Looks like it could soon be 'RIP the NHS'?

Agreed, Jess. My sister was an NHS manager. Over the last few years she had to make her two deputies redundant, which meant she had to do more herself and delegate management responsibilities to more front line staff, which meant that clinical staff, whose main role should have been patient care, had to do more paperwork.

The NHS spends more than £3 billion just on the internal market commissioning services from each other and from private providers. This includes administrators, negotiators, lawyers and accountants - allegedly to save money hmmm..

Getting a bit fed up with people who retired from NHS a few years ago criticising managers. Or "bureaucrats" as are last PM used to call them. The NHS arguably needs more management, not less. There are many very able, dedicated and hard working managers who are doing their best to keep services running in the face if increased demand and ever tightening budgets. I think I am right in saying that there are, relatively very few managers in the NHS considering the size of the organisation. It is certainly the case that some consultants (and maybe other professionals as well?) are very resistant to the introduction of changes in the way things are done, which would potentially make hospitals run more efficiently. This "blame the managers" theme has been pushed heavily by Cameron and many others who wish to detract from the fact that the NHS is being starved of cash and dismantled in a very sneaky way. The decision that NHS services in England have to be put out for tender was not in Hunt's main bill, and so was not debated in parliament. It was shoved through as part of the "regulations" at the end of the passage of the bill which is a very underhand way of making a major change with minimal publicity and potential for anyone opposing it. If you remember the main bill was about clinical commissioning by GP consortia.
I think we should stick up for NHS managers who have a very tough job.

@dj Thank you for the link, which confirms what I just wrote. Government accountants would have you believe that NI doesn't fund the NHS, but some NI contributions do go towards the NHS, although it might not appear that way on the balance sheet.

Lewlew, You're right that the NHS is funded from general taxation. NI is supposed to be allocated to a defined range of pensions and benefits. However, the way the Treasury works all the money goes into a big 'pot' and the link with how everything is funded is fuzzy. The government receives almost as much in NI contributions as it does in income tax. For years, it's been a government trick to keep down the income tax rates, because they make headlines, while the rate of NI has crept up. People never build up a personal 'pot' with NI and there is almost no link with what people pay over a lifetime and what they receive. I would be happy to have a system similar to Germany, where people pay into central bank-backed insurance schemes for illness, unemployment and pensions, related to means. Although they pay more, they receive more back. It would, of course, mean that people would pay for illness cover throughout their lives, not just when they're working.

I think we have a choice now.
If you believe in the NHS, fight for it.
If you do not, do nothing.

I believe in it, and can see no better alternative for me, my children and grandchildren.
There are lots of things that are less important than the NHS.

Strange the government forgot to tell the King's Fund.

www.kingsfund.org.uk/projects/nhs-in-a-nutshell/how-nhs-funded

NHS funded out of taxation and NI.

railman When I took my British Citizenship test, one of the study questions was about NI contributions. They aren't for NHS care, they are for pensions etc. See link below.

www.gov.uk/national-insurance/what-national-insurance-is-for

The NHS is a busted flush. I speak as someone who worked in it for years. The amount of waste is appalling and some of the non medical staff are paid a ridiculous amount of money for doing a very mediocre job. The whole thing needs radical reform, it is unsustainable in its present form. The system is abused by too many people.

How much money is available to replace Trident?
Is that more important than the NHS?
How much money would be avaiable if tax dodgers paid what they should?
Is that less important thqan the NHS?

The money is there. It's the priority that is wrong.

This should be decided by referendum. It's more important than the EU.

I have said for a long time that there are two reasons for the NHS to be in the state it is at the moment. Everyone blames the Government, and yes successive governments have promised to do miracles, without actually grasping the nettle, and increasing contributions sufficiently to cover the ever increasing costs. Then of course there is what appears to be on the surface the inefficiency of those who are supposed to be in charge - managers, etc., who probably know how to manage, but not nurse.
We all take the 'free' health service for granted, but I am sure that heart/lung replacements, prosthetic limbs, etc. were never envisaged as part of such a service - they were not known, and so as our brilliant surgeons and nurses have continued to provide us with a better life, so we have jogged along without contributing sufficiently. I would imagine that it has now got to the stage where increasing contributions would be beyond reasonable.

A good reason for signing up to 38 degrees, railman.

These make an interesting read - especially the comments from 38 Degrees members) on this barely reported topic in the mainstream media:

home.38degrees.org.uk/2016/08/26/38-degrees-crowdfunded-investigation-secret-nhs-plans/

This is the summary report by the PR company:
www.incisivehealth.com/uploads/images/services/38%20Degrees%20-%20STP%20Early%20Action%20Report%20-%20August%202016.pdf

And this is a spreadsheet with more details about where the cuts will fall if they're allowed to go ahead:
docs.google.com/spreadsheets/d/1LfsGoTu7VXrXRSOaxV9WPtPZYMyOX7yQrPUuo8ZZiVE/edit#gid=564142907

Violette - you say providing 'cradle to grave' care for nothing is what the NHS does.

