Healthcare. Is this he thin edge of the wedge?

Urmstongran

It’s not just about money now. The government has thrown £££s at it. The NHS needs to function better. Cut out waste and quangos. Ditch the woke slogans and posters. Cull some of the accepted routines. Find and fund a robust I,T. platform that can be shared across several (or all Trusts). Surely in this day and age this is possible and no longer a technological pipedream?

Years ago (about 6y) our grandson sustained an injury in Spain. He was entered into their health system. The interpreter friend who accompanied us to the local health centre to have his stitches removed afterwards told us his allocated unique number would suffice access at any hospital in their country. I was impressed. In some ways the Spanish health care system is far better than ours (and with outcomes) than what ours delivers.

We need reform, investment and much more. The NHS has lost its way with various Trusts ‘competing’ for ‘clients’ as the money follows the patient. Consequently it cannot decide whether it is running a business or providing a service and falls between the two stools.

Some friends with a holiday home home in Spain had a terrible experience in a Spanish hospital last winter. They waited several hours before he was triaged. The nurses were rude and ignored them. I could on.

The trouble is that for a lot of us it's too late. Anyone over 50 or with existing conditions won't get cover at anything like an affordable price.

I don’t blame you Joseanne. I think more of us would if it were a choice we could afford.

Imagine being wealthy, having a degree of health anxiety and being able to look at the contacts in your phone on speed dial. What a reassurance that would be given the present situation.

It’s a bit like the curate’s egg ... good in parts.

I'm not particularly knowledgeable in any of this, but given the choice of paying towards the NHS or private healthcare I would choose private from past experience.

The Royal Brompton is probably the leading UK hospital in heart and lung conditions, it takes the some of the most difficult and complex cases from all over the country which are extremely expensive to treat. If it partially funds this by being the leading private provider of diagnostics, surely this is to everyone's advantage as long as this is not in any way disadvantaging NHS patients?

Eg
If the waiting time for the tests you were quoted when you saw your consultant is exceeded
If you are told by the radiographer, as it seems you were, that private patients are taking NHS slots
if your appointment time is inconvenient, eg after 5pm because private patients are taking prime slots during normal working hours
If a private patient is prioritised whilst you’re there waiting, and you have to wait past your appointment time in the department
Probably more, those are off the top of my head.

But foxie people wanting scans don't need beds. NHS patients, however, need scans.

To quote someone famous “well he (they) would say that wouldn’t he (they)?”
🤣🤣🤣

How do you prove that you're adversely affected? You would need the lists of appointments and waiting times. The local MP did complain a couple of years ago and there was an article in the press about it, but the hospital denied that NHS patients are affected.

growstuff

Casdon

I retired at the end of 2020. growstuff, and I did work in Wales. The English Health and Care Act only received Royal Assent on 28 April 2022 though, so any changes to the way NHS England operates won’t have been enacted yet.

Yes, they were Casdon. I'm referring to the 2011 Health and Social Care Act.

The Royal Brompton Hospital Trust in London received £33.6 million from private patients in 2014. Goodness knows what it receives now.

www.theguardian.com/society/2014/aug/19/private-patient-income-soars-nhs-privatisation

The cap on treating private patients was lifted to 49% in 2012.

Okay, but the separation rules for private and NHS work still apply in every hospital, so you would still be able to complain if NHS patients were adversely affected. I’m very glad I live in Wales, it’s simpler here.

Foundation trusts have seen greater growth in private practice than non-
foundation trusts (LaingBuisson 2016). Non-foundation trusts which are
struggling to meet NHS financial and other targets are less likely to be
able to treat private patients, since Department of Health guidance states
that private practice must not adversely affect the ability of a hospital to
meet the needs of NHS patients (UK Department of Health 2009). As one
consultant at a trust in the south-east of England put it, “When we are
struggling to meet the NHS targets there is no place for private patients....
There is a massive bed crisis, a bad situation, we can’t manage. So there are
no private patients at all. It is not banned, but there simply is no room
chpi.org.uk/wp-content/uploads/2018/03/CHPI-NHS-Private-Patients-Mar18.pdf

Casdon

I retired at the end of 2020. growstuff, and I did work in Wales. The English Health and Care Act only received Royal Assent on 28 April 2022 though, so any changes to the way NHS England operates won’t have been enacted yet.

Yes, they were Casdon. I'm referring to the 2011 Health and Social Care Act.

The Royal Brompton Hospital Trust in London received £33.6 million from private patients in 2014. Goodness knows what it receives now.

www.theguardian.com/society/2014/aug/19/private-patient-income-soars-nhs-privatisation

The cap on treating private patients was lifted to 49% in 2012.

I retired at the end of 2020. growstuff, and I did work in Wales. The English Health and Care Act only received Royal Assent on 28 April 2022 though, so any changes to the way NHS England operates won’t have been enacted yet.

As mentioned upthread growstuff I retired 8 years ago which is why Casdon helped me out by her confirmation of what I had experience of at my time in the NHS.

growstuff

Casdon and Urmstongran Did you work for the NHS before or after the cap on treating private patients in NHS hospitals was lifted? NHS hospitals are now allowed to treat 49% of their patients privately, as a result of the Health and Social Care Act. Casdon I appreciate that you might have worked in Wales and that healthcare is devolved and could be different from England.

