Would a mixed NHS / Private model work?

jamesd

Kittycat1981 wrote: »

I enquired about a private referral - Bupa, Spire and Nuffield- neither do the testing he needs within a 100 mile radius of where we live, the GP went on to say that we could pay privately to see the same NHS doc in the NHS immunology clinic in the same NHS hospital and be seen quicker.

I personally think its disgraceful and is one of the contributory factors to waiting lists being so high, i could pay to "jump the queue" but at the expense of someone else??

How are you planning to have the NHS force this doctor to work beyond his contracted hours so that they sees more NHS patients?

The private work done by the doctor is in addition to their contracted NHS work, not a substitute for it. Your son would be freeing up a place in the queue for an NHS patient if he was using the doctor's personal time rather than NHS time. He'd also be helping the NHS courtesy of fees for use of NHS services by that doctor in the course of his private work.

Best to pay for your son if it's covered, since you'll be helping both your son and NHS patients who are not as well covered as you.

antrobus

jamesd wrote: »

I read it before posting here. Where do you believe that the NICE guideline says that there is little evidence that excess winter deaths are the result of a lack of heating? Page number and exact quote please.....

Well you could start with page 22 "The Committee noted that there was limited UK evidence on how to prevent cold-related deaths (particularly relating to interventions)"

Or you could read page 41 which contains the statement "It is uncertain to what extent vulnerability to the cold relates to outdoor or indoor temperatures in the UK. Associated with this, it is unknown to what degree indoor temperature may affect out door temperature and ill -health."

If you really want to know about excess winter deaths you could start by reading this - https://fullfact.org/factchecks/31000_excess_deaths_last_winter_cause-29289 - but as far as I'm aware no one has been able to establish a correlation between excess winter deaths and energy prices. The main correlation appears to be with the thermal efficiency of houses.

antrobus

jamesd wrote: »

....That's the spending difference on healthcare, so if it is desired to have a US system that is the cost increase that could be expected. .....

No one outside the US desires to have a US system.

jamesd wrote: »

....The money on alternatives doesn't have to be spent by the government. At the moment we get to keep that $3600 per person per year to spend as we wish. That could be on direct health care or it could be on other things.

Exactly. That $3600 per person per year has already been spent. It's not rolling around spare in some drawer somewhere.:)

theoretica

If I were reworking the NHS I would not start from here and make tweaks, but start from a plan for what would work in 20 years and how to get there.

Private or national - I incline towards national but perhaps with more options to buy into more expensive tiers. Private is trying to make a profit, and if it is possible to make a profit out of it I feel it should be done nationally so the nation benefits.

I would have far more specialised technicians especially in larger cities, I know this wouldn't work so well in sparsely populated areas. Making more use of specialists with shorter training would free up the generalists for where they are really needed, including people with more than one interlinking condition. This would make better use of their expensive time and possibly also making their life more interesting. Most people have some idea what is troubling them and if I have a sore hand and wrist that I think relates to too much computer use I really don't care if the person I am seeing knows nothing about complicated pregnancies. The technicians would of course know when to refer upwards. I would also, as some places are talking about, have walk in and wait GPs near A&E for people who are now going to the wrong place.

One option for paying to skip the queue which might work is to have a specified number of places for paying patients - three appointments a day or whatever. This would prevent an ever increasing stream of people paying and the free queue lengthening for ever. The NHS could then auction off these places. If the queue was short the price would be low and all would go on much as before. If the queue got long and people were prepared to pay significant sums the NHS would get more money which they could be required to put towards resources to relieve that particular area of bottleneck.

Generali

@Graham- Did you actually read the document you linked to?

It states that average income after expences but before tax is £92k.

Graham_Devon

Generali wrote: »

@Graham- Did you actually read the document you linked to?

It states that average income after expences but before tax is £92k.

Yes.

Different expenses. If you just split the money the entire practice gets, you end up with the figures the document quotes (before expenses figures). But that's not what the individuals actually draw down.

They have expenses they need to individually pay after their drawings. Medical cover. Loan repayments for buying in etc etc. All that (normally) ends up deducted from their pay before they get it.

You need to seperate business running expenses from their actual drawings and the expenses they occur individually after that.

GPs are currently going salaried. Why on earth would they if the pay is 40k less? The clue is...it's not. Often salaried GPs are taking more home than the partners.

And suggesting the height of a GPs expertise is prescribing anti-biotics is about as demeaning as suggesting the extent of a high end London bankers intellect is counting up loose change to place in money bags.