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.

RosesandLilac

Indeed She777
Nothing new, this was happening when I first qualified in the mid 70’s, it’s escalated enormously since then.

I'll ask you the same question as I (and growstuff) asked She77. Which part of the country did you work in?

I live in France (as some of you may know) and have done so for the last 14 years. The French govt pays around 70% of our health costs (can't remember the exact figure). For the balance we pay into a "mutuelle" . We are now both 76 so the top up is quite expensive - around 250 euros for us both.

The mutuelles are non profit making and cannot get rid of us, unlike private health insurance companies in the UK. They do have limits as to the amounts that they will pay/. For example if you want a private room there may be an additional charge that you have to fund yourself. There is a limit on the contribution to specs and dental treatment so you cannot get cosmetic work done on your teeth.

There are public hospitals and private clinics and you can use whichever you prefer. It can be difficult because you can chose which specialist you see and where. I think the food may be better in the private clinics.

If you have what is known as a life threatening disease (in my case asthma) the total cost is met by the state. Some medication can only be prescribed by clinicians, not your GP.

Since we've been here we have used the French system more often that we ever used the UK system (apart from GPs) and we joke about being health tourists.

Some years ago my DH had sever pains in his upper left arm. About 10.30pm I called the emergency service and a doctor came within 15 minutes. She had an ecg machine and couldn't find anything wrong so she called the Samu (paramedics) They turned up with a much larger machine but couldn't find anything wrong but it was obvious that he was in pain. The pompiers then turned up and he was rushed to hospital. I think all this took around 30 minutes.
The hospital doctors were mystified and then one suddenly thought of pericarditis, which it was and prescribed massive doses of aspirin. He (and his heart) recovered fully.

The large public hospitals each have a helicopter - do they in the UK? One landed in a field next to us recently. It was called out to a man in his early fifties who had suffered an heart attack. Sadly he died but they were there for about an hour.

As you can tell I am impressed by the health system in France.

She777

I think you need to take into account the number of migrants to the country that come in and need medical attention straight away.
I worked in the NHS for many years and they call it NHS tourism. The amount of people who arrive in this country on “holidays” and end up having very costly surgeries and agree to pay and then disappear int the ether is unbelievable.

I used to plan theatre ops and the number of people who get sent home on the day of their surgery is massive, this is usually due to an emergency case pushing the ORs to run over.

I’m not just talking about Asian or African migrants, they literally come from all over the world to get access to free surgeries. I think the last time I checked it was costing £4billion.

Another factor is the money spent on training people only for those staff to then be poached by Aus, NZ, USA. Those countries can afford to pay better wages because they are not investing as much in training as we do. Years ago you couldn’t leave within so many years of your training but now they get their qualifications and leave the country and don’t pay back student loans/NHS grants.

It is not a Tory problem it is a national problem regardless of who is in power.

It is confusing to call it Health Tourism. Many people are using "Health Tourism" from the UK to other countries.

Top 10 Medical Tourism Destinations in the World

Canada. ...
Singapore. ...
Japan. ...
Spain. ...
United Kingdom. ...
Dubai. ...
Costa Rica. ...
Israel.

These are people from all over the world travelling all over the world and paying for their health care.

The French govt pays around 70% of our health costs

As far as I can see, Dinahmo, (but I haven't found a decent chart to post) that 70% that the French govt pays is far more than the UK govt spends for what is supposed to be a service provided at no extra cost to the user. So your 70&, plus the contribution via the mutuelle makes the UK's look very poor...

Of course, in international comparisons of healthcare spending the US always comes out top, but would we really like a healthcare system like theirs? Which is what our government would like to see...

These are people from all over the world travelling all over the world and paying for their health care.

I think that the inference made by the posters who have told us about 'health tourism' is that all those foreigners have come to the UK for completely free treatment.
And we should be Very Cross about it...

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).

MaizieD

^These are people from all over the world travelling all over the world and paying for their health care.^

I think that the inference made by the posters who have told us about 'health tourism' is that all those foreigners have come to the UK for completely free treatment.
And we should be Very Cross about it...

I would indeed be very cross if a) we had actual data and b) I had any hope the government - since 2010, people - could run a hop related party let alone a functioning administrative system.

Actually, with all the practice, they have probably got hop related parties down to a fine art, while running the country simply deteriorates.

Germanshepherdsmum

I agree eazybee. The sort of managers we have in the NHS are good at wasting money. Since my days in local government I have referred to what I witnessed as a public sector mentality’ based on the way people I worked with, at all levels, functioned. Entering the private sector was like a baptism of fire.

No offence intended, but that is rubbish! The majority of the Managers in the NHS are also working Clinicians who manage their clinical team and department budget. It’s a tiny majority who are general Managers. Not only is there no waste, but there is too little of everything. I retired from the NHS in 2014 and since one year after the Tories came back into Goverment and slashed the budget on the Trust by an unmerciful amount, we were lucky to have enough basic supplies and often didn’t. When there were full day training events, not only could they no longer supply tea and coffee, let alone lunch, they wouldn’t even supply water. They said they could not justify using public money to have staff take the water to the room!