But in practice most hospitals don't have private beds, the ones that do tend to be located in London and as a whole this remains a very small percentage of NHS income, less than 1% in 2016. There are some very good reasons why a private patient might need to be in an NHS hospital eg a non UK person paying for specialist treatment not available in their own country.

It’s not just about money now. The government has thrown £££s at it. The NHS needs to function better. Cut out waste and quangos. Ditch the woke slogans and posters. Cull some of the accepted routines. Find and fund a robust I,T. platform that can be shared across several (or all Trusts). Surely in this day and age this is possible and no longer a technological pipedream?

Years ago (about 6y) our grandson sustained an injury in Spain. He was entered into their health system. The interpreter friend who accompanied us to the local health centre to have his stitches removed afterwards told us his allocated unique number would suffice access at any hospital in their country. I was impressed. In some ways the Spanish health care system is far better than ours (and with outcomes) than what ours delivers.

We need reform, investment and much more. The NHS has lost its way with various Trusts ‘competing’ for ‘clients’ as the money follows the patient. Consequently it cannot decide whether it is running a business or providing a service and falls between the two stools.

Casdon and Urmstongran Did you work for the NHS before or after the cap on treating private patients in NHS hospitals was lifted? NHS hospitals are now allowed to treat 49% of their patients privately, as a result of the Health and Social Care Act. Casdon I appreciate that you might have worked in Wales and that healthcare is devolved and could be different from England.

foxie48

growstuff

foxie If people don't want to fund the NHS, the change needs to be in paying for increasingly expensive procedures and drugs for people who don't have long to live and/or don't contribute to the economy. Would you be happy for that to happen?

Goodness, I don't know how you make the leap from me saying that the NHS needs radical change that this would be "the change needs to be in paying for increasingly expensive procedures and drugs for people who don't have long to live and/or don't contribute to the economy". Nowhere have I suggested that.

Because that's the only radical change which would save the NHS serious money.

Further to my comment above. I am, however, willing to pay more towards my own treatment if that improves the treatment for people who are less well off than I am. I have actually made that clear in an earlier post.

growstuff

foxie If people don't want to fund the NHS, the change needs to be in paying for increasingly expensive procedures and drugs for people who don't have long to live and/or don't contribute to the economy. Would you be happy for that to happen?

Goodness, I don't know how you make the leap from me saying that the NHS needs radical change that this would be "the change needs to be in paying for increasingly expensive procedures and drugs for people who don't have long to live and/or don't contribute to the economy". Nowhere have I suggested that.

foxie If people don't want to fund the NHS, the change needs to be in paying for increasingly expensive procedures and drugs for people who don't have long to live and/or don't contribute to the economy. Would you be happy for that to happen?

growstuff

Well, they're not done in the evening in the hospital I attended. I witnessed it myself and I also know people who have self-funded their own scans, which have been done during the normal day.

You should complain then, if you have evidence that private patients are taking precedence over NHS patients.

If you look at the history of the NHS, it's clear that having enough resources to meet demand has been an ongoing problem. In 2018/19 we spent 12x the amount on the NHS than we did when it was created (even taking inflation into account) and spending has increased since then. It's clear to me that something has to change but it needs to be a cross party decision because it needs radical change and that will never be a vote winner. Sadly I don't think that will ever happen and we will continue to limp along with the service becoming more broken with each coming year. On a brighter note (sort of!) OH contacted our GP with some symptoms, was seen the same day, had bloods taken etc at the same time, received a call from the hospital four working days later and is booked in for a diagnostic test 4 working days after the call as he was happy to take a cancellation. All on the NHS. Our local hospital was in special measures for five years but it seems to have got it's act together! However, when OH called in to pick up stuff for his diagnostic test, there were 16 ambulances queuing at the A&E dept!

Well, they're not done in the evening in the hospital I attended. I witnessed it myself and I also know people who have self-funded their own scans, which have been done during the normal day.

growstuff

Casdon

Grannynannywanny

I can understand that to a certain degree. But it seems wrong for it to be happening in the middle of an NHS clinic session that my son had been told was fully booked for many months in advance.

It’s not normally in the middle of a clinic in my experience, consultants I worked with either saw the private patients between 8 and 9, or at the end of their NHS clinic, often 12.30-1.30. PPs had designated, separate slots for appointments. They were careful not to mix the patient groups, or to encroach on their NHS clinic time with private patients taking NHS slots.

In my recent experience, it probably wasn't happening during consultants' clinic times, but it was certainly happening for the other services I had, such as MRIs, ultrasounds, echocardiograms and blood tests. I was asked each time I visited the hospital whether I was a private or NHS patient.

One of the reasons the radiographer was so put out during the incident I mentioned above was because the private patient, who didn't go ahead with her MRI, had taken an appointment which could have been used for a patient from the NHS waiting list. She told me that the hospital is doing an increasing number of private MRIs. Records show that it earned over £5 million from private patients in 2019/20.

Private X-rays, MRIs, CT scans etc. were always done in the evening or on Saturdays where I’ve worked, as have theatre lists. The payment system for radiologists and radiographers is the same as for other staff working with private patients, so the lists are separated. The only exception would be where there is a private patients ward, and a private inpatient needs an emergency procedure. To accommodate that, extra NHS patients are seen out of clinic times. If a particular department is not working within the private patient protocols, which are very tight, both staff and NHS patients would have a justified complaint.