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Would you pay higher taxes for NHS drugs for all? Poll discussion

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  • When I get ill, I will leave this country and go elsewhere. From everything I have seen in the NHS I would rather not be treated in any of their hospitals. I am sure I would pick up lots of things I did not go in there with.

    And some of the nurses are beyond incompetent. I have heard of them administering insulin to diabetic patients before breakfast and wondering why they were not doing well.
    Errr very sorry to point this out but insulin is always given before breakfast, half an hour for mixtard and just before for basal bolus so what is your point.There is a very tiny minority of nurses who are found to be incompetant and you can see this on www.nmc.co.uk, no nurses would get away with incompetancy.Do your homework on insulin before you post your incorrect facts.There is also a fast acting insulin given anytime if bm greater than 24 with moderate ketonuria, are we wrong to give that before breakfast too?
  • Errata
    Errata Posts: 38,230 Forumite
    10,000 Posts Combo Breaker
    I must declare an interest, I'm still working a few hours a week as a planner with the NHS. Sure, money is wasted in some areas, but I'm constantly surprised at how far money can be stretched by developing new ways of working.
    The NHS has always been underfunded and I suspect always will be, it's the nature of the beast but as someone else has pointed out, stuff like PFI only serves to drive delivery down.
    The NHS is now into it's umpteenth review which we are told will be different from all previous reviews. We will have to see. My feeling is that it's time that treatments which address lifestyle issues - tattoos, breast reduction, IVF, should cease until lifesaving treatments can be funded for all those that need them. At the moment treatment is still a lottery and costs lives.
    Whilst I understand that many may not agree with my views, I believe all views are of value and lead to the wisdom of crowds.
    I would be happy to have my taxes increased by 5% or 10% only if such tax take was hypothecated and the control of the NHS put in the hands of clinicians. I trust them with my life and so why wouldn't I trust them with my tax.
    .................:)....I'm smiling because I have no idea what's going on ...:)
  • I agree Errata, all non lifesaving procedures and lifestyle issues can wait.Treat them that didnt ask for their problem and had no choice.If treatment is so important to them they can pay for it.If it stops people working and contributing to society then help them if not its their lookout.Im sure when the NHS was set up to care from the cradle to the grave, they didnt envisage breast ops, fertility treatment, gender realignment, free heroin for addicts and clinics for stressed people.Although if the NHS wishes to pay for addicts to go into rehab im all for that for the sake of lower crime figures and a genuine desire to stay clean and live a healthy life and work to pay back all they have taken from society.
  • Best thread I’ve ever read on here. wow!

    Declaring interest: I'm also ex-NHS (mental health).

    I'd vote a loud and resounding NO to paying higher taxes into the health system as it currently operates.

    The appalling wastage must be reduced as an absolute priority. Some very useful suggestions have been made by others (medication reviews, patient education, checking entitlement, etc). Ultimately the big one about prolonging poor quality life artificially will have to be addressed (please don't let it be me!), probably through ‘living will’ idea or similar.

    But here is another idea. It is to skew the system deliberately to maximise well-being by encouraging individual responsibility for health promotion.

    Starting with the new baby numbers, an electronic points system needs to be gradually phased in over a generation or two. It would ration the per-capita expenditure on all medication and other healthcare interventions over the life-time of an individual in such a way that the contribution each of us actively made to safeguarding our own health (e.g. through diet, exercise, risk management, etc) would be actively and realistically rewarded.

    Everyone would start out with a number of healthcare years (based on average life expectancy, say, 75), each of which would be equivalent to a fixed number of health-care ‘points’. The idea would be to actively encourage people from the earliest age to become sensitive not only to issues of their own good health and well-being, but also to the economics of health generally.

    Under this system, ALL medications, procedures or treatments supplied by the NHS would be costed in ‘points’. Such a system would allow for the cost of treatments for non-inherited conditions shown by a reliable evidence base to be relatively avoidable to be set at a higher rate. Thus, the less responsibility a person took for their own health and wellbeing, the more points they would have to spend from their fixed quota. The converse would also apply – the more responsibility they took, the fewer points from their quota would need to be spent. Obviously, the less avoidable a condition, the lower its points rating would need to be set. Certain conditions (e.g. congenital or inherited) may even be zero-rated.

    Indeed, the value placed on practically any procedure, intervention, medication or treatment could be adjusted up or down according to a wide range of health-economic needs within society – e.g. those of particular age-bands or communities, or in line with a current health promotion campaign or to reflect public perceptions of the 'triviality/acceptability' of a procedure. Of course, prescriptions could be more tightly controlled than at present. Unused (unopened, within use-by date) medications could be ‘sold’ back and the ‘unspent’ health points re-credited to the user’s health account.

    Points could be traded, but only electronically through a central and highly secure Health Bank, which would also take overall responsibility for strictly limiting the points supply according to known population data. A market would emerge within which those who invested in their health ‘capital’ by healthy living could in certain circumstances trade (but not bequeath) their assets. Those requiring more points (e.g. a chronically obese person requiring a second knee operation) could ‘buy’ them from the Health Bank for real money. On recovery, they could also be offered the chance to redeem them (not the money!) – e.g. by attending an approved weight reduction programme, say, at the rate of ‘x’ points for every month they remained under a target weight.

    I believe such a system could even be adapted to the needs of carers. For example, an individual’s earlier and later healthcare years could be weighted with more points, some of which could be used to pay for the higher level of care required at these life stages. These may be paid to a nursery of the parent’s or care home of the older person’s choice. Mothers looking after their kids or other relatives looking after an elder at home could redeem (a limited number of) the points thereby ‘saved’ for cash.

