Is our NHS already lost

MaggsMcG

A lot of the problems with the NHS is also from misuse and overuse from the general public, and not enough record checking from medical tourists. People need to realise just how expensive research, new technologies and new drugs are. We all need to be aware that SOME of it is caused by us and stop misusing it.

A lot? How much? Claims like that need to be backed up.

maddyone

Because Doodledog we live in a free market economy and therefore we cannot pick and choose who can employ people who are also free to choose where they work. We do not demand payment from companies who employ graduates, who we have topped up their education costs, and we should not expect medics or the companies they work for, to be charged. I repeat, just because medics are employed and trained in the NHS does not give any of us the right to demand payment when they choose not to work in the NHS.

I disagree with you. Medical training is heavily subsidised by the state - much more than most degrees. The state does it for the well-being of the population - not the enrichment of medical graduates.

UK companies who employ graduates are hopefully contributing to general taxation through the tax they pay.

I don't think it's unreasonable for private healthcare companies to pay a contribution for the training of the staff they employ, who make profits for them.

The NHS seems to think it can do as it likes now and nobody will question anything. Can’t get appointments to see a GP, 3 week wait, when you do get there the whole surgery is deserted! What are they doing? The phone message still reports they are experiencing extremely high levels of calls. so where are all these people? I have waited 2 weeks for a nurse to ring me. I have messaged them twice, I have phoned Nurse Admin twice and they assure me she will ring me ….. but when?

Well said Doodledog.

But they don’t pay anything like the cost of training, which is my point. We do live in a free market economy, but that doesn’t mean that we have to do so forever, or that exceptions couldn’t be made. It just seems to me unfair that a profit-driven sector can cream off employees who were trained out of public funding and restrict their patients to those who can afford it, when many of those who can’t will have paid taxes for decades.

I guess doctors have student loans to repay just like other graduates? They are far more likely to repay their loans than some who study subjects which are unlikely to lead to a highly paid, if any job (I’m trying to be polite here),

janipans you clearly have no idea of how the NHS was funded at its inception or is now. It was never intended as an insurance based system, and is dependent (mostly around 80%) on general taxation for funding. Of course National insurance payments contribute.
From the outset it was clear that it would lead to inequalities if treatment dependent on contributions.
I don’t know why this myth continues.

Because Doodledog we live in a free market economy and therefore we cannot pick and choose who can employ people who are also free to choose where they work. We do not demand payment from companies who employ graduates, who we have topped up their education costs, and we should not expect medics or the companies they work for, to be charged. I repeat, just because medics are employed and trained in the NHS does not give any of us the right to demand payment when they choose not to work in the NHS.

Most hospitals do have bank nurses who can pick and choose their hours. They are paid according to their NHS Band for the hours they work.

Agency staff get a higher rate added to which the agency’s percentage has to be paid by the NHS Trust using them.

Maybe so, maddyone, but why should companies profit from the massive subsidies given to medics when they train? Even if they are free to work as and where they choose, why not charge private hospitals and agencies a levy every time they employ an NHS trained doctor or nurse?

Better workforce planning would help.

Midell

As I understand it, the private sector does not train any surgeons, doctors or registered nurses, instead it uses those already trained by the NHS (plus perhaps some trained outside this country). What would happen to their prices if they could not take staff from NHS. Perhaps they should be charged a whacking great premium for taking NHS staff either fully or part time. Agencies also annoy me. If staff want to work ad hoc rather than fully for NHS they should become bank NHS . Agencies charging ridiculous amounts just shouldn't exist, unless they too want to start paying the full training and experience costs.

Whilst I agree that it would be better to have a ‘bank’ of nurses who can be employed as and when, I think sometimes that people think they own NHS staff, just because they partly train in the NHS. We don’t own them, they are free to work for whoever and whatever they want to work. Nurses and doctors attend university and pay fees like all other students. They also work for free on the wards during that training, especially the final years. Then they are employed by the NHS and they work and are paid like any other employee, and like other employees, they increase their skills whilst working. During any further training they are also working. If they choose to go abroad to work, or work in private medicine, that is their choice which they are free to make. They are not owned by the NHS anymore than an employee working for a company who trains the employee, and who then moves on to another company, is owned by the first company who trained them and increased their skill level. It doesn’t work like that in private industry and it doesn’t work like that in the NHS.

Saggi

No ….but it’s a short way off ! It’s what all parties want ….a general slip-slide into the American system…. two tier health …the ‘haves’ and the ‘have nots ‘ …. unfortunately I’ll be a ‘have not’ ….but I’m over 70 so my disappointment in the way this country is heading won’t be long-lived!

