Why are we paying £12 BN extra NI a year?

Doodledog my point, (rather badly made because I worry about my daughter), is that instead of punishing doctors who get so fed up of working in the NHS that they move abroad, it would be better to improve their working conditions so they want to stay and this would improve the lot of every doctor. Actually, I don't think many jobs make as many demands as medicine does, young doctors for the long post graduate period of their training have very little control over where or when they work which means they have a very fragmented social life. As for pay, daughter has friends working as recruitment consultants who earn more than she does! fwiw my niece is a consultant surgeon who went to work in Australia for two years with a particular surgeon who was cutting edge in his field. She came back and works in London, should she have repaid the circa £220K that it cost to train her?

Of course I wouldn't tell a doctor what I think about the cost of their training. For one thing, it would be rude - this is a discussion board where I am chatting online, not a personal thing at all - and for another I use the NHS, in which I think training of medics should be free.

I am very well aware that junior doctors don't have an easy life, but they are well paid for the rest of their careers, which compensates for that. Lots of jobs, trades and professions are not easy either - doctors are not alone in that. All students who earn enough pay back their loans, so doctors are not alone there either, and A level results or other exam passes have no bearing on the cost of their fees or loans.

I am not saying that doctors should pay fees when they are working in the country that pays for the majority of their training, which costs significantly more than £9k a year - in fact I am advocating free training. I just feel that when it costs so much to the taxpayer for medics to train, they should not be able to take their expertise abroad, or work in the private sector at our expense.

Doodledog I think it's interesting that your solution to ensuring that British trained doctors stay in the UK is to make them repay the cost of their training if they choose to leave rather than addressing the reasons that they become disillusioned with working in the NHS. fwiw doctors are already paying 9% of their salary to repay student loans whereas many 54% of graduates never repay their loans in addition to increasingly expensive insurance so they can practice. My daughter has top "A" levels, 1st class degree from a top university and has completed a 4 year post grad medical degree. Following graduation she had to apply for a post to do her two years of foundation training and basically she could have ended up anywhere in the country. Following that she did a year as an A and E doctor again having to apply for a post. Once she had decided to train as an Anaesthetist she had to apply for a training post, again she could have ended up anywhere and she had to move house to take up her position. Then they changed the training so she found herself applying for a part 2 training post a year earlier than expected. Along with 700 other trainees she was unable to secure a post and is now travelling an hour each way to a job in another hospital, on top of working 12 hour shifts. She's 32, unmarried but would love to have children at some point in her life, however she has no idea where she might end up in the country to do the next part of her training and at some stage when she's finished taking all her exams (because they never bloody stop) she'll probably have to move again to obtain a consultancy post. It is a very tough life, fortunately she loves being a doctor but she frequently looks totally exhausted because besides the long anti social shifts, huge responsibility of the job, dealing with seriously ill patients, breaking bad news to relatives, studying for exams etc, she's also doing stuff to put on her portfolio to help her get the next rung in her training. So you want her to pay for her training as well when for a large part of the time she's actually on the ward as an extra pair of hands? Do me a favour, next time you are seen by a hospital doctor, tell them they ought to pay for their training if they want to work abroad and see what their response will be. Doctors don't leave to work abroad because of pay, it's working conditions in the NHS that really get them down. End of rant!

The social care system alone has been seriously underfunded for decades. Too many people needing care. As for waiting list of course it will get bigger from the people that were too scared to go to hospital during Covid.

In Denmark anyone is entitled to a Student's grant that does not have to be paid back for their first University degree or college training and there are no tuition fees to be paid. If you want, you can get a loan on favourable terms that does have to be repaid.

Anyone who wants a second degree or training for some other job than their first training qualifies them for, will usually have to paid for it themselves, unless they have been unemployed for a long time and cannot get the job they originally qualified for. In these cases, some public funding may be made available to them.

We pay two-thirds of our dentist's and optician's bill ourselves, once we are over 18, and the state pays the remaining third. Under 18, dental care is free.

