Is our NHS already lost

Where did you get that figure from Louella? And what relevance does it have to the discussion? It costs a lot to educate and train many other people, but we don’t own them, nor do we own doctors!

Glorianny

I don't think doctors should pay, but I see no reason why private providers using NHS trained staff shouldn't pay something towards that training. So perhaps a sliding scale- doctors employed with 5 years NHS training, x amount paid, 10 years training 2x, and so on with a consultant costing the provider most. A similar system to apply to nurses.
After all if the NHS uses a private operating theatre they have to pay for it.
The alternative is for private companies to fund training and allow training in private hospitals.

This is exactly what I am getting at, but keeps getting ignored.

Nobody is saying that doctors should be indentured, but that agencies which 'poach' state-trained staff should be charged, as they just sweep in and cream off staff.

It's not personal, maddie. I understand your protecting your daughter, but none of what I am saying would affect her at all - she could, like my son, move to another employer, but they would have to pay for the privilege of taking her, and that money could be reinvested in training someone else to work in the NHS.

Glorianny
I think it highly unlikely that a doctor who has worked for five years only in the NHS would be able to work in the private sector. They need to be very experienced and usually Consultant level. In addition, as I mentioned before, most doctors work between the two sectors, and are therefore already working in the NHS. It’s complicated. In addition any patient receiving private treatment is then taken out of the NHS system and so there is a huge benefit already to the NHS.

That’s according to an old DM article. More recent (and dare I suggest credible) reports suggest around £250k.
I don’t think anyone is suggesting that the doctors leaving for a private company here should pay Glorianny, but the companies - though maybe if the doctor is leaving to work abroad they should have to pay.

In addition any patient receiving private treatment is then taken out of the NHS system and so there is a huge benefit already to the NHS.
No they aren't. Patients often jump queues by seeing a consultant who then refers them back to the NHS ahead of those who can't or don't want to pay.

Also, some patients get part of their treatment privately, but then use the NHS for things like intensive care, or if follow-ups are needed because of complications.

The private sector absolutely takes from the NHS, and it is disingenuous to pretend that there is a huge benefit.

Don’t worry Doodledog, I think I know you well enough to know that you’re not being personal. And I often agree with you about other subjects, but we all obviously have our own opinions on everything.
I felt very upset when my daughter and our grandchildren moved to New Zealand and felt quite angry that another country was able to poach her ( and they didn’t pay to train her or pay our country anything for her, and apparently NZ consistently don’t train enough doctors for their needs but prefer to poach from other countries) but I know we do the same, and I don’t really agree with us doing it either. At the end of the day though, we have to accept that all medics, not just doctors, can sell their skills wherever they wish to, and nobody pays the government for them. I would prefer other countries to pay for all the doctors they poach than private providers in this country because at least private providers keep some patients off the waiting lists and the doctors normally work across both systems anyway.

In actual fact we have a huge problem of loss of qualified medics going to work abroad, mainly to Australia and New Zealand. This brings us to the problem of pay and conditions for doctors in the UK and is the more immediate and important problem to solve.

It’s a much bigger problem than doctors working in the private sector.

Not enough doctors in training. Why are their numbers capped?

Doodledog

*In addition any patient receiving private treatment is then taken out of the NHS system and so there is a huge benefit already to the NHS.*
No they aren't. Patients often jump queues by seeing a consultant who then refers them back to the NHS ahead of those who can't or don't want to pay.

Also, some patients get part of their treatment privately, but then use the NHS for things like intensive care, or if follow-ups are needed because of complications.

The private sector absolutely takes from the NHS, and it is disingenuous to pretend that there is a huge benefit.

No they are not. People see someone privately, then are put at the top of the queue- and then treated and/or operated on NHS. I know this for a fact, and on so multiple occasions.

Private patients also take much much more doctors time, and are likely to be prescribed more expensive and numerous tests, drugs and operations.

I find that comment very strange fp. You are suggesting that seeing a consultant privately is a means of being put at the top of the NHS waiting list and that the NHS will treat you accordingly. My own experience of seeing a consultant privately is that you are treated privately, not on the NHS.

When I first saw a consultant privately in desperation at the pain in my knee he said, after examining me and looking at the X rays, that I would have gone to the top of the list for NHS op and offered to transfer me. That felt wrong to me so I stayed private. (Ironically, paid for op with NHS retirement pension lump sum!)

Surely the queue jumping is seeing the consultant privately for diagnosis, not the treatment that results from subsequently being put back into the NHS queue.
My experience with a private neurologist, whilst not having the funds for private MRI etc, was that my GP would have to refer me back to her through the NHS system like any other Tom, Dick or Harry.
No preferential queue jumping, though she did say to bring her letter with her findings to the appointment!
You don't go to the top of the list as I understand it

You are queue jumping if you see the consultant 8 weeks or months before someone who cannot pay, as you are put onto the NHS list immediately and the other patient has to wait, even if their condition is deteriorating faster than yours.

