Is our NHS already lost

Farzanah

The NHS has had many many reforms and each one seems to be mainly regressive. Our system was widely respected as the best, most efficient and value for money in the world until about 12 years ago.

I know however that the rot did start to creep in before then, and I have no illusions Callistemon that the Labour Party is against privatisation, which is what concerns me.

Our system was widely respected as the best, most efficient and value for money in the world until about 12 years ago

That was the rhetoric and we kept being told that until we believed it.
"The envy of the world"
It wasn't actually true as those who live in other countries would have told us.

The Commonwealth Fund a US organisation that rated 11 countries in the world for healthcare judged the NHS best until we started to slip www.independent.co.uk/news/health/nhs-rank-rating-world-top-first-b1897008.html
So it was true. Unfortunately it isn't now.
Nothing to do with the Tory government of course.

It was rated first in 2014 and 2017. So obviously the Conservative government was doing something right. Since then of course we’ve had covid to cope with. Clearly that had a huge impact on treatments.

You beat me to it Glorianny. Thanks. If Callistemon cares to look this is easily confirmed. What the NHS remains at the top in is Value For Money.
USA health system which we seem to be gradually moving towards spends the most on health care and comes bottom in league tables.

Germanshepherdsmum

It was rated first in 2014 and 2017. So obviously the Conservative government was doing something right. Since then of course we’ve had covid to cope with. Clearly that had a huge impact on treatments.

Coalition government 2010-2015. Operating an NHS left by a Labour Government. Conservative government since operating over its steady decline.

Coalition government - that’s scraping the barrel. How do you explain the 2017 ranking? What allowance do you make for the effect of covid?

i have just had a look at the map and i don't see anything in glasgow and edinburgh, but i do know that the surgeon that did my bowel cancer surgery works at two private hospitals in glasgow. if people can afford to go private then they should, i had to wait 2 moths for my cancer surgery, i am more than happy for prisons to use private health services as it is less risk to staff and other patients depending on the prisoner.

You are correct GSM that Covid had a big impact on the NHS as it did in all countries. However the NHS was in decline before this which meant our health service was even more vulnerable when the pandemic struck.
The Kings Fund have an up to date report on the Rise and Decline of NHS in England 2000 - 2020.
It’s worth reading for the Key Points alone.
The last one The coalition government (2010-15 and successive Conservative governments since then have failed to heed the warning signs of deteriorating performance and preferred to use short-term fixes rather than seek long term solutions.

What would the long term solutions be?

Renationalise the NHS

I assume that isn’t intended to be a serious answer to my question.

Germanshepherdsmum

What would the long term solutions be?

That would be an interesting debate. And one that should involve to some extent the 'service users'. Or patients, as they used to be known .

I'd start off by suggesting that the very first requirement for long terms solutions would be that we understand what the NHS can provide - and that there is a commitment / willingness to provide it on behalf of government - any government.

It's easy to lay the blame now at the door of this government - but they have inherited the results of previous short-term solutions / restructuring. Hence Sunak looking around desperately for a solution to the 8 o'clock scramble. He doesn't have a lot of immediate options does he? So although I'm critical of his proposal, I think the man is in a difficult position.

Germanshepherdsmum

Coalition government - that’s scraping the barrel. How do you explain the 2017 ranking? What allowance do you make for the effect of covid?

I agree the coalition government was "scraping the barrel". Since then the Tories have been flogging off the barrel.

I agree Dickens. Numerous restructurings seem to me, from the outside, to have, at considerable expense, created additional layers of bureaucracy and postcode lotteries. And Sunak doesn’t have immediate options available to him. I don’t think anything short of a root and branch reform, unpicking some of the unsuccessful restructurings which have, for instance, eroded the purchasing power of a behemoth such as the NHS in favour of individual trusts doing things their own way, will bring about change. Until then there is no option but to apply sticking plasters, chuck money at the NHS which is never enough (Lord knows what levels of taxation would be needed) and draw on such facilities as can be provided by the private sector without criticising it as ‘privatisation’.

Dickens That would be an interesting debate .And one that should involve the ‘service users’.
I agree but would add this should be a cross party debate, which unfortunately any government does not seem keen to initiate.

There are certainly some hard questions which need to be addressed. For example as medical science advances more treatments/drugs which are very expensive are becoming available. The cost benefit for quality/longevity of life has to be considered. This is a real problem already and cases often hit the headlines causing is a huge public outcry when certain treatments are denied.

I don’t think anyone would argue that the NHS can continue in its present state, and changes are necessary. My concerns are that decline has been conveniently engineered so that the public gradually come to believe that the NHS is unaffordable, and that a more “efficient” private system is the answer.
I fear we are moving towards a US style system, which there is clearly no evidence for. It is by far the most expensive, and fails so many of its population.

