Would a mixed NHS / Private model work?

PasturesNew

The real answer is to get employers to pay more for lower paid jobs, reducing the Govt's tax credits bill and gaining more from NI contributions. That's a major root cause of lack of money. Us little people not being in a position to contribute more because of appalling wages.

lostinrates

LydiaJ wrote: »

That's awful. I'm getting much better service than that from my practice. And yes, I do understand about work putting restrictions on when one is available. As you know, I'm a part-time teacher, so for anything other than emergencies I'm expected to fit things like doctor's appointments into the times when I'm not timetabled to be teaching.

The triage phone call is usually quite short - a few minutes - and it's done by the doctor you will be seeing if you come in for the same day appointment, so it cuts down on the time you spend in the room talking to the doc, because part of the conversation has already happened. Sometimes it turns into a phone appointment instead.

Real examples:
Me: My daughter has earache and is in quite a lot of pain. I don't know if she needs antibiotics or not. Can she have an appointment today please?
Receptionist: The triage doctor will phone you within half an hour.

---

Triage doc: Hello, I'm returning your call. What can I do for you?
Me: My daughter has earache and is in quite a lot of pain. I haven't got an auriscope so obviously I can't tell if it's infected or just congested so I don't know if she needs antibiotics or not.
Triage doc: You'll need to bring her in. Just turn up any time today.
Me: Thank you.

[Similar conversation with receptionist]
Triage doc: Hello, I'm returning your call. What can I do for you?
Me: [Affliction I've had on several previous occasions has happened again. Details omitted because it's a public forum.]
Triage doc: Ah yes, I can see you've got a history of that and that medication x has worked well for you in the past. I'll leave a prescription for you at reception, and [details of arrangements for test to confirm that it is indeed the same thing I've had before].

Me: I want to make an appointment for my son to see Dr Y. It's not urgent, but I don't want him to miss school, so it needs to be after 4pm on a Tuesday or a Thursday.
Receptionist: I can offer you one in 4 weeks' time.

Me: I would like to make an appointment. It doesn't need to be today, and I don't mind which doctor I see, but I can only come on a Thursday, or else a Friday morning.
Receptionist: I haven't got anything for this Thursday but I can offer you an appointment on Thursday next week with Dr Z.

Very very sensible. Just wouldn't happen at my practice :mad:

I have had same days when I have had rash / swellings and said, 'don't care who I see, just want it seen in the flesh today' ( confirmed my diagnosis of roacasea and occular rosacea/ blepharitis......not important in their own right but because they might be important as secondaries.


I've never had to wait and long as this for a telephone appt I think.

PasturesNew

lostinrates wrote: »

Pn, you don't go to the doctor anyway . Have you registered yet:cool:?

Shh. I don't need to go yet... I'll register when something becomes critical. Nothing of particular note at the moment. Last time I went was 2 years ago - for a leg sore, which 2 visits and numerous expensive prescriptions failed to fix. £50 spent buying prescription items .... which I then bought over the counter in Tesco a couple of times to finally fix it.

On average, I go once every 10 years.

lostinrates

PasturesNew wrote: »

Shh. I don't need to go yet... I'll register when something becomes critical. Nothing of particular note at the moment. Last time I went was 2 years ago - for a leg sore, which 2 visits and numerous expensive prescriptions failed to fix. £50 spent buying prescription items .... which I then bought over the counter in Tesco a couple of times to finally fix it.

On average, I go once every 10 years.

One could argue that by not registering, not going and not being part of relevant screening you are at risk of costing more by not catching potential critical sat first opportunity.

kabayiri

Not wishing to be awkward, but shouldn't we ask a different question first?

Does our current system work today, and will it still work in 5 / 10 years time if unaltered?

Frankly, I don't think it does. Current bill is well over £100bn; differing cost pressures could easily see this move to £150bn in time. These are huge figures.

The use of money is perhaps loathesome but I can't think of a more effective method of regulating demand at the point of consumption.

margaretclare

I think there are times when it makes sense to combine both public and private.

A week ago I had occasion to call 111. They sent out a non-emergency ambulance. It turned out, this is a private service under contract to the NHS. Two very nice friendly and competent guys with some impressive equipment who did a battery of tests and took an extensive history, and I got transferred to A&E. They were excellent. An African doctor took blood, and that's the first time in many years of having bloods taken that I did not feel it. Not! I said to him 'You're good at what you do'.

Upshot was, I was sent home about 1 am with a letter for the GP, a possible diagnosis and 'this needs investigating further'. Well.

To get it investigated further in the NHS would mean a wait of 4 weeks minimum just for a consultant's appointment. I decided that if it needs investigating, it needs investigating sooner rather than later. I phoned the local Spire hospital and got an appointment with a consultant Wednesday morning. I'm having a CT scan on Tuesday cost £780. It may be something or nothing. Tummy upset, or more sinister? Who knows? Need to find out. Can't spend time worrying about it and waiting for appointments to come through the post.

In our experience, DH's and mine, the emergency services are excellent. That's A&E, the paramedics, critical care, those parts of the service. Not so much where you're waiting for appointments and worrying about it.

Southend1

The NHS already operates a mixed public and private model and has done since day one. GPs are private contractors.

The recent problems with Hinchingbrooke show that the private sector should not be allowed to go further. Imagine a company such as G4S or Serco running an A&E dept.... Patient numbers would be misreported to boost income, staffing would be dangerously low, poorly paid and badly trained, equipment would be outdated/broken/ non existent.

Andy_L

PasturesNew wrote: »

I
At £25 I'd probably never go to a Doctor. I'd end up Googling stuff and buying things from abroad over the Internet.

BUPA charge £70 for a "pay as you go" (ie non-insured/non-member) 15min GP consyltation

IronWolf

Southend1 wrote: »

The NHS already operates a mixed public and private model and has done since day one. GPs are private contractors.

The recent problems with Hinchingbrooke show that the private sector should not be allowed to go further. Imagine a company such as G4S or Serco running an A&E dept.... Patient numbers would be misreported to boost income, staffing would be dangerously low, poorly paid and badly trained, equipment would be outdated/broken/ non existent.

Rubbish, the US private healthcare system is among the best in the world.

Southend1

IronWolf wrote: »

Rubbish, the US private healthcare system is among the best in the world.

The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance. Among the 11 nations studied in this report—Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2010, 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last or near last on dimensions of access, efficiency, and equity. In this edition of Mirror, Mirror, the United Kingdom ranks first, followed closely by Switzerland (Exhibit ES-1).

http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror