Continuing Discussion
657359
Last edited by: VxFan on Mon 23 Jan 23 at 10:21
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Who doesn't want to have 'free', quality, healthcare throughout their life? We have pretty much had this for 70 years. The fact is that it can be afforded - yes, demography, mortality trends, and advanced treatments mean it is more costly than ever but the nation is far wealthier than it was when the NHS was founded.
If voters are even moderately rationale, the long term repair of health and social care will be the key issue when we vote for the next government in a couple of years. On that basis it will be a hard sell for the party of capital.
Then again, it should be a hard sell whatever the burning questions are. After a dozen years of venality, cronyism, incompetence and dishonesty, everything is broken.
They know this, which is why they are trying to make us think it was all inevitable. And if it wasn't, it's the fault of the poor people, aka strikers. That is what is behind all the talk of charges, insurance based healthcare, and so on. They can't actually promise to fix it because we would all want to know who broke it.
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>> Who doesn't want to have 'free', quality, healthcare throughout their life? “
I’d quite like free food, free housing, and free energy too, all equally vital but I don’t see anyone advocating that.
What we don’t pay for, at least in part, we don’t value and just as importantly the providers don’t see the recipients as customers to be valued.
How many hotels, restaurants, garages vets etc. would stay in business if their attitude to their customers was anything like that of average GP surgery ?
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What's your point?
It's basically reasonable to think that we can work to put a roof over our heads, clothe and Fred ourselves and pay the bills. Free could afford the kind of treatments that the NHS provides every day, and to probably a large proportion of us at some time in our lives.
It's hard to imagine how fearful the mass of people must have been of serious illness before the NHS. How many times have you heard people say that the most important thing we have is our health?
In 2010 it worked well enough for me...except for the care home elephant.
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My point is that it eminently reasonable for people to contribute something directly to fund the provision of health care whether by direct payment or by insurance. Our health system is failing. and the idea that the NHS is some sort of sacred institution for which we cannot examine the method by which it is funded is the major reason for the failing.
Free at the point of use is a recipe for failure.
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>> Free at the point of use is a recipe for failure.
Why?
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As i already stated
"What we don’t pay for, at least in part, we don’t value and just as importantly the providers don’t see the recipients as customers to be valued."
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>> My point is that it eminently reasonable for people to contribute something directly to fund
>> the provision of health care whether by direct payment or by insurance.
>>
...or by taxation?
...IMO, not much different from insurance (which is also "free at the point of use").
Though effectively, a largely state-funded (from central funds) system doesn't dis-enfranchise the poorest and most needy.
The need to control (unmerited or unendorsed) demand is a different kettle of fish, and any remedy should recognise this.
(And yes, I have taken advantage of employer subsidised private healthcare in the past).
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"IMO, not much different from insurance (which is also "free at the point of use")."
With Insurance here is a real and perceived cost to the individual .
There is nn perceived cost with the current system. It provides the illusion that cares is free and what is free has no value.
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...with taxation there is a real and perceived cost to the customer - at least there is to me ;-)
I'm not sure what you're actually proposing that changes that. Pay your insurance and then it's free (until, possibly, you have a major, urgent procedure and your premium rockets, inhibiting you from taking it out again and thus taking you out of the system (and/or onto "social funding").
I don't disagree that the NHS might need some method of controlling access/costs, but I'm far from convinced that moving the burden onto insurance is going to achieve that equably.
(I also have little doubt that, if insurance is proposed as an answer, the UK being what it is it won't end up with it being a "mutual" arrangement; the market will be involved and want to make money).
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>>
>>
>> Then again, it should be a hard sell whatever the burning questions are. After a
>> dozen years of venality, cronyism, incompetence and dishonesty, everything is broken.
>>
>>
>>
It is exactly the same with the NHS here in Wales, where we've had a Labour government for longer than that.
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>After a dozen years of venality, cronyism, incompetence and dishonesty, everything is broken.
They kill kittens as well!
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>> >After a dozen years of venality, cronyism, incompetence and dishonesty, everything is broken.
>>
>> They kill kittens as well!
Even a stopped clock is right twice a day, but they are still not fit for office. I detest cats. Bird murderers.
