It has taken a little over 10 years and Tory cuts to push the NHS from the top to second from the bottom of risk nation health care.

Remember the complaints when NI went up? People don’t want to pay what it takes to fund their treatment. And yes, I know that NI payments just go into the pot. People don’t put their money where their mouth is, do they?

Mamie

growstuff

What kind of reform?

It would certainly require more money.

As others have said one of the things we have in France is top-up insurance. Serious illnesses are funded 100% and other treatments at 70% with the top-up insurance picking up the rest. Earlier in the thread someone was talking of an 18€ charge for A and E. In fact this is a charge to the top-up and would be invisible to the user who would use their Carte Vitale for administrative purposes in the hospital. This card is essential to prove that you have the right to treatment.
If you have a low income you are funded at 100%.
The top-up insurance is one method of enhancing the state funding which is done through the equivalent of National Insurance.
We pay it willingly for the quality of service that we receive.

Normal and reasonable in many countries. Not here, apparently.

As others have said one of the things we have in France is top-up insurance. Serious illnesses are funded 100% and other treatments at 70% with the top-up insurance picking up the rest.

Yes, someone mentioned that yesterday. But when I looked up comparison figures for state spending on health that 70% that the French government contributes is more than the UK government contributes to offer the service completely free.

Even if the UK govt. contributed as much per capita as the French government we could see 'some' improvement.

But Mamie in total, you pay more for your healthcare - and that's the issue!

No. Look at Grantanow's post. There hasn't been a government estimate for about ten years, so claims that health tourism is costing £3 billion (or whatever) are unfounded.

The rules state that (apart from pensioners with an S1), people must have been resident in the UK at some stage in the last three months to be eligible for NHS.

Anecdotally, I've heard of non-pensioners using the NHS when they usually live abroad. A few months ago, I overheard a heated exchange with a patient and my GP receptionist. The patient said he'd been living abroad and the receptionist said he couldn't be accepted for NHS care. It all got a bit angry and he was taken off to the practice manager, so I don't know the outcome.

In any case, it's all guesstimates.

growstuff

What kind of reform?

It would certainly require more money.

As others have said one of the things we have in France is top-up insurance. Serious illnesses are funded 100% and other treatments at 70% with the top-up insurance picking up the rest. Earlier in the thread someone was talking of an 18€ charge for A and E. In fact this is a charge to the top-up and would be invisible to the user who would use their Carte Vitale for administrative purposes in the hospital. This card is essential to prove that you have the right to treatment.
If you have a low income you are funded at 100%.
The top-up insurance is one method of enhancing the state funding which is done through the equivalent of National Insurance.
We pay it willingly for the quality of service that we receive.

growstuff

Mamie

But the majority of this is attributed to British migrants that live overseas and return to the UK to use the NHS.
I wondered how long it would take before I had to mention the S1 form.
People who live in the EU and are in receipt of a State pension (OAP) are perfectly entitled to use the NHS if they so wish.

But not all the returnees are pensioners.

Is there any hard data at all growstuff?

Mamie

*But the majority of this is attributed to British migrants that live overseas and return to the UK to use the NHS.*
I wondered how long it would take before I had to mention the S1 form.
People who live in the EU and are in receipt of a State pension (OAP) are perfectly entitled to use the NHS if they so wish.

But not all the returnees are pensioners.

What kind of reform?

It would certainly require more money.

Freya5

2022/2023 158 billion fund8ng. Compare this to 474.1 billion in 2021, for Germany. So even more now, but can't find figures. We need dedicated social health insurance, , even the King's Fund have moved this.
Can the NHS learn from Germany Health system
bbc.co.uk
From personal and family experiences in that country, I would say yes.

We could learn a lot from our European neighbours, most of whom have far better health systems than we have. This would however require massive reform of the NHS and I cannot see either of the main parties being prepared to do it.

But the majority of this is attributed to British migrants that live overseas and return to the UK to use the NHS.
I wondered how long it would take before I had to mention the S1 form.
People who live in the EU and are in receipt of a State pension (OAP) are perfectly entitled to use the NHS if they so wish.

Let's nail this frequent moan about 'health tourism' - allegedly ineligible foreigners deliberately visiting the UK to use the NHS for pre-existing conditions - which is often whipped up by the Tory press to divert attention from underfunding (just as they whip up feelings against so-called benefit scroungers to deflect attention from wealthy tax evaders).

