Magic Bullet

One thing re tax I've often thought of is, how many landlords don't declare rental income? Especially the slumlord type - most likely to demand cash in hand, and there are plenty of slumlords about.

There is no national register of landlords, and on a self assessment tax return you are only asked how many properties you have, and what the rent is, they don't ask for addresses.
I wouldn't mind betting there are masses - and not just slumlords - who don't declare it at all, or who declare only part of it. If you don't declare it, who is to know? -that is unless your tenants suspect and shop you to the taxman.

This must be an obvious thing to crack down on. I do realise that it would mean more admin, but IMO given such a large private rental market in the U.K., it's high time it was better regulated.

Cottage hospitals are very useful. But that doesn't mean they are cost effective in comparison with alternatives that may be inconvenient, but which perhaps redirects some money towards more critical cases. I don't have any stats on the subject, but spending money on small hospitals to treat minor injuries doesn't feel to me the right way to go. There may be other ways to do something similar but at less expense, perhaps through expanding the remit of some, larger, GP practices.
Ginny - I like your idea of charging the drunken wasters!

I agree with everything you say vq. The Tories say they are the party who will reduce the national debt but in spite of all their austerity measures they've increased the debt. Of course this hasn't had an impact on the government. I understand the vast majority of the cabinet are millionaires, can't see many of them down at the local hospital. They want to run the NHS down to such an extent that they think people would have no option but pay for treatment if they can. It's OK paying but if something goes wrong the NHS have to pick up the pieces. I worked in the NHS before retirement and I've seen it first hand. Many hospitals have been forced to close down wards contributing to a lack of beds.
Plus government said OK we'll put social care under local government control, starve them of funds then say "it's nothing to do with us, not our responsibility." Stop closing down local authority care homes. Private homes do it for profit. Medical tourists are another smoke screen the Tories and right wing media like to blame. This amount is insignificant in the scheme of things. My daughter is a doctor and if someone comes to her from abroad they pay up front. I go to Spain a lot and have had no problem getting excellent medical care. Just produce my EHIC. Stop selling our NHS to people like Richard Branson. Make big companies like Google pay the right amount of tax. My son in law has his own small business.HMRC are ruthless in collecting his taxes.

When I was in an emergency situation NHS 111 advised me to get myself to the nearest A&E and I had a choice of two not too far away. An eye specialist was called from his bed in the night and he saved the sight in my left eye. Amazing service from the moment I stepped through the door.

All staff were extremely professional and caring whilst they dealt with the very sick, a young man who had been in a fight and was still in drunken fighting mood; a young man who was hiding a can of beer behind his seat and was complaining loudly about having to wait to get a gashed hand stitched; a young man behind a screen where the nurses were shouting to keep him concious and trying to ascertain whether he'd had alcohol, drugs or both. Apparently this is a common occurrence most Friday and Saturday nights. I formed the opinion then that some patients should be paying for treatment for injury caused by drunken/ reckless behaviour. It must cost a fortune in every town and city.

The medics in A&E Depts are amazing people and we (and Mr Hunt), can be very, very grateful that they continue to do their job, sometimes in the most dire circumstances and poorly paid, as without them we really would be f.....

We must campaign for the NHS to be maintained and in some areas, restored.

There have been two major studies of NHS management over the last five years: one by the King's Fund and the other by the Nuffield Trust. Both concluded that the NHS is, if anything, under-managed in terms of numbers doing management roles. The number of managers compares unfavourably with big private companies.

However, one of the conclusions is that management spend too much time doing administrative jobs, which could be done by lower paid and less skilled staff.

One of the reasons for this is that managers have too many centrally imposed targets and are not allowed to use their management skills to run hospitals, etc effectively.

The big con of the Health and Social Care Act was that it was supposed to put the NHS in local hands, but it did nothing of the sort. More than ever targets are set by central government and local providers have to go through the hoops, tick the right boxes and save money at the same time. Managers have no control over the targets - they just have to try and make them work. (Schools are in a similar situation.)

A truly patient led, local service would look at all the issues in a given area and, as others have mentioned, almost certainly decide that local 'cottage hospitals' are needed.

Not everyone needs to go to a large A&E miles from home with a cut finger requiring a couple of stitches, an eye which needs irrigation or even an X-ray to ascertain if the injury is a sprain or a break.

Unfortunately, many Minor Injury Units have closed and patients now have to travel miles to 'centres of excellence' where they have to wait hours because they are not a high priority.

DD has a friend who is an anaesthetist. Some years ago he was complaining that most hospitals had more managers than beds and I doubt if anything has changed since.