It does not, nor has it ever operated such a policy. It is paid for by National Insurance (NI) contributions, and in previous decades the higher proportion of income taxes we paid during our working lives also supported things like convalescent homes, patient transport and almoner services etc.

The British problem is that we have become accustomed to the idea that 'lower taxes' bring greater benefits for the individual - when clearly here in the UK today, that is far from true.

I remember when Simon Stevens took over the running of NHSE.
He was filmed at a local hospital, saying that all hospitals like that were needed in the community and would keep the services they had then.
He was filmed there because that was where he had started his NHS career.
That was the one I couldn't go to for my broken wrist because the xray facilities closed at 5.

Sorry, Shelagh, I haven't done any of that.
It's not my fault that A&Es are closing. It's the fault of national government that wants rid of the NHS.

If you do not know that by now, you must have been living in a cave since this government came to power.

I don't think this is scaremongering at all - it is a very real fact that we must stop abusing the NHS. We must keep appointments - not forget - it costs money. We musn't expect to have prescriptions for everything we can buy over the counter. Prescriptions should be for drugs unobtainable unless we have seen the doctor. We shouldn't expect IVF, sex changes, cosmetic ops, cigarette smoking cures, advice on diets etc. etc. Abuse of the NHS has been endemic for years and doctors have been far too liberal with handing out antibiotics and drugs, helping to make them not effective. I could go on and on but I think we all know that it is down to us to help. A&Es will close because of the abuse they suffer from drunks etc. Our own faults !

Looseloafers ...like you, I worked in the NHS, retiring in 2001 ......I do so agree ....too many inefficient 'managers' managing each other ...too many being paid on long term sickness because of 'stress' (!) .......nurses, doctors, other healthcare professionals were tired of being 'managed' so much so that doing their jobs was difficult.

Here in France, we pay 25 euros for each consultation with the doctor. Friends in the UK were up in arms when I suggested it might be a good idea to save time wasting in a doctor's surgery ...you would not believe the number of appointments that are not kept, whilst someone in real need could have had that appointment ! The NHS employs at vast expense translators for every tongue in the world .....whereas here in France, as when we lived in Spain, if you do not speak the language fluently enough you MUST provide, at your own expense, an interpreter ....quite right, in my opinion ! One hospital appt in Spain ...interpreter, 20 euros an hour (in 2001) .....plus travelling expense, plus a coffee before the appt to explain what my appt was for ! ...and in the end, the conversation was just to deliver some results of a routine test, which I understood myself any way ! There were notices in the doctor surgery to the effect that YOU WILL Not be seen unless you have an interpreter ........

We also pay a top up medical insurance, which is not private, but pays for taxis to the hospital, trains, or whatever, plus a specified amount for overnight stays in hospital, the tv, water, meals, etc etc ....and something towards glasses and teeth ...although new rules coming into effect have reduced the amount refunded ! At the moment, as UK OAPs the costs of our treatment are refunded to France and the rest of Europe. However, with the current rumblings about the NHS it is looking likely we will no longer be covered ....many ex pats are having to consider returning to the UK ....at an age where they are going to require on going treatment at vast expense to the NHS ....whereas many countried in Europe fail to refund the NHS for the treatment of their citizens living in the UK ! We have already lost our Winter fuel payment, although it is often minus 10 here in winter !!!!......to take out a private insurance to cover our many medical conditions (things like cancer, long term illnesses, and others, are covered 100% by the French state, so no insurance is required to cover those, at the moment, with the NHS refunds) on enquiring, private medical insurance to cover everything we have wrong with the pair of us would cost over 2,000 euros a month, each (more than our total monthly income !.....long term care here, like in the UK, is very costly, and would require the sale of our house to fund it, and then it would only cover a couple of years !

