The NHS is gone ...

DaisyAnne

Jannipans

How about, as a start, all NHS staff who leave the NHS to go into private practice, having to repay the cost of their training. If the private practice wants them that badly they will need to cough up, if they themselves want it so badly they can pay by installments from their new increased salary!

Do you mean a Private Practice should repay the doctor/nurse what their training has cost them?

What's happening in my area is that a number of the GPs in NHS practices are cutting down their hours and have set up a wholly private practice, where they work for one or two days a week. They continue to work for both. How could they be charged for their training? They are still working for the NHS, but for fewer hours.

Thank you to everyone who has posted actual, bona fide links to factual information. I think we should be very wary of the media. TV and newspapers want viewers and readers so the more dramatic and inflammatory their outpourings, the more hysteria they create. The saying, 'there's lies, damn lies and statistics' (attributed to various sources) is worth remembering.

I don't think they would either Casdon, but what we're seeing is an increasing number of partner-run practices closing when doctors retire and nobody willing to take on the partnership. We're also seeing housebuilding and no new GP practices, so the existing practices are totally overwhelmed. The NHS could set up up wholly NHS-run practices in these circumstances. They would be better protected than existing practices from a takeover by corporations such as Centene.

Jannipans

How about, as a start, all NHS staff who leave the NHS to go into private practice, having to repay the cost of their training. If the private practice wants them that badly they will need to cough up, if they themselves want it so badly they can pay by installments from their new increased salary!

Do you mean a Private Practice should repay the doctor/nurse what their training has cost them?

Calendargirl

Back to prescription charges.

I know they are expensive, but a high proportion of people get them dispensed free- pensioners, those on certain benefits, children, expectant mothers…..(think I’m correct on those examples).

Just know that a friend who was a dispenser said that a high proportion of prescriptions were ‘free’. And I think if you have multiple prescriptions, you can get an annual discount, assuming of course you can afford to pay upfront,

My DD, who lives in Australia, has always had to pay for all her prescriptions, even for the children.

As has been mentioned before we have our own prescription charges experiment running in the UK.

The data shows that it is cheaper to give everyone free prescriptions than to charge for them. People in England are literally paying for the privilege of paying for their prescriptions.

Meanwhile ... this article from the Times is worth reading and remembering. (It's not behind a paywall.)

archive.ph/9Now6

The government is insisting on maintaining a cap on the number of medical school places which universities can offer. Almost everybody is saying there is a shortage of doctors and we can't/shouldn't rely on overseas-trained doctors, so this makes no sense at all.

MaizieD

A long, but, I think, very pertinent blog post on the funding of the NHS

www.taxresearch.org.uk/Blog/2023/01/25/getting-our-economics-right-really-matters/

Who can say that he is wrong?

Interesting and with much that I, and I would guess others, can agree with. Thank you Maizie.

One paragraph I would personally word differently is this:

... entirely bizarrely, it is assumed that only the private sector creates value in society and the value it creates is then absorbed by costly luxuries like healthcare (and education, and so on).

I would change it to ... entirely bizarrely, it is assumed that profit creates value in society... It is profit that drives the far-right. They and their champions measure a person by the profit they make. By using only that measurement, they distort society's values. I know it's a small point, but they will not only "use" a switch to privatisation but cronyism, crookedness, and a sense of entitlement. All for the sake of profit.

It is good to see that he accepts that tax is taken from people and is recycled by the government currently in power into, among other things, the services they receive.

growstuff

MaizieD

GP services were always 'private' in that GPs set up and ran their own surgeries. They weren't salaried NHS staff, they were paid for the number of NHS patients they had.

Same as dentists.

So though I sympathise with Nick Mann, he is incorrect in saying that GP services are being privatised. They have always been an 'add on' to the NHS.

Maizie Nick Mann isn't wrong. What's happening is that Centene, a huge US healthcare company, now owns about 70 GP surgeries. Obviously, it's taking its profits and there are reports they are using lower qualified staff in place of GPs (I think there was a TV documentary about one of its practices).

It's because GP practices have always been owned by individuals (not the NHS) that Centene (and others) are able to buy them without any change in the law or act of parliament. Labour's idea about having them owned and run directly by the NHS would stop that - although they'd face a mountain of criticism from some GPs.