    Such a system would recognise the unfortunate fact that, whether we like it or not, any social health care system can only operate to a finite budget within which its products and services MUST be rationed. The technology certainly exists to implement a system like this. I believe its chief advantage over the current “free at the point of delivery” model (which is most definitely NOT FREE!) lies in its educational emphasis on health economics, and the responsibility of individuals to themselves, their families and communities to safeguard and promote what is essentially our most valuable asset – our health.

  • sinizterguy
    sinizterguy Posts: 1,178 Forumite
    Errr very sorry to point this out but insulin is always given before breakfast, half an hour for mixtard and just before for basal bolus so what is your point.There is a very tiny minority of nurses who are found to be incompetant and you can see this on www.nmc.co.uk, no nurses would get away with incompetancy.Do your homework on insulin before you post your incorrect facts.There is also a fast acting insulin given anytime if bm greater than 24 with moderate ketonuria, are we wrong to give that before breakfast too?


    Sorry got my points all mixed up. It wasnt insulin, it was some other drug which was clearly not meant to be given at that time. If you really want the details, I will get it for you when my fiance returns from work. She is a doctor and she has to fix it or take the flak from patients and their relatives for blunders such as those.

    Either way I have seen and heard of serious incompetencies. Yes, not all of them are incompetent, but its not a gamble I want to take with my life or any of my families. Simple as.

    The last blunder was a nurse who pulled out a surgical drain from a patient. The patient consequently had to have two further surgeries in an attempt to fix the mistake - which were both unsuccesful and the patient died. Routine surgery - went very well. Killed after the surgery due to imcompetent care. As said, not on me.
  • I don't understand why some medications can not be recycled? I recently had a course of antibiotics that caused vomiting and diarrhoea. The medicine was Augmentin which came in blister packs. I had used 5 of the 21 I had been prescribed. The others were sealed and labelled clearly. I took them back to the Pharmacy to dispose of but surely money could be saved this way?
    :j Addicted to money saving
  • Please all remember this when voting ,the scottish get free prescriptions and less tax,which you and I pay for; We are also paying double tax on housing NHS ,food etc on anyone who cares to walk through our borders.So no, i will not pay more tax,i want to keep more money in my hand so that I can buy what I want! Governments waste your money!:money: Why else are we all reading Martins MONEY SAVING TIPS- if you want to pay more tax, go to another site,this one isnt for you!!this is about saving money not giving the government more hard earnt cash to waste on things that you dont benefit from. Health Insurance is cheaper than what we are paying for the upkeep and drugs of the NHS!!
  • sinizterguy
    sinizterguy Posts: 1,178 Forumite
    I don't understand why some medications can not be recycled? I recently had a course of antibiotics that caused vomiting and diarrhoea. The medicine was Augmentin which came in blister packs. I had used 5 of the 21 I had been prescribed. The others were sealed and labelled clearly. I took them back to the Pharmacy to dispose of but surely money could be saved this way?


    And what if you had tampered with the tablets you were going to return ? Why do you think anyone would accept half a blister pack of medication from a pharmacy when half has clearly already been used ?
  • Why on earth would anyone in their sane mind go through 5 years training, 2 years of PRHO crap, years of further hassle to work for peanuts such as that ?

    You obviously do not have a clue what it involves.

    Tie themselves in for 16 years ? I wont even comment on that because I doubt I could keep profanity out of it.

    Erm I think I would somehow, 5 As at A level, a MA 1st class in Maths im training to be an actuary which should eventually see me to a nice 60K paypacket. Prob about 7 years+ all in all to get all the qualifications, im 24 now and bloody lucky to be getting what im getting.

    As for the time, it takes about 8 years of training and a min of 3 Bs at a level to become a chartered civil engineer yet the best they can hope for is 30K max. There are loads of proffessions where you require 8years + training to get proffesional recognition, but luckily you live in a world oblivious to that fact.

    As for levels of english, well most doctors ;) you know. Their writing is a mess, they misspell drugs and kill people too.

    So why do GPs deserve 100-200K paypackets, while working a easy 9-5 job and dont even have a clue whats wrong with any of their patients, to the level that killed my mother!!!!!!!!!!!!!!! why do they deserve the money for being incompitent. Whats wrong with my idea of putting a 16 year tie in, the training cost what? 1 million? I think the country deserves its payback to society, RAF pilots have to sign up for a similar time after training and they are actually competent and constantly reassessed.

    How are GPs expected to know there job if they have been trained 40 years ago? If you think that its such a bad idea for reevaluation maybe every 3 years and CPD courses like most professionals.

    Most of my mates are doctors, lawyers, engineers, officers etc so I know about what they do and what they dont do. One of my mates who is training to be a doctors is well not too bright, his parents paid for his a levels with private tutors. I know hes turned up for work hung over before (as i went out with him, hes barely scraped though his exams (all they need is 50% to pass), his english is just as bad as mine and I just know hes going to get himself a cushy GPs job in 10 years earning 3 times as much as me for telling people to take an asprin and go home. So im fairly jealous hes going to get such an easy ride, he knows it and takes the !!!! back.

    I know the government wont change things as it would be deeply unpopular with the country, which doesnt really know any better. So I guess im playing devils advocate ;)
  • Errata
    Errata Posts: 38,230 Forumite
    10,000 Posts Combo Breaker
    Hard Saver presents an iteresting arguement, but I'm stuggling to see how different the solution is to health insurance in America which is also a form of points system. Once you've run out of insurance - that's it.
    .................:)....I'm smiling because I have no idea what's going on ...:)
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