Junior doctors strike

When people haven’t even got £25 to spend on a week’s food it is not a small charge. With any “exemptions” to the charge it will become a two tier system. Look at the way dental services are being delivered (or not). People are reduced to pulling out their own teeth.

The insurance companies must be salivating at the idea of charges for NHS services being introduced.

The cost of administration of such charges would also negate any profit.

Your figures are distorted by the cost to the NHS of the pandemic ronib.
www.statista.com/statistics/317708/healthcare-expenditure-as-a-share-of-gdp-in-the-united-kingdom/

As the health of the population is of the highest priority, and improving health status improves GDP, why do you see spending a bigger proportion of the GDP on it as an issue?

consider small charges to see a gp for example. £25 a visit was suggested.

What about the people for whom £25 isn't a small sum?

I was in the doctor's waiting room earlier this week (nothing serious). There were little old ladies, children, people who appeared to be chronically sick, a couple of younger people, and me. (I guess I'm a little old lady ) Many of those people probably don't have £25 to spare and so they would think twice about going. So, we might want to set up a system where they get free appointments. But then setting up and running that system would cost the NHS money...vicious circle.

Its like when people complain about free prescriptions in Scotland. If we had to pay for them, the exceptions would be many and it would cost more money in the end. So just pay more tax in the first place if you can afford to pay for your prescriptions.

Countries where you pay money for a consultation have an entirely different healthcare system than us; we either change things completely to ensure care is free at the point of need, or we leave it alone. Tinkering at the edges won't help.

ronib

MaizieD A health professional told me that the Nhs needs so much spent on it that it’s time to consider small charges to see a gp for example. £25 a visit was suggested.

We already spend almost 12 per cent of GDP on healthcare so to increase spending to 25 per cent of GDP seems very radical but is required.

I know you don’t see a problem with spending MaizieD but I was looking at the way think tanks approach this issue.

Would the idea be to discourage people from seeing a GP?

For many people, £25 isn't a small charge, especially if they are then given a prescription with charges of £9.65 an item.

I'm afraid it would deter some people who most definitely should be seeing a GP from making an appointment.

I can't see how that's preferable to funding GPs through general taxation.

HousePlantQueen

Wyllow3

Boris Johnson, 2019

"Boris Johnson could not have been clearer in his first speech as prime minister about his intention to finally come up with a solution to one of the great policy failures of the last 20 years.

“My job is to protect you or your parents or grandparents from the fear of having to sell your home to pay for the costs of care,” he said.

“And so I am announcing now – on the steps of Downing Street – that we will fix the crisis in social care once and for all, and with a clear plan we have prepared to give every older person the dignity and security they deserve.”

www.theguardian.com/uk-news/2019/aug/01/promising-to-fix-social-care-could-cost-boris-johnson-dearly

I know of many people who voted Tory on the basis of this promise. I wonder how they feel now, especially with the 50% cut in funding. If these are manifesto promises, should we sue them for failure to provide as promised?

I really wish we could sue for breach of election promises.

I know we can all have good intentions that for various reasons don't happen as we wish, but why not say that all parties have to have five key promises that will be held to*? If they have measurable benchmarks which had to be independently and publicly reviewed each year and graded on a traffic light system, voters could see at a glance how they are doing. They inflict this sort of thing on schools, universities, hospitals and so on, but are not held to account themselves. It would also show voters where the priorities of the party leaders lie.

If there has been something like Covid that has interfered with their plans, they should be able to explain, but not just wave criticism aside with sweeping statements - special pleading should get a heavier touch review, and require a full audit trail and statements from all involved to show how the promise was affected by the unusual event.

*or some other predefined and measurable set of criteria - I picked 5 promises as Labour did this and the Tories copied it but made theirs 'priorities'. 5 pledges seems reasonable though. Too many would dilute the impact, and one or two would allow too much else to go to the wall.

ronib

Callistemon21

^There is enough money in the economy to pay for a decently run NHS^

This
I have said that several times.

There is no will to do so.

King’s Fund points out that we spend more than the EU average on health apart from Germany, France, The Netherlands and one other country. Bit puzzling.

Amanda Pritchard insists that the Nhs delivers value for money spent - Nhs is wonderful talk to conference members for ‘we are the Nhs’ available on YouTube.

Something like 3.8 per cent uplift each year in spending? Or thereabouts…up from 1.5 per cent.

It’s beginning to feel that the Nhs needs double the amount spent on it ? Time to rethink the whole concept?

You mean letting those people without personal means to pay die?

Yeah! Great idea!

The idea of £25 to see a gp is not mine but suggested to me by the mother of an impoverished 30 year old junior doctor.

Well I'm sure s/he's a very good doctor but his mum is no economist.