The fact is so-called ‘health tourism’ is a political concept for which there is very little evidence.

According to independent checker Full Fact the Government’s own estimate puts the cost of deliberate misuse of the NHS by overseas visitors at between £100m and £300m at most – equating to roughly 0.3% of the NHS budget. But the majority of this is attributed to British migrants that live overseas and return to the UK to use the NHS. Moreover, it is easy to confuse (and anecdotal evidence from nurses, etc., contributes to confusion) deliberate misuse with foreigners - holidaymakers or workers) being treated for falling ill or having an accident while in the UK. The Government thought some £220m of the total could be charged back to EU countries under the health card scheme just as the costs of UK nationals treated in the EU could be charged back to the UK.

The government estimate was made in 2012/13. The misuse cost is not entirely negligible (and there are confusing factors which mislead) but it is noteworthy the Tory government has not bothered to re-estimate the cost which suggests it is marginal compared with other embarrasing losses to the NHS such as paying for unusable PPE, the excessive costs of the Private Finance Initiative and additional accountancy costs to support internal NHS market initiatives.

In my opinion the real culprits are the Tories who have run down the NHS over the past 13 years, not foreigners. One only has to compare the German spend on their health service (39% higher - thank you, DaisyAnneReturns!) with our own to see that the Tory priorities lie elsewhere.

software it's
software is

Freya5

DaisyAnneReturns

Freya5

2022/2023 158 billion fund8ng. Compare this to 474.1 billion in 2021, for Germany. So even more now, but can't find figures. We need dedicated social health insurance, , even the King's Fund have moved this.
Can the NHS learn from Germany Health system
bbc.co.uk
From personal and family experiences in that country, I would say yes.

I think you must had missed these figures Fraya. It shows the continuous underfunding by this government. This seems to offer a very acceptable argument to explain why we are having to make very expensive attempts to catch up with others.

There was no "stitch in time" by this government. Their behavior didn't lose us a kingdom for the want of a nail, but has led us perilously close to losing the NHS for the sake of the far-right policy on government run organisations.

Anyway, this was the earlier post.

Analysis published by the Health Foundation's REAL Centre has found that over the decade before the pandemic, the UK spent around a fifth (18%) less on average than the EU14 on day-to-day health care costs (per person living in the country).

The UK’s total health care budget was £187bn per year, on average, between 2010 and 2019 (unadjusted for inflation overtime). But if UK spending per person had matched the average across the EU14 over the pre-pandemic decade, then total UK spending per year would have been £227bn – a difference of £40bn more on average every year.

The analysis also looked at comparisons with the UK’s closest European neighbours. In every year between 2010 and 2019 the UK would have had to spend an additional £73bn more to match Germany’s spending per person (39% extra). When compared to France the UK would have to spend an additional £40bn extra every year (21% extra). Just four countries (Spain, Portugal, Italy and Greece) in the EU14 spent less per person than the UK over the same period.

^The charity also looked at capital health spending on vital buildings, technology and equipment comparative to European neighbours. Comparing capital spending with the EU14 countries for which data are available it found that between 2010 and 2019, cumulative UK investment in capital health infrastructure would have needed an additional £33bn to match the total EU average invested over that period (around 55% higher than actual investment).^

No I didn't miss this. I just wanted to put my point of view over, not subject someone with a lecture.
It's Freya, thank-you.

Wow, you have got the knives out, haven't you. Firstly, let me apologise, on behalf of my dictation software, for the misspelling of your name. I have had it happen to me, but felt that although it's irritating it is understandable. I can't put my proper software on sadly. Having murdered my computer this tablet doesn't have sufficient memory. Apologies for that. Unfortunately the tablets own dictation software it's pretty awful.

Then there is your suggestion (dig?) that people are being "subjected" to lectures. As far as I have always understood, it has, for many years, being accepted that News and Politics was for discussion and debate, while Chat was for over the fence opinions. Once again my apologies if I have missed the memo telling us of a change.

However, that is just anecdotal - the bigger question is:
How is healthcare funded in countries which now have better outcomes than the UK, have they improved or have we got drastically worse? How do salaries compare?
Why are other countries poaching our staff and should we be recruiting from countries which are then left with inadequate staffing?

