The NHS is gone ...

DaisyAnne

MarathonRunner

I had a minor procedure done , day surgery
GP referred me to a consultant at a Private Hospital and I had the surgery a few weeks later , paid for by NHS . I'm not too sure why but I was more than happy to accept

How happy would you be to accept if it meant you had to contribute?

I've also had the same happen but my GP delayed investigation and I had a C scare. It was their problem to deal with and my whole family pay tax and therefore pay for the NHS. How is it my problem that the government aren;t choosing to fund it properly?

But this isn't anything new...my friend is a theatre nurse at a private hospital....they have been doing nhs work for at least the last 20 years to my knowledge...maybe longer.... I had surgery 12 years ago in a private hospital as an NHS patient....its not a new thing

You make some good points Dickens. I don’t believe that the government actually do have a master plan, I think in reality they are winging it, to see how much privatisation they can get away with. Boing is correct to a degree in that there are some ‘loss leader’ services that can be run more cheaply in the private sector.
The way I see it is that they favour the Aldi model, rather than the Tescos model. So, a cataract centre for example, buys in surgeons and theatre staff, does 50 patients a day at a cost of £500 each. The cost of a cataract on the NHS is £1000. That’s because they fit the cataract procedures around complex operations, emergencies, calls on medical time to go to A&E etc. etc. - so for cataracts it is less efficient. So, using the Aldi/Tesco analogy, it’s cheaper to provide high volume, low complexity procedures (goods) at Aldi. However, they can’t do low volume, high complexity procedures (goods) because they are low turnover and therefor costly. Hence, you can’t get your special dog food (or whatever) at Aldi. The government hasn’t found a way to match the two objectives. So I think we flatter them to assume they are going for the USA model, or that of any other country - when they don’t have any master plan, just an opportunistic eye on the main chance.

M0nica Mon 23-Jan-23 18:54:33
... in the same way that there are members of the Labour party, who support a massive nationalisation of every significant industry in this country, but nobody suggests that that is on Labour's Agenda.

I think they would be if we had a Labour government that is as far to the left as this government is to the right. In fact, wasn't that exactly what the Conservatives were saying when they thought Corbyn might get power?

Personally, I don't want communistic socialism, neither do I want fascistic conservatism either. My worry is that some on either side simply cannot see that they are the extremes.

Boing

A few examples of 'saves NHS a fortune' are:

Advertising jobs (costs money)
Recruitment/interviewing (manager time)
Holiday pay
Maternity pay
Sick pay
NI contributions

I still don't think that shows what you said, which was Lots of private companies operate within the nhs - services are put out to tender and the private companies bid for them, they employ their own staff as part of the service level agreement, they pay their own staff costs - saves the nhs a fortune.

To do all in your post will still cost the private company and they will pass that cost on plus a profit. The only place I have noticed savings is that they pay people less. However, this often has to be made up by government in the benefits they then have to pay.

The issue is, that the NHS, while it has to make its income from the government go as far as possible, does not have to make a profit. You can almost hear the screams from this far-right government over this. Their ideology says that there must be profit in everything. This profit is coming from our pocket (sorry Maizie). We have seen how often it goes into their cronies' bank accounts. Even if done legitimately, we all have to decide if the good health of the country, which drives growth in the economy, should really be up for profit.

I'm totally willing to admit that I may have misunderstood you Boing. If so, could you have another go at explaining the savings.

Boing

Lots of private companies operate within the nhs - services are put out to tender and the private companies bid for them, they employ their own staff as part of the service level agreement, they pay their own staff costs - saves the nhs a fortune. You may work for the nhs but you're paid by someone else. Lots of nhs staff have left through various mergers, some made redundant, others forced out by bullying managers whose job it is to make people's lives a misery until they can't take anymore. Then these managers get their pension and walk away laughing. That's why they've no staff left.