I don’t think that’s true. It certainly isn’t the way the NHS operates in Wales, which has a Labour Government with devolved responsibility for health and social care.

….and ‘Growstuff’ ….I think you’ve got the most interesting idea🤔

No ….but it’s a short way off ! It’s what all parties want ….a general slip-slide into the American system…. two tier health …the ‘haves’ and the ‘have nots ‘ …. unfortunately I’ll be a ‘have not’ ….but I’m over 70 so my disappointment in the way this country is heading won’t be long-lived!

A lot of the problems with the NHS is also from misuse and overuse from the general public, and not enough record checking from medical tourists. People need to realise just how expensive research, new technologies and new drugs are. We all need to be aware that SOME of it is caused by us and stop misusing it.

I agree with you Doodledog. Where would it stop?

Well said Midell.

Midell

As I understand it, the private sector does not train any surgeons, doctors or registered nurses, instead it uses those already trained by the NHS (plus perhaps some trained outside this country). What would happen to their prices if they could not take staff from NHS. Perhaps they should be charged a whacking great premium for taking NHS staff either fully or part time. Agencies also annoy me. If staff want to work ad hoc rather than fully for NHS they should become bank NHS . Agencies charging ridiculous amounts just shouldn't exist, unless they too want to start paying the full training and experience costs.

Prepare to duck, Midell .

I agree with you, but you will be shouted down, I'm sure.

It is also unfair to those who have contributed all their working lives who can't get their hip replacements or whatever because there is a person with greater need but who has never contributed.
By this logic, UK citizens should only be treated on the NHS if they have paid in X number of years of contributions? Where does that leave children, the disabled, carers of the disabled, and those otherwise unable to work - not to mention the unemployed or those who have been otherwise 'economically inactive' and have not contributed enough? Would you turn them away, or take money pro rata out of some budget or other to pay for their treatment? Which budget would you raid?

As I understand it, the private sector does not train any surgeons, doctors or registered nurses, instead it uses those already trained by the NHS (plus perhaps some trained outside this country). What would happen to their prices if they could not take staff from NHS. Perhaps they should be charged a whacking great premium for taking NHS staff either fully or part time. Agencies also annoy me. If staff want to work ad hoc rather than fully for NHS they should become bank NHS . Agencies charging ridiculous amounts just shouldn't exist, unless they too want to start paying the full training and experience costs.

janipans

The NHS was designed as an insurance system, with premiums to be paid for from contributions from every working person and a bit extra to cover people unable to work. We now have a situation where massive immigration has led to more people having access to the NHS without having contributed to the common pool so no wonder it is underfunded. It is also unfair to those who have contributed all their working lives who can't get their hip replacements or whatever because there is a person with greater need but who has never contributed. I am not anti-immigration - quite the opposite, I am proud that Britain is generally a welcoming and cosmopolitan place to live, but practically, the additional burden on the NHS has to be accepted and paid for somehow. I think the answer lies in ensuring that for every legal immigrant there is an injection of capital into the NHS equivalent to whatever a person of that age should have contributed to date. That money should be taken from our foreign aid budget.

What percentage of NHS funding is used by "massive immigration"? If you are going to make claims like that, you need to be able to back it up.

I'm afraid that's not how it works. What exactly do you mean by the "usual sources of investment"? Research isn't going to provide a quick return for high stakes investors.

My partner is a university professor of biotechnology and spends much of his working life liaising with the small labs and big pharma companies. While the UK still has a reputation for innovation, we still attract some of the best scientists in the world, although not for much longer, if the government continues to be complacent.

The UK spends a relatively small amount of money on research, but bleats on about being a world leader. In the post-Brexit world, we really do need to invest our strengths, but we're not.

If the usual sources of investment don’t want to know that says a lot. Too much risk. The labs are only taking on risk to the extent that they invest their own money.

They're not acting as venture capitalists in the normal sense. They're investing in research, which is all interconnected.

Small private research labs are the ones who take on the risk. If their research shows promise, they then look for funding from the big pharma companies or research grants (or. in the past, the EU).

University research doesn't operate in isolation. Any techniques developed can be used for a number of purposes and contributes to general scientific knowledge. It is only when it becomes obvious that something looks as though there is a reasonable chance that it will be successful that government funding is sought.

This is still one of the UK's main strengths and it is blinkered not to invest in a success story.