Freya5

Callistemon21

Freya5

Callistemon21

Are nurse practitioners diagnosticians?
Are they being used instead of GPs to deal with matters outside their experience?

We seem to have an impasse at our surgery with a nurse practitioner who cannot or will not refer a problem to a doctor or Consultant and a receptionist who says the only options are to go privately or wait for another six weeks to see a GP.

Nurse practitioners, and Advanced nurse practitioners both those I worked with, and in my surgery are very well qualified, they have to be to be able to practice, and on more than one occasion have checked with a Dr as necessary. They are prescibers in their own right . So complain to your practice manager in the first instance, or change surgeries,because otherwise nothing will change.

We have an appointment now for late July but I really felt as if it was me being awkward; the receptionist sounded affronted that I would question the decision by the nurse practitioner not to even ask a doctor for an opinion.

I know what you mean. One receptionist demanded I see a physio for my knee pain. So I did, he was useless, told me what it could be not what it was,gave me no exercises, or any idea as to the usual pain relief. Rang surgery the next day, was told same,I said I would put in a complaint, Dr's appoint given. , who diagnosed the problem, referred me to an orthopaedic surgeon, advised pain relief, and exercises when tolerated. It is your right to see a Dr, 2nd opinion, if so required, and your right to complain if treatment lacking. Glad you have your appointment, but all so unessessary for you.

Thanks Freya

It is for DH and normally I would go with him, but didn't yesterday as I just assumed the nurse practitioner would have referred the problem to a doctor for an opinion but a good motto is 'never assume anything'.

We only spend $105.8 billion. Far, far lower. We have a lot of private health though and maybe that explains it. It is certainly not as good as it used to be in the1970s when we first came here. We never had to wait for an appointment and everything was just so much easier and more responsive. Thank goodness my children were born then!

DaisyAnneReturns

Freya5

2022/2023 158 billion fund8ng. Compare this to 474.1 billion in 2021, for Germany. So even more now, but can't find figures. We need dedicated social health insurance, , even the King's Fund have moved this.
Can the NHS learn from Germany Health system
bbc.co.uk
From personal and family experiences in that country, I would say yes.

I think you must had missed these figures Fraya. It shows the continuous underfunding by this government. This seems to offer a very acceptable argument to explain why we are having to make very expensive attempts to catch up with others.

There was no "stitch in time" by this government. Their behavior didn't lose us a kingdom for the want of a nail, but has led us perilously close to losing the NHS for the sake of the far-right policy on government run organisations.

Anyway, this was the earlier post.

Analysis published by the Health Foundation's REAL Centre has found that over the decade before the pandemic, the UK spent around a fifth (18%) less on average than the EU14 on day-to-day health care costs (per person living in the country).

The UK’s total health care budget was £187bn per year, on average, between 2010 and 2019 (unadjusted for inflation overtime). But if UK spending per person had matched the average across the EU14 over the pre-pandemic decade, then total UK spending per year would have been £227bn – a difference of £40bn more on average every year.

The analysis also looked at comparisons with the UK’s closest European neighbours. In every year between 2010 and 2019 the UK would have had to spend an additional £73bn more to match Germany’s spending per person (39% extra). When compared to France the UK would have to spend an additional £40bn extra every year (21% extra). Just four countries (Spain, Portugal, Italy and Greece) in the EU14 spent less per person than the UK over the same period.

^The charity also looked at capital health spending on vital buildings, technology and equipment comparative to European neighbours. Comparing capital spending with the EU14 countries for which data are available it found that between 2010 and 2019, cumulative UK investment in capital health infrastructure would have needed an additional £33bn to match the total EU average invested over that period (around 55% higher than actual investment).^

No I didn't miss this. I just wanted to put my point of view over, not subject someone with a lecture.
It's Freya, thank-you.

Callistemon21

Freya5

Callistemon21

Are nurse practitioners diagnosticians?
Are they being used instead of GPs to deal with matters outside their experience?

We seem to have an impasse at our surgery with a nurse practitioner who cannot or will not refer a problem to a doctor or Consultant and a receptionist who says the only options are to go privately or wait for another six weeks to see a GP.

Nurse practitioners, and Advanced nurse practitioners both those I worked with, and in my surgery are very well qualified, they have to be to be able to practice, and on more than one occasion have checked with a Dr as necessary. They are prescibers in their own right . So complain to your practice manager in the first instance, or change surgeries,because otherwise nothing will change.