The Centene-run practices can't charge its patients, but it can downgrade the services offered, so that waiting times are longer, patients don't see GPs, face-to-face appointments are rare, etc. There are even plans for patients to have remote appointments with people in another part of the country (or even world). GP services would be like 111. Eventually, patients get fed up, so pay to see one of the fully private GPs, who are popping up everywhere.

I don’t think Labour would force the hands of flourishing GP partnerships growstuff, certainly if experience in Wales is anything to go by, what’s happened here is that if there is a failing GP practice, typically in a poorer area, where GPs retire and replacements can’t be found, the GP practice then comes under control of the Health Board, who recruit salaried GPs and employ all the support staff needed to provide the service. No practices are being run by private companies as far as I know, it’s an incremental change process to Health Board Management when needed.

MaizieD

No-one has read my link, then?

I have.

MaizieD

GP services were always 'private' in that GPs set up and ran their own surgeries. They weren't salaried NHS staff, they were paid for the number of NHS patients they had.

Same as dentists.

So though I sympathise with Nick Mann, he is incorrect in saying that GP services are being privatised. They have always been an 'add on' to the NHS.

Maizie Nick Mann isn't wrong. What's happening is that Centene, a huge US healthcare company, now owns about 70 GP surgeries. Obviously, it's taking its profits and there are reports they are using lower qualified staff in place of GPs (I think there was a TV documentary about one of its practices).

It's because GP practices have always been owned by individuals (not the NHS) that Centene (and others) are able to buy them without any change in the law or act of parliament. Labour's idea about having them owned and run directly by the NHS would stop that - although they'd face a mountain of criticism from some GPs.

The Centene-run practices can't charge its patients, but it can downgrade the services offered, so that waiting times are longer, patients don't see GPs, face-to-face appointments are rare, etc. There are even plans for patients to have remote appointments with people in another part of the country (or even world). GP services would be like 111. Eventually, patients get fed up, so pay to see one of the fully private GPs, who are popping up everywhere.

No-one has read my link, then?

18 years ago I had to have a procedure carried out in Day Unit, wasn't even a day, half day more like. I arrived as directed and thought I was in the wrong unit. All the staff including Drs were in a private company uniform. Recently having to visit hospital faurly frequently with DH I noticed the hospital has offices for private health companies on the premises. Nothing new about NHS using private companies when needed to back up a creaking service.

Years ago I lived in a country where we had to pay for medical insurance.

In recent years, in that same country, because of my parents age - the 'limits' on what they could claim back got worse and worse .

Sometimes the insurance company wouldn't shell out for treatment because it either didn't 'meet the criteria' or they had reached their ceiling limit. So they would be out of pocket. That was awful for an elderly couple and they really struggled. Then the awful blow was when my dad had cancer treatment and the medical insurance company quibbled over bills and, after my dad's death, refused to pay out! My poor mum.

Sadly the NHS has been abused - inappropriate use of ambulances, no shows for GP & hospital appointments; and much more. I wish somehow something could be done to stop such people - and make them pay for non-attendance or misuse of the ambulance service.

I need to keep my mouth shut now as I'm getting quite angry.

The NHS has been a total blessing and I wish it was supported properly by the government.

Money goes to service PFI debts

The NHS needs to be Renationalised

I forgot to mention the lack of available convalescent and social care which is blocking up the hospitals,

I would hate to think that the NHS is ever going to disappear. I worked as a nurse in the NHS for nearly 40 years.

There are many different reasons that the NHS is struggling now — not least that 22,000 European nationals left it following Brexit. This has helped in pushing the remaining staff to their limits.

Covid is another obvious reason and, that was no fault of the government, which, I think, dealt with it well.

Money is another. In order to recruit and retain staff, wages and conditions need to be improved. I believe that the latest stats show only 3.7% unemployment. This must make recruitment hard when the poor pay and conditions in the NHS are so notoriously poor. I know that there is wastage and this is, I believe, almost inevitable in such a huge, unwieldy organisation. Don’t think I am defending the powers-that-be, just saying how difficult such a large entity is to control.

