this page. The gap will be £2billion next year, but that's the amount the government took out of the NHS last year, and it's also the amount that health tourism takes out annually. So we'd be £2billion pounds better off at the next election if the government put it back, and charged health tourists properly.
Maybe that's what they are planning to do between now and next May. It's a bribe! Me cynical?

^ as has already been done with tobacco^

I do wonder if that is part of the problem. I remember, around 12 years or so ago, hearing the figures regarding tobacco revenue and costs of treatment (at that time) being something like: £13billion raised in revenue, costs of treating smoking-related ailments £5billion; leaving an £8billion surplus. With so many people giving up smoking, that must have had an effect on revenue.

Holly, nearly 40 years ago, I took my son to a GP. After he had been sorted out, the GP said, "And what about you?"
I said I was fine so he told me to stand in front of his mirror and swallow. There was a lump in my neck. He took blood samples and the next week I went to hospital for a scan. In those days they could not tell if it was cancerous or not, so took it out to be safe. It wasn't, but I have been on thyroxine ever since.
Similar story; NHS worked for me and still does. In those days I would not have been able to afford to pay.

The Government has no plans to introduce a tax on sugar and foods with a high sugar content.
www.telegraph.co.uk/health/healthnews/10915417/No-sugar-tax-says-Jeremy-Hunt.html

However, that probably means they will introduce it next month

Kitty, I do not believe that those who set up the NHS were as shortsighted as you think. After all, only five years after it had been set up the link between smoking and lung cancer had been established, so they must have been working on that in 1948.
Hip transplants were done in the early 60s, so they must have been researching those in the fifties.

Depends how many of their backers want it, Jane. Macdonalds and Coca-cola advise them on food policy!

Jen I can't believe they could have foreseen all the changes that have come along. They were not far sighted enough to see that my parent's next door neighbours would trot off to the GP, as soon as the NHS started, for a prescription when they ran out of aspirin or cottonwool.

Something has to change. Maybe a system like papaoscar suggests would work but there would be an awful lot of 'linemanagers' made redundant in that system.

My husband used to get cottonwool on prescription when I met him. He was a diabetic and had injections every day. He was also given industrial meths, and I remember once being asked, by a chemist, what does he do, drink it? He used it as a swab and to store his syringes in, because surgical spirit brought him out in a rash.
It is completely possible to have cotton wool on prescription legitimately.
The NHS soon realised that problem and introduced charges for prescription in the fifties, then got rid of them after three years as it cost more to police.
I imagine those who set up the NHS never saw prescriptions costing as much as they do. However. I do not suppose they saw house prices and wages and bonuses being as high as they are, so that's a spurious argument.

I have just been reading an article on www.taxresearch.org uk about the tax gap.
The total tax gap according to government figures in 2011-2 was £35 billion. Avoidance of NIC, income tax and capital gains tax is £2 billion, enough to pay for the gap in the NHS. The amount of VAT avoided for tobacco and alcohol is also £2 billion. In fact the overall VAT tax gap is £11.4 billion. If people did not buy on the black market and paid their taxes, there would be no problem with affording the NHS.

https://www.gov.uk/government/publications/measuring-tax-gaps

Government figures about the tax gap, for those who want to know, and I know there are some on here who would.

NHS worked for me and still does

Then you are very fortunate jen - it didn't work well for me but I have to say, it is more a refelction on the standards here, maybe the UK is better (although I do have a couple of scare stories with them - maybe they just don't like me )

The thing is that it's not working for lots of people in its present form.

I thought the Nazis made the link with smoking and lung cancer?

Unless people are very, very poor - cotton wool and asprin/paracetemol shouldn't be given on a free prescription.

Then there is the abuse of other services (not just GP) - my mother is quite capable of cutting her own toe nails but she has them done at the local NHS clinic because she 'prefers to have the cut for her'.

Hollydaze the link between lung cancer and smoking was established as a result of the British Doctors Study. Probably the most famous, most conclusive and influential epidemiology study ever. Here is some information about it: en.wikipedia.org/wiki/British_Doctors_Study

It reached its conclusions very quickly because the numbers were high in the sample group and so many of them were very heavy smokers in the early 1950s.

How do they reach the figures on health tourism. I would have thought by its very nature it was guesswork. I am fond of the Radio 4 programme More or Less that looks into such figures that are published and repeated by the media.

Hollydaze is right about the Nazis and the lung cancer/smoking link. But their methodology was so appalling that the medical research done during the Nazi era couldn't be accepted at face value. Nor could it be replicated.

Many thanks Lilygran - I was pretty sure it was the Nazis.

ah, interesting. I was thinking about reputable science with academic publications at the end of it.

Holly, I came out of hospital last year with 500 paracetamol. I had had an aortic dissection and was in a lot of pain. I cannot take ibuprofen, tramadol or codeine, which were the other painkillers they tried me on.
Should I have refused them? I have them on repeat prescription if I need them.
Just read today that Calderdale Hospital is going to reduce the number of NHS beds to 88, and have 300 available to private patients. I do not think that is acceptable.

www.nhs.uk/NHSEngland/thenhs/nhshistory/Pages/the-nhs%20history.aspx

www.taxresearch.org.uk/Blog/2014/06/22/the-nhs-worked-now-its-biggest-threat-is-reform/

Very good article, or at least, I think so.