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> They know this, which is why they are trying to make us think it was
>> all inevitable.
There seems to be big changes whoever wins the next GE, the message both parties are starting to put out is it's not business as usual for the NHS.
May all be talk of course and quickly kicked into the long grass by either party.
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You'll get the same service just now, 90% of the users will be exempt from paying, and the working taxpayer will be stealth-taxed once again.
The NHS is underfunded by about 20% I reckon - we've had 12 years of insufficient funding increases just so that bell-end Sunak could spout last year (as Chancellor) that they'd be cutting basic rate tax to 19%.
Social conservatism my ringpiece.
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The NHS isn't a bottomless pit and there are limits to demand - Micawber's Law has somewhat of a role to play.
Pay a few quid too little and the waiting lists stretch - once hospitals are struggling GP practices have to deal with crap service from specialists which then bogs down our side.
Pay a bit over the odds and waiting lists come down and services improve - Blair's Govt made significant progress from ~2004-2009. When I started as a GP in 2001 it was a 2 yr wait for a hip replacement - by 2008 it was about 8 weeks.
12 years of shaving a couple of percent off what is needed annually has left us in the position we are in now.
Don't believe other countries are somehow miles ahead of the UK's provision - the much-touted Irish system is in a worse position for waiting lists - 900,000 Irish on hospital waiting lists as of June 2022 (population 5 million = 18% of the population).
Significantly higher than the UK (England has 7,000,000 waiting = 12.5%)
Last edited by: Lygonos on Sun 22 Jan 23 at 00:07
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20% increase is something like £30-35 bn, it may need that level. How does any government raise/ fund that?
I don't sunak has been in the cabinet for 12 years let alone chancellor.
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£30bn is £500 per person.
For a GP service that actually delivers properly about £35 per person
That's less than the cost of a GP appointment in Ireland.
Or about the same as a haircut.
Or 3 packs of cigs.
Or half a tank of petrol.
How much did your energy costs go up last year?.
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30 billion would actually be around £1,000 each per taxpayer.
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>> 30 billion would actually be around £1,000 each per taxpayer.
When you refer to per taxpayer are you talking of those who pay Income Tax?
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Yes. Atound 34 billion U.K. income tax payers. 37% of adult population don’t pay any income tax.
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Everyone pays VAT.
And you can bet your bottom dollar non-Income Tax payers (and possibly IT paying pensioners) will be exempted from new charges.
I wonder where HMG gets the 150-160bn it spends on the NHS (coincidentally it gets back about 30-35bn on the tax paid by NHS employees)
Last edited by: Lygonos on Sun 22 Jan 23 at 10:09
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I'm sure that's all perfectly true, however where does ~£30bn come from?
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Coincidentally Truss allegedly cost us £30bn (though in the interests of fairness, that figure has been challenged, so I don't know the real truth).
Wasn't there £350m a week for the NHS from BREXIT? Whatever happened to that?
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Her decisions may well have cost that much, but that was a one off. This would have to be year on year.
There seems to be a concensus the NHS should have more money, but there seems to be few answers or solutions. Neither main party know or if they do they are keeping it a secret.
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The main problem I think is that everyone says they want a better health service but few want to pay for it. It should somehow mysteriously be delivered at no cost to them.
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>> I'm sure that's all perfectly true, however where does ~£30bn come from?
If the government had the will to raise £30bn I suspect it could do so.
How much was the National Insurance levy abolished under the Truss regime supposed to raise?
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>> If the government had the will to raise £30bn I suspect it could do so.
>>
As a one off quite probably. Ongoing, it's something like 7p on the basic rate of income tax. Any political parties up for that? Or any combination of other taxes.
>> How much was the National Insurance levy abolished under the Truss regime supposed to raise?
>>
About 4.5bn, something like that i think?
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>>
>> Ongoing, it's something like 7p on the basic rate of income tax. Any political parties up for that? Or any
>> combination of other taxes.
>>
...we just need to ensure MPs and Ministers pay the appropriate amount of tax on time ;-)
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A neighbour, before he retired, was a maintenance manager at our local hospital. He said that prior to year end there would be a flurry of reminders to department heads that they needed to exhaust their budget or the surplus would be deducted from the following year's budget.
