NHS fallen to 31 in the world since Tories took over.

I refer you to How To Lie With Statistics, basically it says Tell what you want to 'ptove' and I will 'prove' it!
I am amazed at how unquestionning people are regarding figures but if they fit their personal agenda...........

Shouldn't the hospitals themselves come under question as to what government funds are spent on ?

EllanVannin

Shouldn't the hospitals themselves come under question as to what government funds are spent on ?

Nothing wrong with that . EV. No institution, public or private, should go unscrutinised. But it shouldn't be left short of funding for ideological reasons.

MaizieD

Sorry, Wwmk2, you were replying while I was typing.

I kind of get your point about taking it out of government hands, but the government is the only body that can create the necessary funding. Anything else would sooner or later encounter the problem of having a finite amount of money, surely?

Yes I am aware of that regarding funding, particularly in times of emergency like now, but there must be a way of deciding what we as a nation want or don’t want from the NHS and the way it is run, and act accordingly.

Sort of a constitution, that governments can’t overrule without national consent, and I don’t mean because they are temporarily in government and putting their own slant in it.

Imo we are where we are because the NHS has be subject to government whims and vagaries, and I don’t think it is what we signed up for.

As for waiting times for non-urgent ops, Essex is 100% Conservative and I can assure you that waiting times are the same here. I've also noticed the service for chronic conditions become progressively worse over the last decade.

The Blair government used to pay for private operations when waiting lists in certain procedures became too long.

In the past we've read about bad management to the point of fraud/embezzlement in one or two areas.
Hospitals are only as good as those who manage them. Successive governments have always poured millions into the health system which has been commensurate with the incremental/ economic and financial
situation at the time.

I've always been interested in wanting to sift through the inventories of some of these hospitals, out of curiosity. I say this with having worked for the NHS and witnessed a lot of wastage such as hiring staff from the private sector when they haven't been needed, costing the NHS thousands !

Each department is responsible for their own budget and certain areas of a hospital such as clinics can manage to work within a budget because it's pre-forecast/ numbered as to the amount of patients attending.

A&E for instance can never work within budget for obvious reasons and invariably go over any allotted amount/ estimate. Not their faults, nor the government's either.

It's a huge job for those concerned in the finance department as well as those responsible for wards etc. in balancing their budgets. Various charities also help to fund the NHS.
This year has been unprecedented because of Covid so I imagine that the much argued £10bn will come to fruition in covering health costs until 2021.

EllanVannin

Shouldn't the hospitals themselves come under question as to what government funds are spent on ?

They are. That's why foundation trusts were introduced.

It still comes down to big questions. Which would you fund? Hundreds of cataract ops or one heart transplant?

Would you spend money on trying to prevent illness? Is it worth keeping people with poor outlooks alive?

We can't prevent some conditions, but we could certainly prolong life and relieve suffering for many, if there were more money.

So you've worked in the NHS and as a teacher EllanVannin? You certainly got about!

Whitewavemark2

So if there is so much wrong, the question is: does our health service need a complete re-think and what do we want, and what do we not want.

I am firmly against the American system.

In would always like a system free at the point of need.

I would not like to see a two tier system in the U.K.

I believe that there are certain principles that I would not like to lose. One is that everyone regardless of wealth is entitled to a comprehensive , quality health care system.

I believe the NHS always will be free at the point of need. However, what it provides will reduce. We're already witnessing that.

Growstuff, I've never been a teacher ? Where did that come from ?

Callistemon

Re the Swiss system, one of our erstwhile posters had said, I think, that it was quite costly. They had to pay quite a lot per month for healthcare.

I think we do need to pay a separate, set amount to fund our healthcare system or pay more in income tax which should be ring fenced for the NHS.

The problems with some systems arise when people are just above the level of earnings to receive free healthcare but struggling to pay essential bills. Someone on a slightly lower wage would receive free healthcare.

Some of the financial problems of the NHS could be solved overnight by charging everybody, including the economically inactive such as pensioners, a health tax, which is what happens in many other countries.

