AndyinLiverpool Posted October 31, 2017 Share Posted October 31, 2017 20 minutes ago, StivePesley said: I think that's a fair analysis .I doubt there are many people in the UK who want a US-style system and we probably all agree that the level of NHS we do want is not achievable without a massive cash injection So would people be supportive of slightly higher taxes if it was transparently ring-fenced for the NHS? Because that's the only real solution - yet as soon as you look at it in the cold light of day, I'm sure a lot of people would say "well if I'm having to pay (say) £50 a month extra in taxes for the NHS, I could just get a BUPA contract and go private instead" Which is sadly where I think it will end up Except, you don't get to pick and choose where your taxes go. It's one of the things we tacitly accept when we pay taxes - that the government is going to spend it on things we don't like as well as things we do. An extra £50 a month would just be that and if we don't like how they spend it, we try to put someone else in charge who will spend it how we want. Over the entire time of my adult life, UK governments have striven to reduce taxes, with the things that I think are important suffering as a consequence. I don't begrudge a single penny of the tax I pay. I'd happily pay more. I don't like the way some of it is spent but that's the contract we tie ourselves to in a civilised society. I would rather more of it were spent on housing and schools and less on nuclear missiles, for example, but it is my lot that not enough people agree with me in this country, so we get a housing shortage and run down schools. I've always found it quite churlish of people who seek lower taxes to criticise that state of the NHS, the police, the army and other parts of the public sector because this is what you get when you pay lower taxes. Sometimes, it really is just a question of numbers. Your 20p tax rate (or whatever it is these days - I honestly don't know) gets you so much but a 25p tax rates gets you so much more. There are things about the NHS that really piss me off, like how staff expect you to know how it all works and how if the right box isn't ticked, you ain't having that blood test or appointment you need (how come you don't know that?) but I think it's great and if there is a will in this country, it will survive. I'm not talking about political will here - far too often we are content to sit back, complain and blame politicians when things go wrong - I mean a will in the population as a whole. To take action, treat the thing with respect and fund it how it needs, it will survive. Unfortunately, I don't thing that will is there. Link to comment Share on other sites More sharing options...
Angry Ram Posted October 31, 2017 Author Share Posted October 31, 2017 1 hour ago, StivePesley said: I think that's a fair analysis .I doubt there are many people in the UK who want a US-style system and we probably all agree that the level of NHS we do want is not achievable without a massive cash injection So would people be supportive of slightly higher taxes if it was transparently ring-fenced for the NHS? Because that's the only real solution - yet as soon as you look at it in the cold light of day, I'm sure a lot of people would say "well if I'm having to pay (say) £50 a month extra in taxes for the NHS, I could just get a BUPA contract and go private instead" Which is sadly where I think it will end up OK Devils Advocate here. What is so wrong with the US insurance system . You pay money to an insurance company and they provide you with cover.. You pay more money in NI to the govt and they provide you with cover.. Do we just need to find a way of supporting those who can't afford? Would I personally have any issue with paying more in NI? No, of course not. I have private medical but would still pay more NI if I could see it being used correctly. Unfortunately I don't at the moment. You have to ask if just throwing more money at the NHS is the answer? Are they fit for purpose to spend that money wisely? Hmmm.. To be honest I know very little about how the US system works and what Obamacare was all about. Link to comment Share on other sites More sharing options...
Gaspode Posted October 31, 2017 Share Posted October 31, 2017 31 minutes ago, Angry Ram said: Would I personally have any issue with paying more in NI? No, of course not. I have private medical but would still pay more NI if I could see it being used correctly. Unfortunately I don't at the moment. You have to ask if just throwing more money at the NHS is the answer? Are they fit for purpose to spend that money wisely? Hmmm.. That's the crucial part - there is so much waste, duplication, and downright incompetence in the administrative side of the NHS that chucking money at it doesn't actually fix the problem - plus when Brown was doing exactly that, the vast majority of the extra cash went towards pay rises rather than addressing issues of capacity etc. (not saying the staff didn't/don't deserve more pay, but it shows how 'more money' isn't necessarily the answer.....) Link to comment Share on other sites More sharing options...
Stive Pesley Posted October 31, 2017 Share Posted October 31, 2017 34 minutes ago, Angry Ram said: OK Devils Advocate here. What is so wrong with the US insurance system . I'm no expert either, but I think the issues are mainly whether you can afford it in the first place, and then whether you can even get health insurance cover if you have pre-existing conditions. Bad luck with your health can literally bankrupt you and leave you homeless - or alternatively - very dead Link to comment Share on other sites More sharing options...
Van der MoodHoover Posted October 31, 2017 Share Posted October 31, 2017 6 hours ago, StivePesley said: I think that's a fair analysis .I doubt there are many people in the UK who want a US-style system and we probably all agree that the level of NHS we do want is not achievable without a massive cash injection So would people be supportive of slightly higher taxes if it was transparently ring-fenced for the NHS? Because that's the only real solution - yet as soon as you look at it in the cold light of day, I'm sure a lot of people would say "well if I'm having to pay (say) £50 a month extra in taxes for the NHS, I could just get a BUPA contract and go private instead" Which is sadly where I think it will end up Good luck if you can get a healthcare plan worthy of the name for £50 a month from BUPA....... Link to comment Share on other sites More sharing options...