He couldn't transfer money to another department that might need it and he couldn't buy complete items because that was 'capital' expenditure so he usually ended up buying 'spares' and doing a Trigger's Broomstick.
If you walk into the hospital today all the (usually unoccupied) staff offices have Herman Miller desk chairs at ~£800 a pop and Dyson tower fans at ~£300 a pop.
If that's representative of other hospitals there's a stack load of money being spent in the wrong places.
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>> If that's representative of other hospitals there's a stack load of money being spent in
>> the wrong places.
Getting money out of the door at the end of the FY as a result of perverse incentives in Government Accounting was a public sector wide thing. Even simple stuff like topping up the franking machine to it's max and placing the office gas/electric accounts in credit was standard practice.
Another year the microwave, fridge and dishwasher in the staff kitchenette were all replaced.
IIRC the arrival of accruals accounting in the eighties removed some, but by no means all, such incentives. For example the credit on the franking machine had to be declared on a return.
Working in the Quango in the mid noughties there were a couple of years where we procured and paid for external advice during February or March while ensuring it was commissioned in such a way it didn't officially count as consultancy.
£800 is way over the odds for office chairs but the price of those that will pass a H&S assessment for a workspace is lot more than in IKEA. And that's before you enter the world of people with Health Conditions affecting their back.
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>> >> I'm sure that's all perfectly true, however where does ~£30bn come from?
>>
>> If the government had the will to raise £30bn I suspect it could do so.
>>
>>
>> How much was the National Insurance levy abolished under the Truss regime supposed to raise?
>
About £12 billion over three years I.e £4 billion per year. Only another £26 billion to find.
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"... something like 7p on the basic rate of income tax. Any political parties up for that? ..."
Absolutely - and then there is fixing all the other public services, both at national and local level, which could do with more funding - starting with maybe the police or social services.
Of course the 7p would be reduce spending power so some people would expect a pay rise to cover it...
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To improve the NHS by spending more money, something else needs to give :
- pay more tax and have less disposable income - extra pay to cover the extra tax does not work
- cut other government expenditure - but what
- borrow more money - interest rates increase - there is no magic money tree
The alternatives - uncomfortable though they may seem - need ruthless implementation:
- improve management, cut waste, quickly
- charge for services - eg: £25 for a GP visit could raise £7-8bn pa, £100 for A&E £2.5bn
- apply to all - not like prescriptions where 90% are issued free
- increase inheritance tax to recover care costs - taxpayers effectively fund larger legacies
- sort out social care - it has been a shambles for decades.
The NHS "free at the point of delivery" may have been a worthy intent 75 years ago - the world has changed - services and funding need to be radically overhauled.
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>> - improve management, cut waste, quickly
First identify the waste; are all agreed a particular spend is waste?
>> - charge for services - eg: £25 for a GP visit could raise £7-8bn pa,
>> £100 for A&E £2.5bn
>> - apply to all - not like prescriptions where 90% are issued free
The weekly living cost rate for a single person on subsistence benefits is £77/week. A third of that for a GP visit?
Are you real?
>> - increase inheritance tax to recover care costs - taxpayers effectively fund larger legacies
>> - sort out social care - it has been a shambles for decades.
Now you're talking. Framing the debate around Income Tax is a distortion.
>> The NHS "free at the point of delivery" may have been a worthy intent 75
>> years ago - the world has changed - services and funding need to be radically
>> overhauled.
What does the alternative, after overhaul, actually look like?
>>
Last edited by: Bromptonaut on Sun 22 Jan 23 at 20:20
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>>The weekly living cost rate for a single person on subsistence benefits is £77/week. A third of
>>that for a GP visit?
>>Are you real?
It's a frighteningly low amount. My fuel bill costs more than that and since 1st January we have been budgeting, out of principle, due to a large credit card bill, that I can easily pay out of my current account but just wanted to bring our spending under control. It's impossible, IMHO to live on under £200 per week, (fuel, food and necessities). Unless you want to be totally miserable.
Seen on the internet:
They're struggling with petrol costs.