We never talk about a 'private sector mentality' but it could well include the kind of managerial incompetence that leads to environmental disasters (like sewage in rivers, the consequences of mining), the wrongful prosecution of subpostmasters for fictitious frauds, audit failings and tolerating a climate of harassment leading to public criticism.

For any company that wastes money it’s down to the management got nothing to do with government it’s the overpaid fat cats. Just look at the water companies etc all these big companies know how to waste money because it’s not their money so they don’t care

grantanow that is so right.

Germanshepherdsmum

And covid - don’t forget that.

Covid was a worldwide pandemic so that shouldn’t have made any difference to our position in the league table.

Whitewavemark2

Germanshepherdsmum

And covid - don’t forget that.

As far as I am aware ALL rich nations grappled with covid.

This

Until we are prepared to accept that we all need to pay more towards our NHS so that the staff, particularly front line, are adequately paid, there will be little improvement. Currently, staff are leaving the service in crowds and recruitment is difficult. This results in a lot of problems that people experience when needing the service.

I don’t doubt that savings are available in administration, but the system itself needs a shakeup to achieve this. I think it unlikely that even that would be enough to finance the NHS properly.

Dinahmo summed up the service here in France well.
I'm 69 and in good health so have not had much experience
of the medical services. I pay 50€ per month to a Mutuelle
and have used it well to pay for Dental treatment with a
Dental Surgeon in a beautifull new centre with available
appointments .
The British public are ill informed on paying for health. Those
who have a low income receive free basic health , its paid for by the Government. It is nothing like that dreadfull system in the
USA. As a result of paying in to the system we all benefit from
a very good service. (however, I don't live in a big city which
always has its own problems)
Government

My knowledge is anecdotal (as I find it hard to trust any news reports and do not trust at all anything politicians say.) All the people I have counselled who work within the NHS (and they are many) report that there are too may managers and they are intent on empire-building, or - if they came from within the admin section - that the bureaucracy is strangling and the culture full of bullying and backsliding. I doubt if there is any one answer but I do believe if we had a government devoted to the NHS instead of one that wants to let it die, we would have more chance of getting somewhere

The NHS is reasonably well funded, by international standards, for a (legal) population of around 68 million. Unfortunately, it is having to service an actual population of around 85 million, and most of the 17 million difference are not paying a penny in tax or NI towards it.

Grantanow

We never talk about a 'private sector mentality' but it could well include the kind of managerial incompetence that leads to environmental disasters (like sewage in rivers, the consequences of mining), the wrongful prosecution of subpostmasters for fictitious frauds, audit failings and tolerating a climate of harassment leading to public criticism.

Well said, Grantnow

pen50

The NHS is reasonably well funded, by international standards, for a (legal) population of around 68 million. Unfortunately, it is having to service an actual population of around 85 million, and most of the 17 million difference are not paying a penny in tax or NI towards it.

So who are the additional 17 million?

pen50

The NHS is reasonably well funded, by international standards, for a (legal) population of around 68 million. Unfortunately, it is having to service an actual population of around 85 million, and most of the 17 million difference are not paying a penny in tax or NI towards it.

Really??

Really!

Can you provide some concrete evidence of this? Like, for example, data?

Nannashirlz

For any company that wastes money it’s down to the management got nothing to do with government it’s the overpaid fat cats. Just look at the water companies etc all these big companies know how to waste money because it’s not their money so they don’t care

But it's the government which sets the NHS' targets and the budget.

How many "fat cats" are there in the NHS as a percentage of the workforce?

Germanshepherdsmum

I’m afraid whatever any of us says based on personal experience is dismissed as ‘anecdotal’. Pointing out that the Kings Fund report refers to bureaucracy is ‘rubbishing’ it.

It suits the most vociferous left-wing posters to claim that all the problems of the NHS result from the actions of the current government.

Lived experience is important but it can only refects only a proportion of the overall picture. I wonder if you have ever done any research on something like the running of an extremely large and nationwide organisation. If you had you would be aware that the Organisational Behavior people usually do interview staff or use questionnaires to find out and report on their experiences.

Message deleted by Gransnet. Here's a link to our Talk guidelines.

I’ve worked in London and Manchester at hospitals.
Lots of people are admitted straight from airports, the ferry etc. They sign forms to say they will pay and then when they are discharged they just disappear. It was very common for major city hospitals.

She777

I’ve worked in London and Manchester at hospitals.
Lots of people are admitted straight from airports, the ferry etc. They sign forms to say they will pay and then when they are discharged they just disappear. It was very common for major city hospitals.

Ferries to Manchester?