How much would you be prepared to pay?

I was a nurse, then latterly did office work for two consultants.

EllanVannin

Growstuff, I've never been a teacher ? Where did that come from ?

Sorry! My fault! I mixed you up with somebody else.

I completely agree MaizieD. The NHS was acknowledged as one of the cheapest and most efficient internationally whilst the last Labour government was in power.

This was because there was a huge financial investment in it.
Of course they did not get everything right, but if we think moving to an insurance based system will improve things I think we will be very disappointed.

The US system is the cruellest system in comparison to ours, where the main beneficiaries are the insurance companies, not to mention drug companies, and the many other tiers involved. The losers are poorer people who are unemployed, those whose insurance runs out, or those who can’t afford insurance. No wonder poor people are sicker and die sooner.

Some European insurance based systems look attractive, but when you look at them they are still more costly than our (properly funded) NHS system.

The NHS budget is £134 billion. The population of the UK is about 66.6 million. That means that there is just over £2000 available for each person in the UK.

A very high proportion of that is spent on the elderly, especially in the last few years of life, so much less is spent on people of working age. Pregnant women and young children are the next most expensive.

We all have different healthcare needs, but I know I'd be pushed to pay for what I've had, if I'd had to pay for it on a PAYG system and I've never had expensive cancer treatment or a complicated op.

The NHS does need more money if it's going to deliver what people want. The big question is whether people should pay for everybody to have better treatment or whether individuals should pay for the better treatment they and their families want (and nobody else).

Some of the financial problems of the NHS could be solved overnight by charging everybody, including the economically inactive such as pensioners, a health tax, which is what happens in many other countries.

How much would you be prepared to pay?

Nobody is listening, are they?

TAXATION DOESN'T FUND SPENDING

We have a sovereign currency. Government can create as much of it as it wants to. It could fully fund the Health service if it wanted to. It doesn't want to.

So long as people go on believing that taxes pay for everything the government can get away with underfunding and selling bits off to private enterprises while everyone goes along with their 'we can't afford it' line.

Exactly Greeneyedgirl. The French system is sometimes praised, but it costs more per person than the NHS and even in France, there are serious questions being asked about rationing services.

Yes, I am listening Maizie and my point stands. The people who cost the NHS most are contributing the least. Most pensioners in most countries continue to pay a healthcare tax.

Even with MMT, taxation needs to be distributed. At the moment, it's not distributed fairly.

Are you seriously suggesting that QE (or some form of it) should finance the whole of the NHS?

The NHS has been in trouble a long time and is getting more and more expensive for 2 reasons - population is ageing and more (expensive) treatments are being found. I think the whole NHS needs a big modernisation overhaul also. Technology should be key. But money is thrown at software companies who cannot produce the goods. Let’s get someone in who can do the job!

I’m currently reading a book of his experiences by an A&E doctor. He is bemoaning the state of the NHS, the money wasted, the poor IT systems, the patients falling through the cracks, the ones denied appropriate, timely treatment, the pressure on staff, the wholesale privatisation of the NHS.

I wondered when it had been published. To my astonishment, it first came out in 2007, in the heyday of the New Labour era.

I agree with you Razzy, especially the first part of your post. Treatments are available to keep people alive for longer, but some of them are prohibitively expensive.

I don't know what the answer is with technology. Personally, I hate being informed by text and remote consultations.

And that was just the beginning SueDonim. The situation has got much worse since then, despite two top down reorganisations by the Conservative governments.

It’s time indeed for an overhaul (not tinkering around the edges) and a cross-party consensus.

The Aussie health system seems to work alright and is much the same as ours. It's freely available regardless of your financial situation and also funded by the government and local governments. They too have private health care.
It's run by a system known as Medicare and each member carries a card to enable care/ treatment to be given on production of the card.

Visitors who have medical needs apply for a medicard straight away and have to initially pay for consultations/treatments and medications but when you take your card to a Medicare outlet ( post office ) a percentage of what you've paid out is then returned to you.
Which in turn, can be claimed back from your own insurance company.