They're struggling with food inflation.
They're struggling with mortgages or rent increases.
I know, let's make them pay to see a GP and to go to A&E!
Charging will kill people. They will put off visits that could catch cancer early, they will miss heart appointments and routine screenings.
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>> T
>> - charge for services - eg: £25 for a GP visit could raise £7-8bn pa,
>> £100 for A&E £2.5bn
>> - apply to all - not like prescriptions where 90% are issued free
>>
>>
And stuff everyone on a low income. Ridiculous.
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If you want to see General Practice become like dentistry then that's exactly how to do it.
You could pay £25 for the crappy NHS style, or I'll give you a shiny smile for £75.
Watch the NHS GP deserts appear in all poor areas.
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If you're not signed up with my dentist they've started asking for a £25 deposit for all new appointments. Too many no-shows.
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There are difficult choices to make re NHS funding - but there are options.
Simply asserting that alternatives are uncomfortable, unattractive, or unfair to a particular group does not solve the problem. I am not advocating a particular solution - simply that a failure to do so (however difficult) means problems will remain unresolved.
As a country we are living beyond our means - low growth, low productivity. We should not delude ourselves that changes for the better will somehow happen without effort and pain.
Other European health services face similar problems with health services funded by alternatives including payment for appointments, contribution to treatment costs, social insurance etc. There is no good reason why these (and other changes) should not form part of the solution.
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General Practice is the cheap bit.
Hospitals are the big money sink.
The NHS does get a very good deal on drug prices however - they negotiate discounts that really P off the Yanks.
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Average cost of 9 minute consutation with GP in 2020 was £39.23 , visit to A & E was between £77 and £359, cost of ambulance trip £292, emergency artery by pass graft £9,212
Figures form Kings Fund whihc contains a wealthof statistics on NHS
www.kingsfund.org.uk/audio-video/key-facts-figures-nhs
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not sure what a 9 minute consultation is :-)
We're 10 mins on 'phone and 15 mins face-to-face.
Out Practice contract is worth about £1.2m per year, for about 8500 patients.
For this £1.2m we provide around 500ish normal GP appointments per week and 50-70 duty ("cannae wait til the morra") appointments.
We do 20-30 housecalls per week.
Another 150ish practice nurse appointments is paid for from Practice income, plus all the admin and some expenses for cleaning/heating/etc, writing/referring to hospitals and receiving correspondence back.
So a raw figure of roughly £40-45 per GP appointment but isn't the whole story.
Took my 12 and 14yr old sons to the dentist today to get their teeth scale & polished.
In and out in under 20 minutes: £65.
(They are NHS patients - the regular check-up is free, tartar removal is not).
Once the genie is out of the bottle for GPs charging patients to be seen it ain't ever going back in and that will be to the detriment of the country.
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Isn't there a better way of remunerating doctors other than just the absolute number of registered patients? Something that would take the probable workload and conditions into account?
Why should a doctor in Glasgow who's flock all grew up drinking from Highland Springs while chasing haggis through the glens have the same number of patients as a doc in Surrey looking after old folks who dodged traffic on the M25 to get to school every day?
Just a thought...
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The vast bulk of the income is from population data.
There are fudge factors applied for age, gender, deprivation.
There is no fudge factor at all for how much actual doctoring is supplied as I have lamented before - I would make more money provising a crappier service to a bigger population.
The ultimate iteration of the current contract would be a couple of partners controlling an army of salaried staff doctors, nurses and other staff.
Basically a mini version of a Health Board.
With all the inefficiency that brings.
Studies show having a regular GP improves pretty much every health outcome including time spent in hospital when compared to "seeing whoever is available."
I appreciate this is a luxury already lost to many patients especially in practice conglomerates.
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>> Studies show having a regular GP improves pretty much every health outcome including time spent
>> in hospital when compared to "seeing whoever is available."
Benefit claim forms for PIP or Attendance Allowance ask for the name of the claimant's GP.
The vast majority can only tell me the name of the practice.
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>> We're 10 mins on 'phone and 15 mins face-to-face.
>>
>> We do 20-30 housecalls per week.