I believe in U.K. at present a straightforward hip replacement for example costs twice as much done privately as it would in the NHS.

Maybe you will end up with a hybrid system like Australia where they tax you at a higher rate if you can afford private health cover but don’t take it out. As you get older, most who can, have private health insurance but it doesn’t work that well because there is a big ‘gap’ payment where you pay for things out of your own pocket. You do get seen to more quickly than in the public health sector so that is what you are paying for. There are dozens of private hospitals now, they are making stacks of money. Better than the American system but not ideal.

Could somebody please explain how and why a universal healthcare system works better for everybody if it's privatised? Or does it just work better for the people who can afford to buy private healthcare? How does private care solve the problems in the NHS - for everybody?

growstuff:
'How does private care solve the problems in the NHS - for everybody?'

It doesn't - still, the long standing, enormous and insurmountable problem is us, I'm afraid.

We're living far longer - and many more years in poor health. There are many new treatments, procedures, diagnostic tools, medicines etc. too.

Still, we expect the same service and waiting times - all free at point of use. Do we vote for the far higher taxes to adequately fund the system? No.

Well, for a start ( and I think Starmer may have mentioned this but I could be wrong) instead of treating people when they do become ill the health service should aim to keep people healthy. Teach children in school about healthy eating and the importance of exercise. Help provide nutritious meals at nursery schools and schools. Make sure schools have playing fields ( wasn’t it a Conservative government that sold them off?). Provide gyms for people to use and make sure they’re affordable. Sort out social care and do something about bed blocking. Thankfully less people smoke these days but someone in the health service told me that vaping is creating another potential long term health problem. If the NHS is overwhelmed these days might it be because, as ever, we seem to be following America in that many people are overweight ( and I do understand that that isn’t always the fault of many overweight people) and we need to do something about obesity in children which leads to health problems in later life.

Still, we expect the same service and waiting times - all free at point of use. Do we vote for the far higher taxes to adequately fund the system? No.

This debate is like groundhog day. We've done it over and over again here on Gnet. It mostly boils down to the same erroneous beliefs that only a finite amount of money is available for spending on public services, that taxation comes before spending and that the NHS is a black hole that swallows money that is never seen again.

There's also the peripheral belief that growstuff has touched on, that privately provided services are going to be much better.

It all seems a bit of a pointless exercise.

MaizieD

^Still, we expect the same service and waiting times - all free at point of use. Do we vote for the far higher taxes to adequately fund the system? No.^

This debate is like groundhog day. We've done it over and over again here on Gnet. It mostly boils down to the same erroneous beliefs that only a finite amount of money is available for spending on public services, that taxation comes before spending and that the NHS is a black hole that swallows money that is never seen again.

There's also the peripheral belief that growstuff has touched on, that privately provided services are going to be much better.

It all seems a bit of a pointless exercise.

Yes

personally feel it will have collapsed by the end of the year. It is functional at the point of emergency care ( car crash, heart attack , broken leg and the likes) but failing miserably with specialist clinics and follow-ups to your emergency.
To few Dr's and other staff available and that can no longer work here thanks to Brexit.
I have been under respiratory for 3 yrs, wait months in between appointments, no continuity as every time you see a different fill in Dr, who says see you again in 6/8 weeks but they never do another clinic locally and ends up being 6 months before you see a different person.

Casdon

Glorianny

The providers on the map are all being given NHS money, regardless of what service they are offering. That is public money going into private pockets. It's also obvious that the only way to provide the service and to show a dividend for share holders must be to cut something. In many cases it will be the pay of poorer workers and the provision of things like cleaning.
Any services that it is impossible to make money on will be abandoned. The NHS will be left with those services.
As for MPs any involvement with private health care providers is a conflict of interests.

You don’t understand how the NHS has, and will continue to provide services Glorianny, so you are making statements which imply that private care is always bad. The logical conclusion to your premise is that the NHS should offer everything people want regardless of the clinical need for it.

A lot of the units on this map provide specialist services. The map would have more credibility if it showed the services which were previously provided by the NHS but have now been contracted out.

To answer your original question -No, the NHS is not already lost, because there aren’t many services in that category at the moment. To qualify my response I must say I worked in a senior role in the NHS for over forty years, and I strongly believe in it - what I don’t believe in is inaccurate scaremongering.

Thank you for your sensible non scaremongering analysis.

Very well put.

The same points seem to be constantly repeated in this thread and I agree about Groundhog Day Maisie re tax funding, but as usual I think posters disregard previous posts.

I agree with you MayBee that preventive services are important and much more attention and funding needs to be directed to community health care. However the biggest predictor of poor health is poverty, and this has certainly got much worse in the last few years.