Would a mixed NHS / Private model work?

JethroUK

michaels wrote: »

While I was abroad recently on my 'holiday of a lifetime' I spent...........option at every stage on a 'pick and mix' basis so that those who could and wanted to pay did so?

On the basis that anything free gets abused I would definitely support a cheap/highly subsidised health service where everything costs money (even a visit to the gp) but it's just subsidised pricing

vivatifosi

I'm a bit late to this thread, but thought I'd chip in as I live relatively close to michaels and under the same local health area.

This time last year I caught community acquired pneumonia. I want to my local GP who listened to my chest and decided that I had pneumonia. At no time was I sent to hospital for any checks. I was prescribed a three drug cocktail. Although the drugs worked quickly, it was still three weeks until I was fit enough to return to work. I was in regular contact with my GP throughout that time.

I was glad not to go to the local hospital which is dreadful and regularly sits near the bottom of national league tables. In the event that I did need hospital treatment, I'd try to get in the L&D rather than the local trust. If that sounds melodramatic, this is the same trust that 1) tried to do the wrong op on my husband, 2) screwed up my mum's breast cancer treatment, 3) tried to give my MIL the drugs meant for the person in the bed next door, 4) sent a friend of mine's elderly mum home with the wrong drugs and a treatment plan for a completely different patient, 5) left the showers in the maternity ward so dirty that my sil had to wash the blood away from a previous user before she could use it, or 6) that my cousin had a C Section and therefore couldn't get out of bed to feed herself and bring a tray back as she was attached to drips. In short they are appalling. The head put in place to turn it round has recently resigned.

So in short, I would be quite happy to see a different and better system. The one that we have means that it is ok locally to fail patients on a regular basis. My cousin is a nurse in Australia and just shakes her head in disbelief at the lack of checks and balances locally. I don't care if I have to pay a bit, providing the system is efficient, effective and I don't feel like they are failing to take people's lives seriously.

BobQ

http://www.kingsfund.org.uk/projects/urgent-emergency-care/alternative-guide-urgent-and-emergency-care-system-england

A fairly balanced view of A&E.......

Masomnia

BobQ wrote: »

It is easy to dismiss the Commonwealth Fund as a pressure group (and I agree it is) but it is not an advocate of any specific nation's system. It is trying to promote better healthcare in the US.

Most of its analysis uses reliable sources like the WHO or OECD. For example.

http://www.oecd.org/els/health-systems/oecd-health-statistics-2014-frequently-requested-data.htm

That's why I question the research though, to be perfectly honest. By a lot of OECD measures the UK does not fair well. We're below average for cancer care, don't do well when it comes to admissions for things like heart attacks, score very low for having equipment; yet they put us top. USA at the bottom when they have among the best cancer survival rates in the world doesn't make sense to me.

JencParker

Masomnia wrote: »

That's why I question the research though, to be perfectly honest. By a lot of OECD measures the UK does not fair well. We're below average for cancer care, don't do well when it comes to admissions for things like heart attacks, score very low for having equipment; yet they put us top. USA at the bottom when they have among the best cancer survival rates in the world doesn't make sense to me.

But only for those that can afford to pay for treatment. I haven't seen the figures, but I would guess that if it is low it is because it is based on per head of population - given the large numbers that have no care and so therefore don't survive, their figures won't be that great.

Masomnia

There are the OECD figures for breast cancer, and as you can see the US has the best five year survival rates, and we're way down. Other diseases are similar. So how these Commonwealth people can draw the conclusions they have is a bit of a mystery to me.

Generali

Out,_Vile_Jelly wrote: »

I think that's awful, personally, and would rather pay more tax to prevent such charges. There should be a difference between 1 and 2, because one is preventable and reversible, and the other isn't.

Lots of stuff people do that is preventable and reversible is treated by the NHS: addiction and its consequences for example & obesity, sports injuries are preventable too.

Generali

JencParker wrote: »

But only for those that can afford to pay for treatment. I haven't seen the figures, but I would guess that if it is low it is because it is based on per head of population - given the large numbers that have no care and so therefore don't survive, their figures won't be that great.

Their overall cancer survival rates are very high, not just for the rich. Perhaps rich Americans are more likely to survive cancer but I'd be prepared to bet that rich Britons are also more likely to survive.

Masomnia wrote: »

There are the OECD figures for breast cancer, and as you can see the US has the best five year survival rates, and we're way down. Other diseases are similar. So how these Commonwealth people can draw the conclusions they have is a bit of a mystery to me.

Commonwealth are a pressure group and so draw a conclusion that fits their argument. The UK comes first out of eleven in pretty much every category and then tenth out of eleven in health outcomes. If the other categories comprehensively assess how good a healthcare system is then there should be a pretty good correlation between the quality of the system and the outcomes from the system.

Unfortunately whereas most healthcare systems are driven by producing excellent healthcare outcomes, the NHS is driven by producing 'fair' NHS outcomes.

zagubov

wotsthat wrote: »

Here it's just accepted that you discuss your problem in detail with a receptionist whose skillset, as well as 'phone answering, includes determining your medical need for a same day appointment.

I contend that one of the big problems with the NHS is the inefficiency that a 'free' service builds in. If we had free petrol, house heating or water would politicians expect usage to go up or down? Why do they expect something different from health care?

A barrier system at A&E with a £10 charge for patients and £5 for each member of their entourage and tumbleweed would be blowing across the floor.

Of course, it's not very well run either so whilst the public are taking the p**s on the demand side I'm not convinced politicians are the best placed to look after the supply side.

We don't have to pay the police when they attend a crime scene, or the fire brigade when they attend a fire. Pretty sure we don't overuse these services.

I read too much Private Eye to be a big fan of the way the government are bringing the private sector into the healthcare system. There may be better systems than the NHS, but a system that creams off profits seems pointless.

jamesd

Masomnia wrote: »

USA at the bottom when they have among the best cancer survival rates in the world doesn't make sense to me.

From the OECD data, cost of medical care per person, per year: USA: $7662, UK: $4033.

That $3,600 difference in spending can deliver other benefits or health benefits in different ways, like giving older people free heating in winter.