>>
>> Another 150ish practice nurse appointments is paid for from Practice income, plus all the admin
Strange?
House calls, you say?
Face-to-face?
A practice nurse?
Where in this sceptered isle do these unheard of events take place? It wouldn't be in bonny Scotland - would it?
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>> House calls, you say?
>> Face-to-face?
>> A practice nurse?
>>
>> Where in this sceptered isle do these unheard of events take place? It wouldn't be
>> in bonny Scotland - would it?
Mrs B saw a doctor F2F yesterday about a rash on her face.
We have Nurse Practioners who do some consultations.
Not sure about house calls. The last one I remember was to Mrs B's Mother who came down with a rotor virus while staying with us. More than 25 years ago as we were still at the old house.
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>Mrs B saw a doctor F2F yesterday about a rash on her face.
I had a F2F with my doctor last week.
He told me that I'm getting worse and there's nothing he can do for me. He's not sure if it's my backswing or I'm moving my head before I hit the ball.
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>> He told me that I'm getting worse and there's nothing he can do for me.
>> He's not sure if it's my backswing or I'm moving my head before I hit
>> the ball.
You are swinging the lead, and he is talking balls.
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>>Where in this sceptered isle do these unheard of events take place? It wouldn't be in bonny Scotland - would it?
Indeed, though my practice is bettered doctored than most even up here because I have focussed on enjoying my work and providing a service I would be happy for my famiky to receive over maximising profits .
9 partners (5-7 sessions/week each) and a 4 session salaried doctor.
More than some 15,000 patient practices have down south.
The crunch point is that without HMG/SG putting more money into practices and specifically partners it will eventually be financially and job security wise better to be salaried in a bloated HMO with an obscenely well paid 'Board' than a partner in a well run practice.
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>> There are difficult choices to make re NHS funding - but there are options.
>>
>> Simply asserting that alternatives are uncomfortable, unattractive, or unfair to a particular group does not
>> solve the problem.
You seemed to be advocating a solution where there were charges made but without concessions (as with prescriptions) for means.
That goes beyond unfair; a third of your weeks income to see a GP takes us back before the NHS.
Dr Ashton, who was my Grandmother's GP from the thirties until she died in 1972, was charging 5 shillings for an appointment in the peace before 1939.
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Article in the Telegraph by a Dr George Caldwell (ret'd) relating to the amount of paperwork involved in a patient going through A&E.
He placed the paperwork on the floor and laid next to it. Hes 5' 10" and it extends way beyond his height. Suggests 70% of time is spent form filling.
www.telegraph.co.uk/news/2023/01/21/pictured-doctor-shows-army-pointless-forms-burying-nhs-hospitals/
It's behind the paywall but the picture can be found elsewhere.
Excessive bureaucracy and systems that don't talk to each other.
Sounds similar to the Police.
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>>Excessive bureaucracy and systems that don't talk to each other.
'Tis the same in many large organisations. I have over 30 usernames / passwords (different systems) to do my job.
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...yeah, well - you don't want to leave too obvious an audit trail, do you?...
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No concessions is by contrast with prescription where I understand ~90% are issued free. If payment for GP visits was administered similarly its introduction would not be worth the political fallout and administration for a fairly trivial sum.
I would fully expect some concessions for those most in need - but would expect 80% + to pay. Or why bother.
As an aside I will admit to being ignorant of the complexities and challenges of life on universal credit - and would not want to be reliant.
But most folk also got help with council tax and rent etc, many when in employment. The average UC payment is £800 per month. Of 5.7m receiving UC, ~40% are in employment.
There are clearly some who would have real difficulty with health charges. However overstating the problem of some/few by generalising its impact on an entire group is a distortion - and risks alienating empathy for those who justifiably deserve it.
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It's inevitable that there is a high percentage of concessions on prescription charges, since the poor and particularly the elderly have the overwhelming majority of illnesses. Many of the poor ill are poor because they are ill.
One of the populist rags the other day had a story on how more than half the population is on benefits. The "story" came from Civitas (address 55 Tufton St) so we know where it's going before we read it.
They say a fifth of households get more in benefits than the pay in tax. It's not clear whether they include VAT in tax but they do include the NHS and social care in benefits. This doesn't surprise me given given the trends in the distribution of income.
They blame Covid and all the special payments for creating a 'dependence' economy. It's quite a result to pay more out in benefits than Labour and at the same time to have greater inequality but of course the two go together.
The most difficult statistic to digest at the moment is that 24% still intend to vote Conservative on a survey of voting intentions. I doubt whether the news on Zahawi, ertswhile Chancellor and leadership candidate, will even move the dial - we must by now be down to the hard core who will tolerate any amount of dishonesty and depravity from the crooks in charge.
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- we must by now
>> be down to the hard core who will tolerate any amount of dishonesty and depravity
>> from the crooks in charge.
>
Two groups, the above and those that wouldn't vote labour if they were handing out gold bars.
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>> I would fully expect some concessions for those most in need - but would expect
>> 80% + to pay. Or why bother.
That's the point. The majority of GP demand is from the those with, in varying combinations old age, low incomes and long term/chronic health conditions. Diabetes, circulatory problems, kidney disease, cancer etc etc all need regular appointments for monitoring. Would you charge for children? Aside from the usual catches in the Nursery petri dish my grandson is in the bottom centile for growth, had an odd sounding heart and struggles to poo. All mean the Doctor wants to see him regularly - at £25 a time?
>> As an aside I will admit to being ignorant of the complexities and challenges of
>> life on universal credit - and would not want to be reliant.
>>
>> But most folk also got help with council tax and rent etc, many when in
>> employment. The average UC payment is £800 per month. Of 5.7m receiving UC, ~40% are
>> in employment.
Note the bolding.
Basically Universal Credit starts by working out what a household needs to live on. So much for a single person, a couple, children (but only 2 if the third or subsequent was born after 01/04/17) and rent - but not mortgage. There are additions for serious long term ill health, disabled children or caring but all those require significant hoop jumping. There are deductions £/£ for most benefits or as a taper for earnings. If you don't let those working keep a good chunk of their wages and get help with childcare then there's a risk that the cost of taking work - travel etc - mean it's not worthwhile.
Whenever you hear an 'outrageous' amount being paid in Universal Credit I'll guarantee you that, barring families with multiple disabilities, the claimant is renting privately and has the misfortune to be rooted in a high rent area like London and the South East. That's why the average is £800.
Even so, the way the limits for Housing costs are calculated are skewed so many don't get the full rent.
They get help with rent because it's not included in the amounts for children and adults etc. Help with Council Tax depends where you live - each council has its own scheme. In most of England, even if you're supposed to be keeping body and soul together on £77/week, you pay 15-50% of Council Tax.
>> There are clearly some who would have real difficulty with health charges. However overstating the
>> problem of some/few by generalising its impact on an entire group is a distortion -
>> and risks alienating empathy for those who justifiably deserve it.
Equally, understating the problem makes charging look far simpler than it would be in reality.
Last edited by: Bromptonaut on Tue 24 Jan 23 at 21:25
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I think sometimes we can look too much about how we do things here, how do other countries that charge/ do things differently manage about those on low income? I presume they aren't dying in large numbers, there must be some way around it?
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>> I think sometimes we can look too much about how we do things here, how
>> do other countries that charge/ do things differently manage about those on low income? I
>> presume they aren't dying in large numbers, there must be some way around it?
It's not just their health system that's different; so is both their culture and their Social Security system.
The danger here is that whether you have co charging or not the issue of rising costs due to ageing population, new treatments etc etc the overall cost stays the same. Whether we like it or not the UK has a longstanding model of 'free at the point of need'. An awful lot of money can be pee'd up against the wall reorganising that to no real gain.
Start with what we've got and make it work.
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We seem to have been trying to make it work for an awful long time. The question is how much longer do we just keep ploughing more money into the NHS year on year whilst the service declines before we are prepared to consider that another model might just work better
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There is no model that will provide more for less.
What a different model will provide is a two-tier system - rich vs poor.
Which is what existed pre-NHS, and is creeping in by the back door.
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“ There is no model that will provide more for less.”
So for an expenditure of £192 billion a year this is as good as it gets or could possibly be?