When I was working, we dreaded a new government coming in because ‘reorganisation’ almost inevitably followed, resulting in confusion and disruption. Ideally, I believe, the NHS should be taken out of party politics, but this would not work because the funding still comes from the government in power.

MaizieD

GP services were always 'private' in that GPs set up and ran their own surgeries. They weren't salaried NHS staff, they were paid for the number of NHS patients they had.

Same as dentists.

So though I sympathise with Nick Mann, he is incorrect in saying that GP services are being privatised. They have always been an 'add on' to the NHS.

Yes, and no. You are right, of course. However some practices always had a large private sector, not paid for via NHS list payments + special items of service (elderly care, pregnancy care, etc, etc). And others chose to work only adn exclusively for the NHS, and not have private patients. My OH inherited a large Private practice- he chose to just let it go, and treat everyone the same. Not a good idea financially, but he thought it was the best ethical choice.

I waited over two years for a hip replacement on the nhs I was in such excruciating pain that I couldn’t wait any longer, so had to take out a loan to pay privately as I didn’t have the £10,500 to hand.
I wasn’t happy having paid insurance contributions all my adult life most of it working in the nhs.

The 42 ICS Integrated Care Systems is privatisation

Unions must call out NHS privatisation

m.youtube.com/watch?v=gx99teZ3LSA&t=94s

...and yet, the UK is STILL sending foreign aid to India. ( who boast about their space programme!). And China? For goodness knows what??? Yet our NHS will suffer -think of what those billions could do to boost it

How about, as a start, all NHS staff who leave the NHS to go into private practice, having to repay the cost of their training. If the private practice wants them that badly they will need to cough up, if they themselves want it so badly they can pay by installments from their new increased salary!

A long, but, I think, very pertinent blog post on the funding of the NHS

www.taxresearch.org.uk/Blog/2023/01/25/getting-our-economics-right-really-matters/

Who can say that he is wrong?

In 1989 only some NHS mental health, surgical and pathology services were run by private companies. But after the introduction of the Health and Social Care Act of 2012 (HSC Act), the list expanded to include GP surgeries and Out of Hours services; urgent care and minor injury units; diagnostic services including blood tests, X-rays and CT scans; maternity care, elective (non-emergency) surgery; community nursing and a range of other community services such as physiotherapy; ambulance services; and prison health. Private companies also became involved in running entire NHS hospitals.

This means you may now find that your GP works for a company like Care UK. Tests that your GP orders on your behalf (like blood tests or scans) may be carried out by private companies, such as In-health. If your GP refers you to hospital for surgery, this might be to a privately run centre with an NHS contract, or to an NHS hospital run by a company like Circle. On return home, if you are lucky enough to receive community care (e.g. district nursing), this may be provided by a private company commissioned by the NHS, such as Virgin Care.

The above is from an article that is well worth reading. www.patients4nhs.org.uk/private-companies-involvement-in-the-nhs/

You may think it biased - although it is mainly factual, it does come from a pro-NHS source. You may think these changes are a good thing.

However, change will certainly come if we move to a system of under-regulated American-style insurance, no doubt with profits going to the US. This system would replace our "free at the point of need". Under such a system, we are looking at unregulated prescription costs - have you noticed the move towards pharmacists doing more? Government talk of saving money has to be set against the American healthcare providers' salaries which rank higher than in other western nations.

I am not against modernisation. I am very, very concerned about losing the last of the "free at the point of need".

Contracting out is not the same as privitisation, it does not require any payment by patients.

Vast quantities of the NHS have been corntracted out since the NHS started. It is the way many organisations carry out their businesses. I was very glad that the NHS used private contractors to meet peak demand when I needed a minor operation. It made no difference to me whether the doctor doing the op was in the NHS or in a private hospital, it was all free to me at the point of need.

M0nica

growstuff You cannot privatise a service without Acts of Parliament and these have to be discussed and announced.

At the next election the Conservatives would be out. That is for sure and Labour, (one assumes) would be in and they would reverse the policy - or would they?

Are you really so naive? Nobody is suggesting wholesale privatisation. However, the current model of tendering means that contracts can be given to privatised services. No act of parliament is needed. We already have one! In any case, any government with a huge majority can do more or less what it wants.