Would a mixed NHS / Private model work?

BobQ

michaels wrote: »

IN the UK seeing the doctor would have been difficult, each prescription would have been 8 quid and probably any 'extras' I would have needed to buy myself. IF they had bothered to take the precaution of an x-ray (less likely in the UK?) I suspect there would either have been a very long wait at A&E or a wait for an appointment (I am guessing here).

I think you are being unfair if you take one instance of care funded by private insurance abroad (do the general public get the same service in that country?) and then making assumptions and guessing what would happen in UK.

In my experience a GP referring you for an Xray does not require you to go to A&E and is sometimes done at a privately run facility (maybe similar to the diagnosis centre Generali refers to?)

Obviously we don't want to dismantle the NHS but if I were in the UK and I had the option of £25 for a doctor's appointment when suits and £30 not to have to wait for an x-ray I would probably take it. However no doubt for this to happen it would probably be by an NHS doctor and at an NHS hospital and thus the 'payments' would be for me to jump the queue and if I jumped a queue it would mean those already in the queue would have to wait longer. On the other hand it would bring in funds to the NHS providing services that they would be providing to me anyway if I had to wait as now.

Not all GPs are the same, if you have a routine appointment what is the problem in waiting? In my experience you can see a GP if it is urgent. Where you get problems is people routinely calling it an emergency and the GP finding out it is not. The idea that you get immediate treatment because you pay is misleading. I pay for private dental care but I still find appointments have to be booked well in advance unless they are an emergency in which case you are seen quickly.

Many GPs will see patients privately at a commercial rate (more than £30!) but they do this in separate sessions to NHS patients.

I think paying for appointments might deter people from not turning up to booked appointments and making them for trivial reasons, but the downside is that people who are genuinely ill would not go as well, particularly if they are poor.

Generali wrote: »

It works excellently in Australia where I believe we have possibly the best physical health care system in the world (mental health provision is woeful, almost as bad as in the UK).

I too have heard that healthcare in Australia is very good from relatives. As I understand it is basically state funded but with some costs paid for "at cost" by individuals who are therefore "forced" to take out private insurance cover for these things. From what you say, there are some things you must pay for that cannot be insured against.

Whether it is better than the UK I do not know but the funding seems overly complex as you describe it with plenty of scope to find yourself uninsured.

LydiaJ

In_For_A_Penny wrote: »

I'm afraid it doesn't quite work like that.

The same numbers of patients need seen by the same number of doctors. In the time that a patient is being seen in a private clinic, that consultant specialist is not available to see patients on the NHS.

It might be argued that private clinics are undertaken in a consultants "free-time". Very often that is not the case and they have merely delegated work to a more junior colleague in their absence.

The same number of doctors as what?

What is fixed about the number of doctors? The total number of actual trained medical professionals in the UK, or the number that the NHS can afford to pay for? Does having some patients paying for their treatment bring in extra money that can enable more doctors to be employed than would otherwise be?

In_For_A_Penny_2

LydiaJ wrote: »

The same number of doctors as what?

What is fixed about the number of doctors? The total number of actual trained medical professionals in the UK, or the number that the NHS can afford to pay for? Does having some patients paying for their treatment bring in extra money that can enable more doctors to be employed than would otherwise be?

If you're paying privately to see a specialist in a given area there are a limited number of specialists who can offer that service. My point being that by going privately there is most often not a reduced burden on the NHS.

In_For_A_Penny_2

LydiaJ wrote: »

Does having some patients paying for their treatment bring in extra money that can enable more doctors to be employed than would otherwise be?

In the current system absolutely not. In fact, it is more likely to result in less doctors being employed.

BobQ

Generali wrote: »

By being operated on privately I took myself out of the public queue meaning that patients in the public system were also seen sooner. I paid for everything I was allowed to pay for which meant I was seen quicker but also meant that someone in the public system got my place in the queue.

.

On the one hand I can take your point that a mixture of public and private works. You are right that if someone gets quicker treatment outside of the public system it does not matter to those in the public system. But on the other hand you said

I then had radiotherapy. I had to wait about 2-3 weeks before it could start and that was wholly covered by the state and unavailable in the private sector.

Is this not just another example of a private care system cherry picking what it will do and so not providing a comprehensive service? I think this is the sort of thing that some people in the UK fear for the NHS with the NHS picking up the things the private sector do not see as profitable or see as too risky.

michaels

Ok, lets be even more provocative.

Suppose I need to go to a&e to get my kids ankle x-rayed in case it is broken. This is clearly not life threatening so the odds are there will be a long wait but the child will be seen eventually. Suppose I was willing to pay £100 to avoid having to wait. The NHS takes in £100 which helps pay fr more staff and does not give my child any extra treatment it just does things in a different order. I am happy to pay as I value 4 hours of my time plus my child not being in pain at least at £100. The NHS benefits, someone else waits an extra 30 minutes as we have queue jumped. Not 'fair' but is the overall benefit worth the unfairness?

jamesd

PasturesNew wrote: »

IIf I were in the queue behind a millionaire and we both had the same thing, is it wrong that they can jump the queue and get it seen to, whereas I sit on an endless list until I die?

That's really not a correct question because the millionaire when paying is removing one person from the queue, them, so moving the NHS queue faster.

Their money isn't available for treatment of anyone else so denying them the opportunity just means worse service for all.

PasturesNew wrote: »

For £20-30 I think it's immoral. If the "fix" is £100k then I can accept that.

Private non-GP cover costs something in the £400-£1,000 a year range through employee benefit systems in the UK. The amount of cover provided and any payment caps vary depending on plan chosen. I don't know of one that covers emergency care, nor GP care, just specialist referral and a range of other things.

One of the things I was considering buying through work was some tests. I checked the private unit of my local NHS hospital and found that they would do the tests more cheaply than the provider at work so that's how I'll get them done. That private unit income will help to fund the NHS hospital it's related to.

lostinrates

In_For_A_Penny wrote: »

It might be argued that private clinics are undertaken in a consultants "free-time". Very often that is not the case and they have merely delegated work to a more junior colleague in their absence.

I've never once been offered or able to get an NHs clinic on a weekday evening, when many of the private consult clinics are. Of course many ARE run weekday day times too, I have fair few of them )

Of course, clinics weekday evenings also mean that those not so unwell as not to be working can remain economically active.

lostinrates

michaels wrote: »

Ok, lets be even more provocative. Suppose I need to go to a&e to get my kids ankle x-rayed in case it is broken. This is clearly not life threatening so the odds are there will be a long wait but the child will be seen eventually. Suppose I was willing to pay £100 to avoid having to wait. The NHS takes in £100 which helps pay fr more staff and does not give my child any extra treatment it just does things in a different order. I am happy to pay as I value 4 hours of my time plus my child not being in pain at least at £100. The NHS benefits, someone else waits an extra 30 minutes as we have queue jumped. Not 'fair' but is the overall benefit worth the unfairness?

Your kids ankle isn't an emergency....but depends on what else is in the waiting room.

Presuming nothing critical I wouldn't have a problem with it.

Gets a child out of what can be a rather unpleasant environment sooner too.

In_For_A_Penny_2

lostinrates wrote: »

I've never once been offered or able to get an NHs clinic on a weekday evening, when many of the private consult clinics are. Of course many ARE run weekday day times too, I have fair few of them )

Of course, clinics weekday evenings also mean that those not so unwell as not to be working can remain economically active.

I'm all for evening clinics taking place in the NHS and in many places this is starting to happen.

However, just because a private clinic takes place in the evening doesn't mean the consultant is not on call for hospital cover.