Other medical bills, whether for treatment by a GP or a specialist in their practice or in hospital are paid entirely by the state, as are health visitors' salaries and home care for the elderly.

If you feel wealthy enough, you can choose to be treated as a private patient and pay for the treatment yourself, but cannot be forced to do so. If you are in the top brackets of annual income, you may be required to pay for things like wheel-chairs, walkers or other aids yourself, rather than have them provided free of charge.

There are private schools, which have state subsidies, but most children go to the state run schools where all tutition, books and so on are provided free of charge to the parents.

The funding for all of this comes in through the Income tax we all pay, and probably from some other taxes, such as value added tax and property taxes.

I am mentioning all this, as it obviously is possible, if the relevant ministries employ people who are good enough at figures to work out what money is actually needed for all of this, and if politicians are willing to listen to the financial experts they employ.

If we can make this system of public finance work, so should any other country.

To some extent Scotland already has, as there are no longer tutition fees to be paid at universities in Scotland for those who are permanent residents there.

I believe Scotland is actually ahead of all the rest of us in providing sanitary towels and tampons free of charge to all women of the ages to need them.

Perhaps next time you vote, you all should choose the candidate who seems to know most about public finance and financing? And of course, someone who can actually understand the meaning of the word "honesty."

I was just making suggestions for him...its his M.O isn't it spending other peoples money !!

I am totally opposed to private health schemes which a) basically allow people with money to queue jump the lists, and b) as many of the private doctors and nurses have been trained in the NHS . I have lived abroad and moved to different areas in Britain. Now once again proper thought is not being used, the idea that it is always better to close smaller places and have large centres of excellence is a slanted view point and does not take the differing scenarios in different areas. So here in north yorkshire the powers that be centred all the effort to one site in Middlesborough James Cook University hospital. Well certainly there are some positives in that each department will have good knowledge and training as they are busy with their speciality all the time. However in previous times the consultants based at James Cook would spend a half day a week at the Friarage in Northallerton. This meant that pre op and post op consultations were available reasonably locally for those patients who lived up the dales. Although not very frequent there is local bus services to and from Northallerton. Most local people know their way around, are able to drive there without problem and can also go and visit inpatients So one consultant does one return journey in the week and up to 20 patients can get to see them reasonably easily. They decided that the consultant would no longer come down to the Friarage. This means that all patients have to go to James Cook for everything , whether an hours treatment or five minutes taking stitches out or pre or post op needs. This now entails patients needing to use the hospital car service as part of the ambulance or be picked up by the ambulance. so we now have 20 long journeys of over an hour and by the time they are home it has taken most of the day. Many people do not feel safe driving in Middlesborough so those who would have made their own way to the local hospital now need to be taken to middlesborough. So this so called efficiency saving actually costs a great deal more in time and effort and our patients have to endure very long days to be seen. Many of the doctors now working in private health have been trained in the NHS . Sometimes they would like to stay in the nhs but the ridiculous shift patterns and attitudes from the accounts people who want to query medical decisions on a cost basis makes people want to leave. I ran a country wide communications business. When I had ideas for change I would inform all the staff and ask for their comments BEFORE I did anything so that their local knowledge would often save money and avoid delays.The same needs to be done with the nhs. An idea to use sat navs and be able to let the hospitals know where they were does not work here. Up in swaledale and wensleydale and other areas there is no signal at all and you have to be able to use a land line of a telephone box to get through . doesnt matter what YOU think should be happening or complain about being no signal. What you have to do is deal with the reality .Whatever this lot try to do we must protect the NHS. I have had cancer and other things and if it was only private health available I would be dead by now. there is quite enough in life to worry about at the moment. being afraid that you will not be treated at the right time , if you dont have enough money is not something that should be added to y our worries.

Wasn't it supposed to be for NHS. As N.I. is collected for UK nations will the money be distributed accordingly? It can't all go to one NHS. And if the money flows in other routes surely the other nations will still be entitled to their proportion.

Madashell

The party of low taxation…

and conservative family values

The party of low taxation…

cossybabe

MaizieD

cossybabe

But surely all that money saved by not being in the EU is enough for the NHS - I remember seeing on the side of a big red bus?

???

Hi MaizieD - my comment was tongue in cheek, I bet you are not as furious as my husband and I are with all his lies?

Try me, cossybabe

(I knew you had to be joking)

Gwyneth

What a ridiculous comment paddyann. Staffing is the major issue plus lack of beds. I don’t think even Boris would dare spend NHS money on his wife!!

Absolutely Gwyneth.

MaizieD

cossybabe

But surely all that money saved by not being in the EU is enough for the NHS - I remember seeing on the side of a big red bus?

???

Hi MaizieD - my comment was tongue in cheek, I bet you are not as furious as my husband and I are with all his lies?

Great idea Doodledog. I would back that.

I'm not sure why nurses should get a bursary to study, unlike students of other subjects, when they can leave the NHS to work in the private sector. I would prefer to see a system whereby all medical staff (doctors, nurses and all other client-facing workers such as OTs, dentists, physiotherapists and so on) were trained free, but had to stay in the NHS on graduation or pay back their training costs - maybe by taxation when they leave, rather than in a lump sum.

That is probably simplistic and would need tweaking, but in principle I think it is right. It costs taxpayers a fortune to train medical staff who then leave to work in the private sector or abroad.

cossybabe

But surely all that money saved by not being in the EU is enough for the NHS - I remember seeing on the side of a big red bus?

???

cossybabe that bus was a lie, Boris had not accounted for the rebate we got from the EU and was misleading, to put it mildly, I am furious about the 2019 election because we were lied to, there is no £325bn for the NHS, there was no 'oven ready' Brexit there is no social care plan and rather than our daily living expenses going down, they are most certainly going up. Boris only got 35%ish of the votes yet has an 85 seat majority, the system needs replacing

But surely all that money saved by not being in the EU is enough for the NHS - I remember seeing on the side of a big red bus?

We need to train more of our young people to be nurses, instead of some of the courses that have no job prospects

LadyGracie

Too many chiefs and not enough Indians.
Tell me why they had to employ all those people on ludicrous salaries to decide how to spend the money they were given.

Which people? Do you have any details?

Too many chiefs and not enough Indians.
Tell me why they had to employ all those people on ludicrous salaries to decide how to spend the money they were given.

thats Bursaries are £10.000 a year

Visgirl nursing /midwifery are £10,000 a year here in Scotland ,despite the scare stories in the MSM nursing students have more than doubled in the past 5 years .Other countries in Scandinavia and some Australian states are using the SNHS in lectures as a huge success story .Check online as I dont have time to find links,

There is a huge problem with staffing shortages some of it is because doctors and nurses are not treated well. eg there is a national shortage of consultant anaesthetists with another big problem in the pipeline in a few years time because of an "age bulge". A change was made in anaesthetic training in 2020 resulting in over 700 trainees being unable to progress on to the next stage of training, this is likely to add at least another two years to their training. These partially trained doctors can either work in hospital jobs on a contract which doesn't contribute to their training or locum. Locums are paid a much higher rate per hour, have greater flexibility on when and where they work and generally have a much better work/life balance. This is very costly for the NHS and IMO complete madness. I know this because my daughter is one of the 700 and guess what? She's intending to take several months break to volunteer abroad, she's also considering moving abroad to work permanently. The waste in the NHS is mind boggling!

Some interesting points have been made about the new privately run 'health care units' delivering NHS care.Their profits are presumably factored into the costs charged to the NHS, but how and from where are their staff recruited? What assurances do we have about qualifications and training, and where do they fit into the system if surgery goes wrong?

Some posters are knowledgeable about this, many thanks for explaining.