How to solve the NHS funding crisis

economic

westernpromise wrote: »

Once you recognise that, all the whining can be seen for the snivelling after other people's money that it is. Tube drivers make 60 grand a year but, as always with the public sector, you never hear a syllable of gratitude or appreciation to the taxpayers who fund it all. What you get instead are surly demands for even more money, plus constant, pretty much annual threats to strike over "safety" concerns that are only ever allayed by more money - odd, that.

And when there is noise about how robotics/automation can replace tube drivers and taxi drivers, all hell breaks lose about the drivers losing their jobs.

economic

I am undergoing physio at the moment via the NHS. Since i had to wait so long for the NHS for an appointment i decided to undertake physio privately a few months back, paying for it out of my own pocket. Soon as i started the NHS treatment, i discovered the wait just was not worth it. NHS quality of service has been very poor compared to the private physio. The NHS treatment feels more like a tick box exercise for the therapist where they just follow the same exact methods they are taught. The private therapist has done extensive research and not only gives detailed explanation of why i am suffering from the symptoms, but also detailed recovery program suited to my personal needs and problems. I am not sure why NHS even exists. It should all be privatized.

westernpromise

economic wrote: »

And when there is noise about how robotics/automation can replace tube drivers and taxi drivers, all hell breaks lose about the drivers losing their jobs.

I can't wait for that to happen. The London black cab trade has always been a total racket. There has never been a reason why you couldn't have a premium service, where the driver knows the way and charges you £36 to take you 8 miles, alongside a cheapo one where you might have to direct the driver but he only charges you £20. If he's got a satnav he doesn't even need to ask directions. If black cabs and their Knowledge were genuinely so wonderful, they would be in no way threatened by the cheapo minicab alternative. They'd outcompete Ladislas with his satnav and his Passat.

We'll always have those iconic black cabs on London's streets; it's just that in the not-too-distant future, they won't have drivers in them.

caronoel

An interesting debate with some very strong and thoughtful comments from westernpromise, in particular. The NHS represents the last bastion of socialism... just look at the outrage from unions around the suggestion by Jeremy Hunt of a 24/7 service. How very dare you get sick after 5pm on a Friday?

I had family visiting on a Sunday evening recently - one of my nephews forgot his athsma inhaler and had an attack. No response from 111, and the nearest open pharmacy was 30 miles away in London. We had no option but to call 999 to have an ambulance crew come out to deliver an inhaler. A huge waste of taxpayers funds.

People dont value something they get for free. Charge £10 (£2 for the unwaged) per visit to your GP or A&E and you will soon see a reduction in the pressure on the health service. This system works well in countries like Sweden and Norway, who also have an annual cap to ensure that the seriously ill are not penalised.

Herzlos

westernpromise wrote: »

Why do you feel the need to gob off and scold people? Who put you in charge?

Some people just seem to like making irrelevant points when they can use it to brag, and that annoys me.

If a private GP can manage to see patients on demand, why can't the NHS? The answer is that the NHS is run for the benefit of its employees, whereas a private GP practice is run for the benefit of its patients.

Private GP's, by merit of not having to take everyone and being able to charge a fortune, have the benefit of not having so many patients per day, and thus have less risk of overrunning.

Private medicine is run for profit, generally where companies know that for a high price they need a high standard.
NHS is run for the benefit of the patients, is badly managed and chronically underfunded and understaffed. The natural outcome of that is that doctors only have a few minutes per patient rather than 10's of.

caronoel

Herzlos wrote: »

...NHS is run for the benefit of the patients...

NHS is run for the benefit of [STRIKE]the patients.[/STRIKE]NHS staff

Corrected that for you.

You're welcome

Red-Squirrel_2

westernpromise wrote: »

If a private GP can manage to see patients on demand, why can't the NHS? The answer is that the NHS is run for the benefit of its employees, whereas a private GP practice is run for the benefit of its patients.

What an absolute pile of steaming BS.

Private healthcare exists to make money.

The NHS exists to provide care for everybody who needs care.

I'd like to see some of these private companies turn a profit or manage to see people on demand if they had to deal with even 5% of what the NHS does!

antrobus

Herzlos wrote: »

...
Private medicine is run for profit, generally where companies know that for a high price they need a high standard.