I’ve witnessed this bullying first hand and it’s horrendous. In the unlikely event of the culprits being taken to task they just get moved to another position often with a promotion.

There needs to be much greater scrutiny about where and how the money is being spent and a significant amount wasted through indifference and incompetence.

Dickens How do we know that is what the governemnt have in mind.

I am not a supporter of the Conservatives, I am sure there are members of the Conservative party who would like an American type health system, though for the life of me I cannot see why, in the same way that there are members of the Labour party, who support a massive nationalisation of every significant industry in this country, but nobody suggests that that is on Labour's Agenda.

Where is the evidence that an American health system is what the Conservative party and government espouse?

dickens. I agree

M0nica

DaisyAnne If we were to privatise the NHS, and I absolutely do not support that in any way, it doesn't follow that the alternative is an American style sytem. Most Eurpoean countries have a system that is a combination of insurance and taxation with the insurance sometimes state provided , and always tightly regulated. All these sytems are organised so that the less you earn the less you pay and the poorest get healthcare free.

I get tired of reading lazy thinkers who keep waving the American system in front of us as the only alternative. Why do they not spend some time looking at how other countries approach this problem of funding health care and give us a critique of those systems.

I think MOnica that perhaps many are aware that the 'American' system is not the only alternative, but are afraid that it is this one that the government have in mind.
Who have they been involved in talks with? Not anyone in Europe as far as I am aware.
Sajid Javid, ex Health Secretary, in favour of payments for GP and A&E visits, is a turbo-Thatcherite, as I believe many of the current government are. They are neo-liberalists in favour of free-market Capitalism, deregulation and a 'reduction' in government spending. They are economically more wedded to the American 'brutal' Capitalism, than they are to the European 'mixed' model.
I believe that economically and 'culturally' we are being steered away from Europe.
I know first hand that other health systems work well - as do others on here who've experienced them.
The health system in Norway works pretty well. There are payments to see both doctors and consultants - though hospital admission via A&E or elective is free at the point of need. It is affordable - bearing in mind of course that wages in Norway are considerably higher than in the UK. But no one is penalised for being chronically ill or having multiple or complex medical conditions because there is a ceiling to the payments and once that ceiling is reached, then you are not charged further.
Looking at the trajectory the Tories are currently following - do you think that is the model they'd go for? Would they, their donors, backers and cronies make enough money out of it?
I have my doubts. And that is because I don't believe they are interested in the public good, they don't actually believe in public services as a principle. They want a 'thrusting' growth-oriented economy with a 'flexible' (ie, low-waged, unprotected) labour force that can be hired and fired at will.

They could have invested in the NHS, years ago. They chose not to for ideological reasons. The crisis is not an accident, in spite of the pandemic, it is in crisis by design.

Exactly Fleurpepper. I thought putting We can discuss the systems used in Europe. However, it is the one they use in America that this government wants. in the OP, had covered this. Ah well.

Marathonrunner - good point. Any charge would be an additional charge. The NHS was at the beginning and until recently, funded out of general taxation.

I agree, Grantanow. We will need to use whatever is available to recover from the last 12 years, paid for from NHS funding with proper progressive taxation to balance the bookkeeping.

Extract from article by Gordon Brown in todays Guardian.

But the direction in which the Conservatives are travelling is already clear. The sick would pay for being sick and charging would force, as has happened with GP and hospital fees in France, the better-off sections of the population to take out private insurance – inevitably creating, in its wake, a two-tier healthcare system.
Today’s Conservatives may have clapped NHS nurses and health workers at the height of the pandemic; yet they are not only opposing decent remuneration for them, but also contemplating a more privately financed healthcare system. It reminds us that exactly 75 years ago they opposed the introduction of the NHS, having attempted in 1944 to impose charges and private insurance.

So comprehensively have senior Conservatives lost sight of the uniqueness of the NHS that their model for future healthcare is not Britain, but Ireland, continental Europe and the United States of America. All this points to them abandoning the special characteristics of a great institution that expresses a very British set of values – that healthcare is not a privilege to be bought, but a right for all who are in need of it.

Their desire to break with the British model is not only morally concerning: it would also be very costly and economically wasteful. Never do NHS doctors or nurses have to ask sick patients, “Who is paying for this?” When we leave the hospital or GP surgery we are not pursued by bills or subject to complex negotiations with insurance companies or legal threats. But as the overseas experience of billing and means-testing shows, charges not only mean higher administration and collection costs – and thus raise far less than is predicted – they also discourage the sick from seeking treatment until too late, when more severe problems require not only more intensive, but more expensive interventions.
As a former chancellor, I have said for some time that the NHS refinancing that Labour achieved in 2002 – a 6.3% real terms annual rise between 2000 and 2010 – had to be revisited every decade. This hasn’t happened under the Conservatives, and the consequences are visible to all of us. But the pressures the NHS faces make the case for comprehensive funding through national insurance even stronger; and show why this is to be preferred to either European-style social insurance, or private insurance.

The reasons are clear. None of us know in advance which of us or our family members will need medical interventions or hospital stays, the costs of which could run into hundreds of thousands of pounds. A system that guarantees comprehensive cover paid for by general taxation and that shares the costs across the whole population is the best insurance policy we could dream up – and indeed, if properly funded, is bound to be the best in the world.

A few examples of 'saves NHS a fortune' are:

Advertising jobs (costs money)
Recruitment/interviewing (manager time)
Holiday pay
Maternity pay
Sick pay
NI contributions

There are short term issues and long term issues. The elective surgery waiting list needs to be reduced by whatever methods can be used including buying in private sector work, French hospitals if convenient, opening local surgery hubs to bypass hospital problems, etc., short of charging patients: they have already paid for treatment through their taxes. Training places have to be expanded, pay increased for retention purposes and a capital programme instituted for new equipment and to update whatever needs updating given 12 years of Tory underfunding. What we don't need is another reorganisation so the Tory ministers can look busy.

M0nica

DaisyAnne If we were to privatise the NHS, and I absolutely do not support that in any way, it doesn't follow that the alternative is an American style sytem. Most Eurpoean countries have a system that is a combination of insurance and taxation with the insurance sometimes state provided , and always tightly regulated. All these sytems are organised so that the less you earn the less you pay and the poorest get healthcare free.

I get tired of reading lazy thinkers who keep waving the American system in front of us as the only alternative. Why do they not spend some time looking at how other countries approach this problem of funding health care and give us a critique of those systems.

Of course there are other systems. But the only one this Government is striving for, is the American one! THAT is the problem.

When I worked in a psychiatric day hospital which also housed the community team we were offered 2 days of consultations regarding whether to close my day hospital and the only other one in Bristol.. but subsequently discovered that the decision to close them had already been made.. So money was wasted on those 2 days and we felt very angry at having been duped.. All these closures and privatisation are being done covertly and in my view illegally..

DaisyAnne If we were to privatise the NHS, and I absolutely do not support that in any way, it doesn't follow that the alternative is an American style sytem. Most Eurpoean countries have a system that is a combination of insurance and taxation with the insurance sometimes state provided , and always tightly regulated. All these sytems are organised so that the less you earn the less you pay and the poorest get healthcare free.

I get tired of reading lazy thinkers who keep waving the American system in front of us as the only alternative. Why do they not spend some time looking at how other countries approach this problem of funding health care and give us a critique of those systems.

DaisyAnne I would not be happy as I've paid into the NHS all my life and certainly would not be able to afford it . This isn't a new arrangement though as my husband had a knee replacement over 7 years ago and my sister a hip replacement at Private hospitals paid for by the NHS.
I support the NHS wholeheartedly and I hate what is happening .

Good for that surgeon.

