Can the UK afford the NHS (in its current form)?

Enterprise_1701C

I think it should grow a pair.

Sex change operations should not be allowed for starters, yes it appears to be vital to the people concerned, but I think cancer treatment should be prioritised over that.

Fertility treatment should not be funded, if you cannot afford fertility treatment you cannot afford kids. And no, kids are not a right, they are something you have to work towards however you get there.

Another thing they should not fund - translations and interpreters. I know it is only 20 - 30 million pounds a year, but all that counts, and if you live in this country you should learn English, if you can't speak English you should pay for an interpreter.

Non-residents should not have access to the NHS. You hear of people coming over here and immediately reporting to A&E so that they can have heart surgery that would cost X in their own country. I am not saying deny them treatment, but if they can wait long enough to fly over here then they can wait long enough to enable them to put a deposit down that would more than cover the treatment and hospital stay, any excess can be refunded afterwards.

I think this is one good reason to introduce ID cards. The only people with any reason to object are the sort of people that should have them anyway. If we had to carry an ID card at all times then it would give us access to NHS treatment and if you could not produce an ID card you would have to pay for treatment or go somewhere else.

I know those views will not be popular, but it is the only way to save the NHS for BRITISH people, as it was originally intended.

kabayiri

Enterprise_1701C wrote: »

...
Another thing they should not fund - translations and interpreters. I know it is only 20 - 30 million pounds a year, but all that counts, and if you live in this country you should learn English, if you can't speak English you should pay for an interpreter.
...

I disagree. Provide translators but make it a profit centre. The NHS needs niche sectors where it can make a profit, to plough back in to the main care business.

There is no harm in charging for a premium service, which could include language support.

Fertility is an interesting example. Depending on where you live you get limited support for fertility.

We spent the equivalent of a nice compact executive car on fertility. It certainly was not free!

Again, I think there should be a base layer to service, and people can choose to pay to top this up with premium services.

mwpt

kabayiri wrote: »

Again, I think there should be a base layer to service, and people can choose to pay to top this up with premium services.

You have to be very very careful going down that route. I'm not saying it can't work but there are places where the model was followed and base services end up being eroded until they are almost useless and nearly everyone above the very poor pays for premium services.

padington

Open immigration through Europe plus free medical care will Increase taxes year on year.

It's like offering to do surgery to anyone passing your house.

Lovely idea but very costly.

lawriejones1

I work as a journalist in the healthcare sector, so perhaps have a slightly skewed view. I believe that the concept of the system is incredible - but that the reality (inefficiency, bureaucracy, political meddling, chronic underfunding) are all taking their toll.

Having seen private sector involvement in the NHS I estimate it works well about 20% of the time, averagely 30% of the time and disappoints 50% of the time. I don't think the Conservatives have a plan to sell off the NHS but they despise large bureaucracies and are trying to challenge it. The problem is the schism between clinicians and managers. The system needs excellence and respect on both sides, but often gets neither.

Bringing lifestyle issues into it conflates two things. The NHS and public health. The NHS is neutral and non-judgemental, as it should be. Free at point of use is a fundamental part of the system, it's heart if you like. It's us as society, public health teams and the Government that should be making changes to lifestyles. But we prefer to blame the monolith that is he NHS.

lawriejones1

padington wrote: »

Open immigration through Europe plus free medical care will Increase taxes year on year.

It's like offering to do surgery to anyone passing your house.

Lovely idea but very costly.

Of course immigrants very rarely get free care. We claim the money back through their systems (as they do with the E111). Foreign nationals outside the EU are charged for care unless they have been here for a set period of time and are legally allowed to be here, often contributing to the country's economy.

CLAPTON

lawriejones1 wrote: »

I work as a journalist in the healthcare sector, so perhaps have a slightly skewed view. I believe that the concept of the system is incredible - but that the reality (inefficiency, bureaucracy, political meddling, chronic underfunding) are all taking their toll.

Having seen private sector involvement in the NHS I estimate it works well about 20% of the time, averagely 30% of the time and disappoints 50% of the time. I don't think the Conservatives have a plan to sell off the NHS but they despise large bureaucracies and are trying to challenge it. The problem is the schism between clinicians and managers. The system needs excellence and respect on both sides, but often gets neither.

Bringing lifestyle issues into it conflates two things. The NHS and public health. The NHS is neutral and non-judgemental, as it should be. Free at point of use is a fundamental part of the system, it's heart if you like. It's us as society, public health teams and the Government that should be making changes to lifestyles. But we prefer to blame the monolith that is he NHS.

so a bit like communism : excellent in principle but somehow doesn't work in practice : in fact like communism it kills a lot of people

your solution is to blame the patient.

Andy_L

kabayiri wrote: »

I wouldn't have gone so far.

I think PFI has use in certain circumstances, but good implementation is absolutely key. It's easy to give the procurement role to people who are inexperienced or up against time pressures.

Perhaps for political reasons, there was too much of a rush into some of these contracts.

Bernard Gray (the Private Sector trouble shooter bought in to to try and turn around the MODs procurement wing) said his main problem was that he was unable to pay enough to recruit & retain good procurement experts in the civil service.

Andy_L

zagubov wrote: »

In HE PFI has been lets just say distinctly underwhelming.:(
The academisation of schools is another example of ideological asset-stripping. If the private sector can help deliver public services, let them do so with complete transparency and keep the providers under the microscope.

ISTR one company just paying the penalty charges and walking away from a school PFI

CLAPTON

lawriejones1 wrote: »

Of course immigrants very rarely get free care. We claim the money back through their systems (as they do with the E111). Foreign nationals outside the EU are charged for care unless they have been here for a set period of time and are legally allowed to be here, often contributing to the country's economy.

if you really are a journalist in the healthcare sector then tell us how much money we recover from EU migrants and how much from other foreigners.