I think it is time the NHS reviewed its policy of providing 'cradle to grave' care for nothing ...unpopular as this idea is, it could be on a scale according to income. Also, there are many unemployed people in the UK (I watch those 'on benefits' programmes, where people are claiming 'it's not enough to live on ....when they are getting a 1,000 plus a month ! they should be pensioners !!) could be required to act as volunteers in homes for the elderly, care assistants in the hospitals, volunteer drivers, there are a wealth of opportunities for the government to introduce such a scheme to 'earn' their beneifts ! another unpopular idea, though ...why ? If I were claiming benefits (sorry ...forgot, the Old Age pension is now classed as a benefit !!!!!! what cheek !) I would be happy to go to work as a volunteer to justify my benefit payments ,,rather than sitting at home all day watching tv (or playing on the most expensive, latest gadgets as on those programmes !)

so called 'bed blocking' (a term the government in the UK is now trying to tone down !) is another problem ...when I worked in the NHS if we had an elderly patient requiring to leave hospital, you would not believe the trouble we had in trying to find a placement if they were not able to manage alone at home. Families were the first port of call ....'Oh, sorry, we cant look after mum/dad......' (or more like don't want to !) ....councils would have no places available in care homes, and no one to help the person at home, unless they were able to pay a private carer, they had to stay in a hospital bed ........aargh ! I get mad ...I could go on, but enough ranting for the moment !!

There will of course be many who disagree with me, and therefore I would welcome their suggestions !

Thanks for the petition link durhamjen. I have signed it. They need to get more signatures.
At 100,000 signatures, this petition will be considered for debate in Parliament. Only got 14,379 or so at the moment.

petition.parliament.uk/petitions/124340

Missdeke you can' possibly manage the whole NHS from a central government office. It makes no more sense than saying every ward should run as collective and make their own decisions. In something this big, far bigger than, say, the UK army, you have to have some kind of hierarchical organisation. However successive governments have "market-ised" the NHS - starting with the original creation of Trusts, about 25 years back, in which you could have several separate trusts in one city all competing for patients and possibly doubling up on expenditure.
In Wales the trusts are gone and there are regional health boards, each managing their geographical patch.

Let's be honest, it's not really a National Health Service any more, it's a Regional Health Service and has been for quite some time. The introduction of Trusts to run regional services was the start of the breakdown, to have a truly National HS it needs to be run at national level.

I think the introduction of targets was a mistake, although the thinking was good, it just doesn't work, for instance, included in the 4 hour A&E turn around are the 'patients' who shouldn't be there, eg coughs and colds, drunks, and other minor ailments, all non urgent cases should be made to wait as long as necessary so that the true accidents and emergencies can be seen.

It is lack of money now, though, and it is political.
This government wants an insurance based system like that in the USA and Canada, so that they can make money out of it.

Only political will can stop them.
It doesn't matter how many posters write on here. What matters is how much else you do; joining groups and getting petitions going so they can see how much opposition there is to their plans.

Stevens headed the US private healthcare group which stands to gain from this.
Hunt wrote a book about privatising the NHS.
It's political.
This has been planned since before the Tories came to power, by the Tories. That's how it managed to get to how it is now in such a short time.

I used to work for the NHS as a nurse. I know from bitter experience all about "consulation". Just lip service then then they will go ahead with the cuts.

The death of the NHS was talked about openly before Cameron was elected for the first time so the plans for its destruction were in hand even back then. A high-ranking Tory called Mark Britnell told a conference run by the 20 billion dollar private equity firm Apax Partners that - and I quote - 'In future the NHS will be a state insurance provider, not a state deliverer' and advised his audience that if they wanted to make a killing the best bargains would be up for grabs in the first two years. At this moment they are putting the final touches to what they have always planned to do.

I worked in the NHS some years ago and quickly realised it isn't lack of money that is the problem it is decent Managers, buyers and admin staff that is needed. I was appalled at the complete inefficiency and waste of resources by the administration. Nothing but praise for the medics

Please do not be duped into thinking that any "social insurance" scheme will result in comprehensive coverage like our nhs, even now. We lived in Canada (BC) for some years where Social Insurance is the model. Canadians continually tell themselves how much better their system is than that of their southern neighbour, the USA; probably it is is, but the basic provincial coverage is very limited with 'extras' like prescription dispensing, medicines, dentistry, ophthalmology not covered and only provided, with varying excesses to people with supplementary insurance like Blue Cross. This is often provided as part of an employees benefit package, but this leaves the most vulnerable, seniors, unemployed, poor self employed and children in many families without any coverage for these optional extras. My village held fundraising events to raise the $3,000+ cost of basic and essential ortodentic work for a 9 year old that his parents could not afford. Do you really want that here? And you should see how wide, but nothing like comprehensive, insurance coverage pushes up the cost of services the insurance companies include in their coverage. An appointment with a dental hygienist costs $225 first appointment.....who could self fund that without insurance? Doctors are not employed by the health service they all maintain an office and are paid for services provided with some having negotiated " hospital privileges" with specific hospitals. This has huge negative implications for preventative work and continuity of care. Don't lets go there. We are the NHS generation, we must stand and fight for our children and grandchildren to inherit this national treasure .