Sadly, and for a very long time, some Consultants have very deliberately kept their waiting lists hugely long, to encourage people to go private. And are the ones making a lot of money currently too, and profiting even more thanks to this Governement policy.

Fleurpepper

tickingbird

My friend is going in to have his hip done tomorrow and he’s got in quickly. It’s being done in a private hospital but on the NHS. The NHS is paying for private health care!

I could not blame anyone in pain or danger wanted to avail themselves of that opportunity.

But it is all designed to undermine the NHS- just bribes for those who are desperate.

It stinks. But good luck to your friend, I truly can't blame her/him.

Friends of mine paid for some tests because her husband was so ill. The surgeon they had gone to privately told them to transfer back to the NHS, where he would be doing the operation anyway.

He said that if they continued down the private payment line without insurance, it would bankrupt them.

I worry that people don't understand how many individuals would have no health service if we privatise the system.

The question to ask ourselves is, "if the NHS was privatised tomorrow, could you afford the insurance?" The answers will range from 'no', through 'some', to 'yes, I would be fine'. The politicians trying to privatise the NHS are all, it seems to me, in the "yes, I would be fine" category and probably already have shares in health concerns.

It’s deliberate of course, but the aim at the moment is to convince the electorate that the Tories can be trusted to bring waiting lists down before the election. That’s how shallow they think our regard for the NHS is.

Yes, and no! It is deliberate, calculated- to create a need, and then to offer 'bribes' in desperation- to privatise by the back door.

Fleurpepper

tickingbird

My friend is going in to have his hip done tomorrow and he’s got in quickly. It’s being done in a private hospital but on the NHS. The NHS is paying for private health care!

I could not blame anyone in pain or danger wanted to avail themselves of that opportunity.

But it is all designed to undermine the NHS- just bribes for those who are desperate.

It stinks. But good luck to your friend, I truly can't blame her/him.

This has been done since the eighties to cut waiting lists in orthopaedics and surgical specialties. It’s not a new initiative. I’m very much pro NHS, but recognise that as the emergency pressures are so bad and the chronic underfunding of the NHS so pervading, it’s the only way to reduce waiting lists at the moment - unless anybody has a magic wand?

Fleurpepper
Why?

But it is all designed to undermine the NHS- just bribes for those who are desperate.

It stinks. But good luck to your friend, I truly can't blame her/him.

As noted above. I did the same with a carpal tunnel op. Buying in care from elsewhere when there is peak demand makes absolute sense. Where does the bribery come in?

tickingbird

My friend is going in to have his hip done tomorrow and he’s got in quickly. It’s being done in a private hospital but on the NHS. The NHS is paying for private health care!

I could not blame anyone in pain or danger wanted to avail themselves of that opportunity.

But it is all designed to undermine the NHS- just bribes for those who are desperate.

It stinks. But good luck to your friend, I truly can't blame her/him.

DaisyAnne

I think your "How do you boil a frog" quote exactly sums up what is going on with this government and the NHS Urmstongran.

However, I would not see the Kings Fund as an unbiased source. As far back as 2014 they were listing charges that could be made to fund the NHS.

Simply, I would say the answer to the question "can the NHS still be funded" is, quite obviously,"yes". The question under discussion, here and in the country is "how?"

Should it remain free at the point of need and funded by taxes. Should it be privatised and funded by the individual. Or should there be some compromise solution?

My worry is that the second of those choices - privatisation - is being imposed on us with no one ever having voted one way or the other. A privatised health service is, in no way, a National Health Service.

You didn’t answer my earlier question about the source of your original post DaisyAnne, or about whether you were referring to the UK as a whole, or just England?
The Kings Fund is an independent think tank, and one of the most reputable in the UK, but I accept that it’s not the only source of information about privatisation of the NHS. There’s lots of information available out there from other sources, and if you want a serious debate about this rather than anecdotes about personal experience I’m up for it, I expect others would be too, but it important to understand exactly what your contention is based on in order to do that.