Volver3 her mother is a health care professional who has watched the decline of the Nhs and she thought the Nhs model is not working and needs a rethink. From her day to day working experience!

So. Not an expert in funding large organisations then.

Volver 3 is anyone?

ronib

The idea of £25 to see a gp is not mine but suggested to me by the mother of an impoverished 30 year old junior doctor.

Well who would this hit most? The sick, the elderly and those with young children. My mother had a number of illnesses that needed regular GP monitoring, at £25 a go she would just never have gone. I suppose she would have saved the NHS money by dying earlier.
This is so contrary to what good healthcare involves one part of which is monitoring the health of people to prevent serious conditions developing and deterioration. So it isn't just unaffordable for many it's a stupid idea as well.
Imagine the choice for a parent not just "heat or eat"but "heat or eat ,or take my sick child to the doctor"

Maybe with exemptions for children?

ronib

Maybe with exemptions for children?

And how much will the exemption system cost the NHS to run?

ronib

Maybe with exemptions for children?

So old people like my mother can just die earlier?

The people who get prescription exemptions would get a payment exemption under the type of system you propose ronib. So nearly 90% of people wouldn’t pay. The cost of administering the system for 10% of people would not be worth the hassle due to the administrative costs, just as it isn’t for prescriptions. Meanwhile, those in the 10% who can’t afford to pay would get sicker, resulting in higher costs to the remainder of the NHS. It doesn’t stack up.

ronib

Volver3 her mother is a health care professional who has watched the decline of the Nhs and she thought the Nhs model is not working and needs a rethink. From her day to day working experience!

It's this woman who needs re-educating.

How would a £25 fee to see a GP help improve the health of the nation?

Casdon

The people who get prescription exemptions would get a payment exemption under the type of system you propose ronib. So nearly 90% of people wouldn’t pay. The cost of administering the system for 10% of people would not be worth the hassle due to the administrative costs, just as it isn’t for prescriptions. Meanwhile, those in the 10% who can’t afford to pay would get sicker, resulting in higher costs to the remainder of the NHS. It doesn’t stack up.

It's a inane idea.

Glorianny

ronib

The idea of £25 to see a gp is not mine but suggested to me by the mother of an impoverished 30 year old junior doctor.

Well who would this hit most? The sick, the elderly and those with young children. My mother had a number of illnesses that needed regular GP monitoring, at £25 a go she would just never have gone. I suppose she would have saved the NHS money by dying earlier.
This is so contrary to what good healthcare involves one part of which is monitoring the health of people to prevent serious conditions developing and deterioration. So it isn't just unaffordable for many it's a stupid idea as well.
Imagine the choice for a parent not just "heat or eat"but "heat or eat ,or take my sick child to the doctor"

... and expectant mothers. If you look at a graph showing who uses the NHS most, there's a big bump for women in their late 20s and 30s - mainly for maternity care.

Glorianny

ronib

The idea of £25 to see a gp is not mine but suggested to me by the mother of an impoverished 30 year old junior doctor.

Well who would this hit most? The sick, the elderly and those with young children. My mother had a number of illnesses that needed regular GP monitoring, at £25 a go she would just never have gone. I suppose she would have saved the NHS money by dying earlier.
This is so contrary to what good healthcare involves one part of which is monitoring the health of people to prevent serious conditions developing and deterioration. So it isn't just unaffordable for many it's a stupid idea as well.
Imagine the choice for a parent not just "heat or eat"but "heat or eat ,or take my sick child to the doctor"

Are these people likely to vote Tory?

BTW My partner's father (in his 90s) has been in hospital over the last couple of days. No complaints about the care he's received. It would appear that emergencies have indeed been covered.

Some research on the feasibility and effects of charging a ‘nominal’ fee for primary care and other NHS services www.ncbi.nlm.nih.gov/pmc/articles/PMC6532806/

Also worth noting -since the article references it - that Ireland, which has a mixed private-public system has a shortage of GPs and hospital beds, and non-consultant (junior) doctors are leaving in unprecedented numbers to work elsewhere.

The Nhs has costed out missed appointments and appointments cancelled without sufficient notice. It’s a significant figure. A payment system might stop this?

I know that an impoverished country like Greece has a fee to see a gp in place. Also the Greeks I know seem very well informed on basic health care, nutrition, exercise etc plus use of pharmacy as first port of call. My feeling is that somehow the Nhs continues to struggle and some reform will become necessary in the future. It feels as if the two options here are very expensive private health insurance or an increasingly stretched public health sector.

Yep! The NHS needs reform - more funding would be a start!

How exactly would a fee to see a GP make the nation healthier?

Greece is infamous for not being very efficient about collecting taxes.

Maybe those patients who consistently miss appointments and/or cancel without adequate notice could be fined or "struck off", but why should everybody else pay for them?