Many of the current problems of the NHS arise from poor and short-sighted thinking. The closure of so many local and district hospitals and the concentration of A&E and all other facilities in large high care hospitals is not just the problem of bed blocking but also patients with simple problems requiring hospital care occupying high tech high cost beds, when they could just as well have been treated in less well equipped cheaper local hospitals.

Of course we need the centres of excellence, but not every patient needs to be there. One way to save money would be to expand community hospitals or develop halfway hospitals close to Regional hospitals which patients could be moved to as soon as they ceased to need high tech care or daily supervision by a specialist. Something like convalescent homes.

It seems to me that currently the NHS is run for the convenience of the administrators and civil servants rather than the patients and staff

We are the fifth largest economy in the world. It's a disgrace that we cannot look after our elderly and ill. We are going to build a new railway line that gets us to Birmingham 10 minutes quicker though! So what if the NHS is overfunded ??...who wouldn't want to be properly looked after in a comfortable place with well payed caring people to look after us when we are desperately ill... priorities priorities!!!... my friend of 98 who was a teacher in the east end during the war and looked after children fleeing from the Nazis, was sent home with a terribly broken arm to spend the night alone because caters worked days only. She fell, she was readmitted , she was sent home again... she died not long after. I despair... money fixes most things in life.. our health comes first.

Foreign Aid accounts for 0.7% of our taxation, while undoubtedly, some of this is misspent, even if you abolished Foreign Aid completely the amount of money released would be insignificant compared with the NHS need and next time there is a catastrophic earthquake in a country like Nepal or Haiti, we would do nothing to help, neither send specialist rescue groups nor provide basic tents, temporary housing or food for those suffering and dying. We would just not get involved. Would you be happy with this. I wouldn't

The main problem lies in this countries resolution under parties of all persuasion to make us a low taxation economy that is attractive to international companies, banks etc etc. The idea is that this benefits us all, but I can see scant evidence of that. All it has done is make the rich richer.

If we were to have tax regimes like those in France and Germany, not only would our total tax take be much higher, but if we spent 10% of our tax take on health, the amount of extra investment in the NHS would be far greater than just stopping Foreign Aid.

A few years back Sir Gerry Robinson made some tv programmes entitled " Can Gerry Robinson fix....." One of the problems Sir Gerry looked at was the NHS. He came up with reasoned, sensible solutions using his expert, experienced business eye.

These programmes are now used by the Open University but, as far as I know, none of his sensible suggestions were put into practise.

Just a note re the Baby Boomers. I am a Baby Boomer and wonder why the powers that be didn't plan ahead properly for us. They knew that post-war there would likely be a rise in the birth rate, but precious little seems to have been done to prepare for it.

Doing the best I can to stay healthy here !

As suggested by some that overweight people should not be treated as this is usually, although not always, their fault. How about those who have problems through drinking, drug taking. Also if you indulge in a sport and have an accident, you drive a car etc which is entirely your choice. The list is endless. Where does it stop?

Just been chatting with someone who is a secretary in a local general hospital. She herself is 'bank' staff but has been working at the hospital full-time for 3 years. She said the hospital is regularly employing extra managers whereas they expect the bank staff to take on any extra work. I know the medical staff do an amazing job but I do wonder how much money is being wasted on admin and 'management'.

As well as greedy corporations and businesses not paying their share to the taxman,there are many rich British people (including celebrities) with several homes in a number of countries, whose accountants help them to avoid paying tax in Britain. One dodge is to spend only a limited amount of time over here - while still qualifying for residential advantages - including the NHS emergency and other services.

We had a neighbour at one time who was a consultant obstetrician. He earned a lot and had inherited a lot.Anything he didn't immediately need for his fast cars (he told us) was invested in offshore companies to avoid paying tax....Time to close these loopholes! And ringfence the money saved (crucial).

But let me tell you a funny story. My son is a paramedic.A key issue for him and his colleagues is that people call for an ambulance when it is not an emergency.Of course this wastes money and prevents really ill people from being treated quickly.

A few years ago, he and his colleagues were getting thoroughly cheesed off with late Saturday night 999 calls from one drunk in particular who regularly claimed to be dying of alcohol poisoning and to be having difficulty breathing. They soon realised that the drunk was using the service as a taxi because he lived next door to the hospital! One Saturday night they picked him up - but went out of their way to drop him off at another A&E fifteen miles away. He was furious that it was not his local hospital and that he had to make his own way home.Yes, the team had spent an extra half an hour taking him there. But he never did it again......