You don't go to the top of the list ahead of others who are already on it, but you certainly do queue jump and you certainly get to the top much faster than those who have to wait to be seen in the first place.

Some years ago I saw a consultant privately. A woman I was working with had the same problem.
She was seen before me going through the NHS route.

maddyone

Glorianny
I think it highly unlikely that a doctor who has worked for five years only in the NHS would be able to work in the private sector. They need to be very experienced and usually Consultant level. In addition, as I mentioned before, most doctors work between the two sectors, and are therefore already working in the NHS. It’s complicated. In addition any patient receiving private treatment is then taken out of the NHS system and so there is a huge benefit already to the NHS.

Fine but as I said it would be a sliding scale. Consultants are not trained by the private sector. The qualification and training involves a lot of work by NHS staff. I see no reason why any private provider using a consultant should not contribute towards the cost of that training. They obviously benefit from it.
The employment by both sectors is irrelevant.
As is the patient being taken out of NHS treatment. We all know that any failure or serious complication will see that patient returned to the NHS.

There are a whole range of occupations where people receive ongoing post degree training in the public sector and then move can move into the private sector. Physios, audiologists, pharmacists, teachers, tax inspectors, soldiers, sailors and airmen etc, why are doctors singled out? Out of interest, how long should doctors be employed by the NHS before the have "paid their debt to the tax payer/society"?

Nobody is singling out doctors! Why don't you read the posts properly?

What people are suggesting is that the agencies and private healthcare companies, who make a great deal of money out of doctors without the expense of training them, pay some kind of levy.

Nellybrook

Surely the queue jumping is seeing the consultant privately for diagnosis, not the treatment that results from subsequently being put back into the NHS queue.
My experience with a private neurologist, whilst not having the funds for private MRI etc, was that my GP would have to refer me back to her through the NHS system like any other Tom, Dick or Harry.
No preferential queue jumping, though she did say to bring her letter with her findings to the appointment!
You don't go to the top of the list as I understand it

Well, that's odd because I know somebody who had a hip replacement two weeks age after waiting only three weeks. She saw a consultant privately, who then put her on his NHS list.

I’m sorry Glorianny but I disagree. Consultant doctors work in both sectors, private and NHS. Not all do, but some do. They fulfill their contractual obligations working in the NHS. What they choose to do in their own time is nobody else’s business. They could choose to play golf, look after their grandchildren, or do further medical/surgical work for which they are paid. It’s nothing to do with us or anyone else. And the private hospitals have no need to pay the NHS because doctors choose to work privately outside of the NHS in their spare time! Incidentally dentists do it all the time!

Interestingly, if a graduate from a good university goes to work as a financier and makes millions, or at a successful business such as IBM and earns a huge amount of money, or makes himself into a millionaire using the skills learnt at university, nobody bats an eye nor thinks either the graduate, or the company he works for owes anyone a penny. Doctors don’t actually get that rich, and private hospitals offer a service, just like a hairdresser does, or a chiropodist, but because of our NHS, people really do get on their high horses about the possibility of doctors earning a bit more, or private companies benefiting from their education. It’s ridiculous really and boils down to the politics of envy, which I have never subscribed to. We do own the NHS but we don’t own the doctors who work in it.

Germanshepherdsmum

I find that comment very strange fp. You are suggesting that seeing a consultant privately is a means of being put at the top of the NHS waiting list and that the NHS will treat you accordingly. My own experience of seeing a consultant privately is that you are treated privately, not on the NHS.

And your comment is very naive. Many Consultants work for both NHS and private- and this is what happens very often.

Strangely enough I am fully aware of that. What I have not encountered is a private consultation resulting in being put at the top of the NHS list and being treated accordingly on the NHS. I am not naive. Please don’t insult me in that way.

foxie
Good post. Thank goodness someone understands what I’m saying.
Successful companies make profits off the backs of graduates all the time. Every day of the week. But doctors and private hospitals are being singled out. I think it’s because people love our NHS, I do too, and so they think they have some sort of rights over doctors and where they work. People don’t like private hospitals because they see them as poaching medics and as treating patients more quickly. By insisting private hospitals should ‘pay back’ they see it as punishment to the private hospitals, but they don’t see that other companies earn profits from the graduates that they employ.

maddy, a non-medical graduate merely owes the state repayment of their student loan. A medical doctor receives much post-graduate training at the expense of the state. You can’t compare the two.

Whether or not private patients get moved to the top of the NHS lists is not what this discussion is about. It’s about whether private hospitals should pay some sort of debt to the NHS (meaning government) for having the audacity to employ doctors trained in our universities in the doctor’s own time.