We have an appointment now for late July but I really felt as if it was me being awkward; the receptionist sounded affronted that I would question the decision by the nurse practitioner not to even ask a doctor for an opinion.

I know what you mean. One receptionist demanded I see a physio for my knee pain. So I did, he was useless, told me what it could be not what it was,gave me no exercises, or any idea as to the usual pain relief. Rang surgery the next day, was told same,I said I would put in a complaint, Dr's appoint given. , who diagnosed the problem, referred me to an orthopaedic surgeon, advised pain relief, and exercises when tolerated. It is your right to see a Dr, 2nd opinion, if so required, and your right to complain if treatment lacking. Glad you have your appointment, but all so unessessary for you.

Some receptionists are under the illusion that they are doctors I think. The practice I go to has several and most are fine but there is one I avoid because she is rude, condescending and quite aggressive.

Freya5

2022/2023 158 billion fund8ng. Compare this to 474.1 billion in 2021, for Germany. So even more now, but can't find figures. We need dedicated social health insurance, , even the King's Fund have moved this.
Can the NHS learn from Germany Health system
bbc.co.uk
From personal and family experiences in that country, I would say yes.

I think you must had missed these figures Fraya. It shows the continuous underfunding by this government. This seems to offer a very acceptable argument to explain why we are having to make very expensive attempts to catch up with others.

There was no "stitch in time" by this government. Their behavior didn't lose us a kingdom for the want of a nail, but has led us perilously close to losing the NHS for the sake of the far-right policy on government run organisations.

Anyway, this was the earlier post.

Analysis published by the Health Foundation's REAL Centre has found that over the decade before the pandemic, the UK spent around a fifth (18%) less on average than the EU14 on day-to-day health care costs (per person living in the country).

The UK’s total health care budget was £187bn per year, on average, between 2010 and 2019 (unadjusted for inflation overtime). But if UK spending per person had matched the average across the EU14 over the pre-pandemic decade, then total UK spending per year would have been £227bn – a difference of £40bn more on average every year.

The analysis also looked at comparisons with the UK’s closest European neighbours. In every year between 2010 and 2019 the UK would have had to spend an additional £73bn more to match Germany’s spending per person (39% extra). When compared to France the UK would have to spend an additional £40bn extra every year (21% extra). Just four countries (Spain, Portugal, Italy and Greece) in the EU14 spent less per person than the UK over the same period.

The charity also looked at capital health spending on vital buildings, technology and equipment comparative to European neighbours. Comparing capital spending with the EU14 countries for which data are available it found that between 2010 and 2019, cumulative UK investment in capital health infrastructure would have needed an additional £33bn to match the total EU average invested over that period (around 55% higher than actual investment).

growstuff

I'm afraid I just smile sweetly and ignore receptionists with attitude.

The sigh was audible when I insisted on a GP appointment.

Saetana

Whitewavemark2

But the issue isn’t with management - that is just your constant hobby horse.

The Kings Fund say it is

FUNDING CUTS

What funding cuts? The NHS was protected from austerity, and in recent years has had a ton of money poured into it - whilst still providing a worse and worse service. Its not money that is the issue here - it needs massive reform but neither Conservatives nor Labour will bite the bullet and do it.

The NHS wasn't protected from austerity.

What reform do you think the NHS needs?

I'm afraid I just smile sweetly and ignore receptionists with attitude.

Freya5

Callistemon21

Are nurse practitioners diagnosticians?
Are they being used instead of GPs to deal with matters outside their experience?

We seem to have an impasse at our surgery with a nurse practitioner who cannot or will not refer a problem to a doctor or Consultant and a receptionist who says the only options are to go privately or wait for another six weeks to see a GP.

Nurse practitioners, and Advanced nurse practitioners both those I worked with, and in my surgery are very well qualified, they have to be to be able to practice, and on more than one occasion have checked with a Dr as necessary. They are prescibers in their own right . So complain to your practice manager in the first instance, or change surgeries,because otherwise nothing will change.

We have an appointment now for late July but I really felt as if it was me being awkward; the receptionist sounded affronted that I would question the decision by the nurse practitioner not to even ask a doctor for an opinion.