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For about £180bn for GP/community and hospital health services, including social care I suspect so.
For only a GP service for 66 million people for £10-11bn absolutely.
Last edited by: Lygonos on Wed 25 Jan 23 at 10:16
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>>
>>
>> “ There is no model that will provide more for less.”
>>
>> So for an expenditure of £192 billion a year this is as good as it
>> gets or could possibly be?
Anything is capable of being improved. But it won't necessarily get more efficient just by changing the concept. US healthcare costs far more than ours but denies treatment to many and bankrupts others.
I share your belief that people waste free things. It's annoying and costly but it is just possible that it is one of the least bad ways of dealing with it. As Bromp says, a large minority with chronic, sometimes multiple or progressive, complaints practically live at the doctor's. Younger people might go decades between visits.
Private insurance and treatment IMO doesn't work for healthcare and it certainly doesn't make it more efficient.
What we currently have could be called insurance - the government underwrites the cost, and when we need to "claim" we present ourselves and get treated. You can save money by
- withdrawing or rationing treatments
- removing eligibility from some people
- better efficiency/elimination of waste
but beyond that it is just a question of how we pay.
I also think there is a lot of glib talk about how much is spent compared to other countries. Working that out can't be simple. It's complex to capture the costs but far more so to match it to scope and local input prices, and the comparisons necessarily use exchange rates which are volatile. Brexit in crashing the £ has made the NHS look comparatively more expensive.
We should start at the end of the chain with social care so we can get people out of hospital, out of A&E, and out of ambulances. There is no point building more hospitals to house convalescents and patients who can't be treated.
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Whether we like it or not the UK has a longstanding model of 'free
>> at the point of need'. An awful lot of money can be pee'd up against
>> the wall reorganising that to no real gain.
>>
>> Start with what we've got and make it work.
>>
I get that to a certain extent, expectations are set by the public and it's very difficult to shift away from that. We are in that set system, for better or for worse, that the government provides the health care be that provided by nationalised care, PFIs or private companies.
It's politically extremely difficult to move away from that, however when the current system doesn't work and no-one body/party has any idea how to fund the money then what is to be done?
Carry on the same and hope something turns up? I think in terms of what works and what doesn't, does the system we have now work?
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www.bbc.co.uk/news/uk-england-manchester-64392018
Apparently the biggest complaint about this is that it falsely claims you can get to see a GP.
Still, at least he did more to reduce the NHS waiting list than the tories.
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>> www.bbc.co.uk/news/uk-england-manchester-64392018
>>
>> Apparently the biggest complaint about this is that it falsely claims you can get to
>> see a GP.
>>
>> Still, at least he did more to reduce the NHS waiting list than the tories.
Shipman was on duty at Pontefract hospital when my Grandmother died there in April 1972. He signed the form for her death. Her case was one of those looked at by Dame Janet Smith's inquiry.
The victims of his main spree were younger and much more recent.
As somebody with a vested interest I find that ad offensive. I'm surprised anybody old enough to be employed thought it could possibly be appropriate.
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>> As somebody with a vested interest I find that ad offensive. I'm surprised anybody old
>> enough to be employed thought it could possibly be appropriate.
Did you see the ad before it was brought to your attention to be offended by?
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>> Did you see the ad before it was brought to your attention
And?
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>> And?
So you were pre warned you might be offended, so deliberately made sure you were.
Last edited by: Zero on Thu 26 Jan 23 at 17:21
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>> So you were pre warned you might be offended, so deliberately made sure you were.
(a) either something's offensive or it's not; how it was found is neither here nor there
(b) nothing in your post at 15:12 suggested Shipman
But you're (being diplomatic here) trying for a rise.
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(b) nothing in your post at 15:12 suggested Shipman
>>
>>
Apart from it saying 'Shipman Advert' in his post
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It got them lots of front page advertising for free though, and I expect there are a good many (including me) who smiled at their cheekiness. I even nearly laughed at their strapline "Life insurance is to die for", and the company name (Deadhappy) despite that both my parents have died (uninsured I might add), and I might too at some point.
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NHS Unsustainable? - Manatee