People from all walks of life call ambulances for many reasons which are not emergencies - and often when it would be quite possible to get to A&E under their own steam or with the help of a friend or relative with a car...that would save the NHS a few pounds.

Every time I see an article on the tv about the NHS, I notice how many nurses, doctors etc are all doing admin work, on the phone, on the computer. Hardly any on the actual ward, all gathered round the reception desk. I am not exaggerating. I think nurses cannot carry out "nursing" any more as they are too busy with paperwork/admin. Just a thought, but why can't the NHS have office staff to deal with reception etc, completely separate,so nurses can get on with looking after people. I understand a certain amount may have to come down to the nurses but I'm sure they did not sign up to be administrators. No wonder morale is low. It probably would not save any money but at least nurses would be nursing, therefore providing a better service.

I agree with Granimimi, we need to be told the truth about what is a healthy diet - not all this crap about eating low fat. Ever since the public were advised to eat low fat and lots of carbohydrates people's weight has crept up and up, resulting in an obesity crisis and all the related health problems, eg diabetes

We also need to stop wasting 12 billion a year on foreign aid!

I imagine Blueskies that most of us here know when the NHS was founded.
As other posters have said upthread, the NHS at the outset was treating a much smaller population and only carried out a tiny number of procedures, it was never envisaged ( how could it be?) what it would be like 70 years later.

And I don't need a history lesson, thanks blueskies!
Nor do I appreciate being patronised...

I agree Ana a quote from a Labour politician made a heck of a long time ago means nothing at all.
It wouldn't matter which political party was in charge of the NHS, it still needs overhauling in so many ways.

For some reason my post was deleted as I was typing. Ana: Aneurin Bevan founded our NHS in 1948. There is an excellent DVD which you can get from Amazon or your library if it is still open --The Spirit Of 45. My discussion group watched it and they are still talking about its message. If you are interested there is also the NHS Action Party which has lots of information. So much information and so little time but we have everything to lose.

Should say some of our taxes

Holly100 is right, the NHS doesn't need money it needs to manage the money it has. Why does it not have a purchasing department? Why do we read about other projects going way over budget. Who signed the contracts without clauses to stop this, or stop late delivery, etc. We, you and me, paid aboug 90 billion on an unuseable it system. Who was not managing this for the NHS? Commercial companies have to manage their spending or go bust. The NHS is financially sloppy and it's my money and your money they are giving away. Have you read that the NHS paid an American drug company significantly more for drugs than anyone else. This bad financial management is costing you and me not only our money but good health care.

Well said vampire queen you couldn't have put it any better. All the different parties that have governed this country have never done any thing but our taxes are going to a garden bridge if it gets built.?Grrrrr
Yes we all need to take responsibility for ourselves and our health.

And exactly how many years ago did Nye Bevan say those words, blueskies? I'm sure we can all find quotes damning one party or another.

While the health service did come into existence under a Labour Government, its foundations were a cross-party creation - the NHS White Paper which paved the way for the system was published by a Tory health minister (Henry Willink).

So whatever Bevan thought of the Tories is neither here nor there.

I'm not sure what/who you mean by 'it is comfortable to remain in ignorance' - it may well be, but I wouldn't know about that.

I approach this thread with trepidation as I certainly don't know how to fix it but, like many of you, I have my own pet hates and some theories. I think the NHS is awash with money BUT it is very badly disbursed and mismanaged. We constantly acknowledge the excessive top heavy and overpaid administrators. What does ANY ruling party do about that? NOTHING. We recognise the foibles of bulk buying and contracting out repairs and cleaning. Again......NOTHING. These same or similar common sense problems are being aired daily and have been so for years. Again......NOTHING. My own pet hate are the conferences and meetings that go on daily up and down the length and breadth of the country and achieve very little other than huge bills for accommodation, meals and travelling expenses. They used to be called talking shops but now I hear them referred to as networking. I would ban them all immediately for a trial period of six months. My other troubling issue is the many good and competent members of staff who are suspended on full pay. Now I have nothing against the system here. Rules are there for a reason but the time it takes for the staff in question to be exonerated or charged beggars belief. In the interim presumably someone else is being paid as a substitute for the missing staff member. Might even be agency - who knows. Scary. I have personal experience of those last two points, by the way. Truthfully I think the whole service needs thoroughly re jigging from top to bottom but I really don't think that will happen nor do I know if it's possible. The system and staff seem so institutionalised that I'm not sure it's fixable. As a positive (oh yes!) mostly, at my point of need, I have been fortunate enough to have been helped incredibly. On that happy note coffee feels desirable..........