Not all of it.

Nuffield Health is not for profit. And, as I recently discovered, my local community health is a not for profit CIC. (Which of course, only means they don't have shareholders who expect dividends.)

Besides, NHS dentistry has always been delivered by profit seeking dentists, NHS pharmacy has always been delivered by profit seeking chemists such as Boots. I imagine most GPs are pretty keen on making a profit.

I'm not sure how you could make a profit delivering any kind of health service unless you did so for the benefit of the patients. Making a profit is simply an indication that you are doing something right.

westernpromise

The NHS is always supposedly in crisis, falling apart and at breaking point.
The NHS is state-funded.
The NHS is heavily unionised.

All three features are bound up with each other.

Here's a thought experiment. The NHS is essentially a health insurance business that socialises premiums among people at large, based not on the actuarial risk they present, nor on what use they make of it, but on what they earn. What would a National Motor Insurance Service look like if run on the same basis?

First off, no driver would have to pay car insurance premiums - instead, the state insures you. When your car is stolen or in an accident, you wouldn't phone your insurance company (unless you choose to have private insurance), you would phone the NMIS. The NMIS does not collect premia from drivers; instead everyone is taxed to pay for the premiums that aren't being collected.

An unemployed 17-year-old with a criminal record, three recent claims and 9 speeding points on his driving licence could therefore drive a Subaru Impreza belonging to anyone else. He pays no premium because NMIS, and as he's not working, nor does he even pay tax from which a hypothetical contribution to the NMIS s taken.

A 55-year-old woman judge driving a Vauxhall Corsa also wouldn't pay any premium, but although she presents an insignificant claim risk in comparison to Jared in his Scooby, she would be in the 62% tax band. So she would certainly pay the higher taxes that are required to provide the NMIS with funds in lieu of the premiums that it doesn't collect.

Jared then wipes out her Corsa. He doesn't really need to stop and leave details because he's still insured regardless, but he does so because he is still at risk of a ban. After the ban he just starts driving again, insured as before by the NMIS.

The lady judge then has to wait 11 months for an appointment with an NMIS loss adjuster because the NMIS is in crisis, falling apart and at breaking point. She's required to turn up at the wrecker's yard at 8.30am and when she gets there she finds there are 50 other waiting who've all been given the same 8.30 appointment. Eventually she is seen at 5 to 5 but the NMIS staffer ends the meeting at 5pm because that's when he clocks off. She returns the next day and waits until 3pm to be seen. A different NMIS staffer who doesn't speak English properly asks all the same questions as the previous day, and when the judge expresses impatience with this, becomes aggressively rude and calls security.

Eventually the judge is informed that her car is repaired and ready for collection. When she turns up she finds her red car is blue where the damage was because the NMIS repair workshop only has blue paint "because of the cuts".

She writes to the Guardian to complain, and an opposition Labour MP is quoted as saying that the NMIS is in crisis, falling apart and at breaking point, because it's underfunded. The solution, says the fairness-driven man of the people, is to charge "the rich" an excess of £1,000 per claim, because judges can afford to pay for their use of the NMIS, whereas Jared can't.

The judge decided she's going to go for private insurance (the Labour Party hates people with private motor insurance and wants it outlawed).

So it's great for Jared, who gets his irresponsibility subsidised, but not so good for those fleeced to subsidise him (and who are then vilified for being "rich" enough to do so, and for daring to suggest that the NMIS is an unaccountable poor quality racket). The same would follow if there were a National Food Service or indeed any NxS one cares to postulate.

westernpromise

Red-Squirrel wrote: »

What an absolute pile of steaming BS.

Private healthcare exists to make money.

The NHS exists to provide care for everybody who needs care.

I'd like to see some of these private companies turn a profit or manage to see people on demand if they had to deal with even 5% of what the NHS does!

Private medicine can only make money by offering something worth paying for, and it has to provide it for whatever people are prepared to pay.

Neither of these constraints bind the NHS, despite which we never hear of the private sector being underfunded while from the NHS we hear nothing else.

My mother can remember the begging bowl coming around her school for poor Africans back in 1930, and it still is. Some things don't change. NHS, same thing. It's 70 years old and in 70 years' time we'll still be hearing the exact same snivelling for money.