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

CLAPTON

Graham_Devon wrote: »

Let's put it this way - if you removed politics from the NHS, it would be sorted out within a decade. As it is, it's used as voting fodder, so will never be able to function as it should.

if my removing politics you mean abolishing any state funding then that would be most interesting

HappyMJ

GwylimT wrote: »

I wish I could buy my prescription only hayfever tablets for £1.50.

We already pay £800 a month for medical treatment the NHS doesn't fund, to then have to pay twice to use the NHS would be very frustrating. So for us £10 would be a huge difference, especially when we pay national insurance to use the NHS.

If you're paying NI it's highly likely you would not qualify for free prescriptions and therefore not require a prepayment certificate.

Paying NI contributions isn't a pre-requisite to use the NHS. I'm a company director and do not pay NI yet I can use it.

Could your hayfever tablet's be purchased over the counter. Telfast for instance is prescription only but in other countries it can be purchased over the counter. Some of these non dangerous drugs should be allowed to be purchased at a pharmacy.

zagubov

vivatifosi wrote: »

I would look at the Australian model... My Aussie family speak very highly of it and I agree with the co payment element. Also we should look to see what the likes of France Germany and the Scandinavians are up to.

I don't think we should wholesale copy any of them. Rather we should acknowledge that there are things they do better and see how those elements can be picked up here.

The new plans to make greater use of pharmacists, plus also nurse practitioners seeing patients with minor injuries rather than a full a and e service also seem a good idea.

Pharmacists are an under-used resource. The new positions like physician associate may help meet some of the NHS's shortages.

As for examples to look at, the Canadian provinces run healthcare schemes that make the US "system" look primitive.

Generali

zagubov wrote: »

Pharmacists are an under-used resource. The new positions like physician associate may help meet some of the NHS's shortages.

As for examples to look at, the Canadian provinces run healthcare schemes that make the US "system" look primitive.

Fundamentally, the problem with NHS funding is the 'free' at the point of use aspect means many people have no respect for the system and will consume as much NHS as they see fit.

If there was some sort of co-payment system then people would think twice before consuming NHS.

HappyMJ

Generali wrote: »

Fundamentally, the problem with NHS funding is the 'free' at the point of use aspect means many people have no respect for the system and will consume as much NHS as they see fit.

If there was some sort of co-payment system then people would think twice before consuming NHS.

Some people would decline to go their GP at all if they had to pay even if they were suffering from something potentially quite serious.

Some prefer to prioritize other payments over that of healthcare. We all know they shouldn't but some families must have Sky TV at the expense of a good healthy balanced diet. Would that extend to co-paying for GP services? What would be a fair charge?

As we've mentioned Australia so far in this thread and I lived there for many years finding a GP willing to charge the Medicare Benefits Schedule fee of $37.05 for a consultation of "up to" 20 minutes (which is fully covered by Medicare) is getting much harder. There are many patients who would prefer to travel for many miles to get a free GP rather than use their local GP which a co-payment is required even if that co-payment would enable them to see a GP quicker.

vivatifosi

Generali wrote: »

Fundamentally, the problem with NHS funding is the 'free' at the point of use aspect means many people have no respect for the system and will consume as much NHS as they see fit.

If there was some sort of co-payment system then people would think twice before consuming NHS.

That's the crux of it. The per capita cost of the NHS is quite low compared with other Western European countries and other developed nations such as USA, Canada, Aus. It has also more or less doubled since 2000. So there are some other things that can be done to tinker around the edges, but otherwise co-payment is inevitable.

This table, which shows both total and government spend per capita, by country, is interesting. For example, Australia has a much higher health spend, but a similar government health spend to us.

http://apps.who.int/gho/data/node.main.78?lang=en

Generali

HappyMJ wrote: »

Some people would decline to go their GP at all if they had to pay even if they were suffering from something potentially quite serious.

Some prefer to prioritize other payments over that of healthcare. We all know they shouldn't but some families must have Sky TV at the expense of a good healthy balanced diet. Would that extend to co-paying for GP services? What would be a fair charge?

As we've mentioned Australia so far in this thread and I lived there for many years finding a GP willing to charge the Medicare Benefits Schedule fee of $37.05 for a consultation of "up to" 20 minutes (which is fully covered by Medicare) is getting much harder. There are many patients who would prefer to travel for many miles to get a free GP rather than use their local GP which a co-payment is required even if that co-payment would enable them to see a GP quicker.

TBH I keep being told that it's getting harder to find a GP that won't charge above the maximum Medicare fee but I find it easier and easier as more medical centres open up.

CLAPTON

HappyMJ wrote: »

Some people would decline to go their GP at all if they had to pay even if they were suffering from something potentially quite serious.

Some prefer to prioritize other payments over that of healthcare. We all know they shouldn't but some families must have Sky TV at the expense of a good healthy balanced diet. Would that extend to co-paying for GP services? What would be a fair charge?

As we've mentioned Australia so far in this thread and I lived there for many years finding a GP willing to charge the Medicare Benefits Schedule fee of $37.05 for a consultation of "up to" 20 minutes (which is fully covered by Medicare) is getting much harder. There are many patients who would prefer to travel for many miles to get a free GP rather than use their local GP which a co-payment is required even if that co-payment would enable them to see a GP quicker.

lots of people die now because there is insufficient funding : I would prefer people died because they favoured SKY over a co-payment that people die with no alternative due to free at point of use.

michaels

zagubov wrote: »

The discovery of antibiotics can be by private or public funding, no need for ideology about it. The distribution and use of them needs shedloads more central organisation and perhaps micromanagement than currently exists.

Didn't the 'public' human genome mapping project end up getting overtaken by a much cheaper private sector competitor? I think that says a lot about the relative effectiveness of huge centrally planned research efforts compared to for profit research.

zagubov wrote: »

A chap wrote a letter in one of the newspapers ages ago making the tongue-in-cheek point that most executive and management jobs are pointless and unproductive.

The answer would be to allow all pen-pushers to keep their job titles and salaries and perks but instead of loafing around in offices, do socially useful work like working in care homes or visiting homes to look after the elderly, or caring for the disabled.

We'd all be as well off but a vast amount of needs would be met that currently aren't, and we'd all be doing genuinely important work instead of pretending our work's vital when it's not.

I don't understand why we in this country denigrate organising things properly 'put the doctors in charge of the NHS' is often the cry. Personally I would like my doctor to be an expert in health care not an expert in logistics and supply chain management and I would like modern management techniques applied to maximising the output from limited NHS resource rather than just the organisation supplying what the doctors fancy doing. I believe in the past there was under provision for geriatrics because it wasn't a 'sexy' area for doctors to go into.

michaels

I think the is a huge gap for 'co-pay' NHS plus in the UK - you pretty much have the choice of one size fits all NHS or top 1% affordable private treatment.

I bet there are many who would like to be able to top up their NS provision in little ways - for example seeing a GP quicker and outside normal working hours and by allowing this to develop as a co-pay model it would allow the existing provision to be better funded whilst offering more options for those with spare income but time poor.

Sadly this is where politics gets in the way, even though this suggestion does not lead to any worsening of treatment options for those who can't top up their treatment the political howls of 'not fair' make it impossible to introduce.