Non-political Save our NHS

Its not what we're used to and people generally dislike change. Reading the thread about healthcare in France compared to here certainly gave me pause for thought.

The NHS simply cannot survive in its present form - there are too many demands on it.

PS pleasant surprise to be asked to debate this in a non-politicslly arena

Politicslly ?

As I have said before we have accepted by stealth insurance/private health care arrangements for several parts of the NHS already - dentistry, opticians, audiology are well on the way- chiropody is virtually unavailable except to high risk patents. A significant number of people have had their procedures and operations undertaken in private hospitals under NHS contract. A number of procedures are not now available on the NHS at all possibly because they are not thought to be of significant clinical benefit and in some cases are not thought to be cost-effective. Anything though to be 'alternative' will not be funded. Hospices and Macmillan/Marie Curies services are only 50% funded by the NHS - the rest is made up from fund raising. It's already a mixed economy and will be extended.

Agree with both posters above.
The care in th UK now is not what it used to be. Quite shocking at times. Some sort of insurance based scheme may deliver better care.

x post with Teetime's.

As I see it there are multiple issues

An ageing population
The NHS was set up to treat people with diseases. Many of the diseases that would have killed people 65 years ago, have been cured, which is brilliant. While that means people are living for longer, it also means that they are, probably, living with one or more illnesses (long-term complex conditions) such as diabetes, heart and kidney disease. In turn, that means ongoing treatment and specialist care.

Lifestyle factors
The way we live now is also having a negative impact on our health. Drinking too much alcohol, smoking, a poor diet with not enough fruit and vegetables and not doing enough exercise are all major reasons for becoming unwell and needing to rely on our health services. Increasing numbers of overweight children show us that this problem is currently set to continue.

The change in public expectations
Originally, tackling disease was the main job of the NHS. Now, we all expect so much more. From advice on healthcare management through to mental health and social care, contraception, antenatal and maternity services, vaccination programmes and the fast, efficient processing of our medication and appointments. All of this with a growing population due to living longer and higher birth rates with lower infant mortality.

Accident and Emergency departments
More and more people are visiting A&E departments and minor injury units – which is stretching the ability of the departments to cope. A lot of the visits are unavoidable, but some are visiting because of inconsistent management of their long-term health conditions, the inability to get a GP appointment or insufficient information on where to go with a particular complaint. Winter sees an even bigger rise in visitor numbers with staff finding it harder by the year to cope.

Rising costs
The current financial crisis, rising costs of services, energy and supplies; innovations and technological breakthroughs that require more investment – along with higher numbers of people to cater for – all spell out a huge economic disaster for the NHS.

It is estimated that without radical changes to the way the system works, as demand rises, and costs rise too, the NHS will become unsustainable, with huge financial pressures and debts. If we make no changes we face a £30 billion funding gap for the NHS nationally by 2020 .

Perhaps before we decide we ought to take a look at different systems around the world and see how the different populations fare with their systems. I will set to work!!

Good idea WW - I think I read somewhere the Dutch are getting to grips with their health system.

That is a big task whitewave!

My family has limited experience of 4.
And different types of medical care used.
And some through work schemes, some not. Some EHIC. Some not.

Let's keep this neutral and focused. We're not asking for personal experiences S2B we are trying to think strategically.

NHS managers and I was one of them have been despatched far and wide across the world to look at other healthcare systems for some years now. I was sent to Nashville where I saw what I thought was a great solutions to primary care issues. When a patient attended the primary care physician (in our terms the GP) they were triaged by a highly trained nurse who made a decision based on agreed algorithms whether to send the patient onward to varying levels and expertise of nurse practitioner or therapist within the practice. Very few patients actually needed to see the doctor - most were sorted by the nurse practitioners who also carried their own caseloads usually of patients with chronic illnesses. The practice did its own blood tests analysis on site, plain x rays and ultrasound scanning - hence very few referrals to hospitals. I reported this back to my masters about 8 years ago - result- no change.

Have begun to have a look and think I will start with an overview of our nearest neighbours. So type of system, life expectancy, cost per GDP. I also think it would be important to ensure that everyone is catered for under the system, that it is'nt multi-layered I.e. some get better care than others etc.

Bum I posted before I finished I also meant to say does that seem OK or am I missing something? I do think that we have to keep it at a macro level as that is more than enough.
Just off to sort out Mum so will start this evening.

I remember attending a hospital whilst on holiday in Ibiza. It's a long story but the care and attention I received was amazing. I was quite prepared to sit there waiting for hours and hours (as we would have to do at home if we attended A &E) but I was seen within 15 minutes. The doctor took my bloods, carried out an ultrasound all in the same room within a period of less than 10 minutes. No charge. A report for my GP, no charge and a prescription which cost (if I remember right) around 4 Euros !

Knowing of other systems in recent years is strategic.
But I dont know enough about all of them in detail.

And peoples' up to date personal experiences are relevant.

Of course they are soontobe what is the point of going over and over what happened or didn't happen 30,40,50 years ago?

I have a point I would like to raise about lifestyle (if thats okay).

Today we are inundated with information about what we should or shouldn't do. What we should/shouldn't eat. How much exercise we should have, suncreams etc.

My grandma is a very old lady. She has eaten well all of her life but not "well" in the sense that she ate butter, lard, fried food, very little fresh fruit, lots of pies, pastries, sugars etc.
She sat in the sun without suncream, she didn't go to the gym or jog but she did work physically hard. My point is are too many people today perhaps relying on what they are told instead of doing what their instinct tells them is right?

Apologies if I am not making my point well. I hope you know what I am trying to say.

The King's Fund had a review last year. The Barker report came up with the following.

" The commission recommends moving to a single, ring-fenced budget for the NHS and social care, with a single commissioner for local services.
A new care and support allowance, suggested by the commission, would offer choice and control to people with low to moderate needs while at the highest levels of need the battlelines between who pays for care – the NHS or the local authority – will be removed.
Individuals and their carers would benefit from a much simpler path through the whole system of health and social care that is designed to reflect changing levels of need.
The commission also recommends a focus on more equal support for equal need, which in the long term means making much more social care free at the point of use.
The commission largely rejects new NHS charges and private insurance options in favour of public funding."

The government is now ignoring this.

Good luck, whitewave. The WHO has given up comparisons because it found it too difficult. It now just compares continents rather than countries.

If we went down the private route what would happen to people like me who are chronically ill. No insurance company would touch us. Also would an insurance company limit the number/length of treatments. What would happen if they decided you were no longer insurance worthy i.e. they were unlikely to make a profit out of you.

The NHS, for all its faults, is there for everyone and that's the way I would like it to stay.

Hopefully we'll be dead before it gets that far, vampire.

Just back so will start. Wonder if it will be too big a task? Well will give it a go but would a appreciate anyone of any accurate knowledge of other countries healthcare and the way it is funded be grateful with your input.