Van der MoodHoover Posted October 31, 2017 Share Posted October 31, 2017 4 hours ago, Angry Ram said: OK Devils Advocate here. What is so wrong with the US insurance system . You pay money to an insurance company and they provide you with cover.. You pay more money in NI to the govt and they provide you with cover.. Do we just need to find a way of supporting those who can't afford? Would I personally have any issue with paying more in NI? No, of course not. I have private medical but would still pay more NI if I could see it being used correctly. Unfortunately I don't at the moment. You have to ask if just throwing more money at the NHS is the answer? Are they fit for purpose to spend that money wisely? Hmmm.. To be honest I know very little about how the US system works and what Obamacare was all about. Many issues with the US system Angry.......try this as a (hopefully accessible) primer...... https://www.washingtonpost.com/blogs/right-turn/wp/2015/11/19/obamacares-problems-get-worse/?utm_term=.9a37c54bad78 Link to comment Share on other sites More sharing options...
Angry Ram Posted October 31, 2017 Author Share Posted October 31, 2017 7 minutes ago, HantsRam said: Many issues with the US system Angry.......try this as a (hopefully accessible) primer...... https://www.washingtonpost.com/blogs/right-turn/wp/2015/11/19/obamacares-problems-get-worse/?utm_term=.9a37c54bad78 Okay so that's flawed as well.. So 6 pages in an we are still buggered. Good old BUPA. Link to comment Share on other sites More sharing options...
Van der MoodHoover Posted October 31, 2017 Share Posted October 31, 2017 Apologies if I sound patronising but the basic premise of insurance - regardless of who provides - is that the overall cost is redistributed among a pool who pay in. Insurance of itself does nothing to reduce/control cost or demand (which is much the same thing) or address the quality issues that have been suffered by @Angry Ram and I daresay some others. We have yet to have a fundamental debate on what we, as a nation, want our health service to be about. The original 1946 Act contained the following objective as its section 1.1 It shall be the duty of the Minister of Health ... to promote the establishment ... of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness and for that purpose to provide or secure the effective provision of services ... Nothing in there about palliative care for the elderly. An implication that conditions caused by lifestyle choices such as smoking, tattoos, weight might not have been thought to be "in scope" for the new NHS. A focus on diseases rather than accidents/emergencies. All of the circumstances have moved on a long way since the formation of the NHS. Increasing populations of future elderly citizens will make matters worse. Private provision can help in some cases but the funding of long term care has been repeatedly ducked and now there is evidence to suggest that "bed blocking" is a problem in some trust areas. Until we can agree on what we want it to do, we cannot hope to address the other issues that we must in order to make the NHS a "gold standard". Link to comment Share on other sites More sharing options...
Van der MoodHoover Posted October 31, 2017 Share Posted October 31, 2017 To illustrate the private medical insurance thing. Mrs Hants has a chronic hip issue ("clicky hip"?) dating from when she was 2. Expectation is that she will require hip replacements by the time she's 50. Health insurance for the family was £230 per month - with an exclusion for Mrs Hants' hips. A hip op currently can be had for 10-15k so basically I cancelled the insurance, crossed my fingers that nothing else would go wrong and started squirrelling the money away...... Health plans are renewable annually - so if something goes wrong and the insurer pays out, then typically they will exclude that condition from further cover. Or put a cap on the maximum benefit that will be provided (in case you might be in for multiple hospital stays). And your premiums will go up and up with increasing age. I used to have insurance through work. You then pay the tax on the deemed "benefit amount" of the cover - that is, the premium that the company pays on your behalf. When I left work and tried to get cover privately the premium was more than double the "deemed benefit" amount. Since I was paying tax at 45%....the actual cost of providing the SAME cover for my family as a private individual increased by FOUR TIMES relative to having it paid through a works group scheme. Sorry for the long winded rant - but generally I am in favour of buying through the state if it can be done competently and professionally. I guess the issue is we don't have either. Link to comment Share on other sites More sharing options...
King Kevin Posted October 31, 2017 Share Posted October 31, 2017 Both my sister-in-law and her husband both highly trained para-medics left the NHS due to poor management and an ultra PC culture which they could no longer tolerate. Most of their time was spent treating self inflicted and trivial ailments which quite frankly the people wasting their time should be punished in a way to make them think twice about doing it again . The times they treated genuine cases left them feeling the job was worthwhile but unfortunately didn't occur often enough.They now both work in the private sector . Link to comment Share on other sites More sharing options...
MrsRam Posted October 31, 2017 Share Posted October 31, 2017 I work in the NHS - just moved to a big department seeing over 150 patients a day (not me obv) and the one thing that annoys me more than anything is the people that don't turn up. The ones that phone an hour before their appointment time, what is that all about? You probably moaned to me that you had to wait about 4 weeks for your appointment in the first place - we could have filled that four times over. One woman phoned about ten minutes before her appointment saying she couldn't make it because the hairdresser had just put a colour on her hair, she was running late...........WTAF - could she remake it for tomorrow anytime after 12? Err, no. A fortnight is the first one - isn't there anything sooner - YES, there's one in about ten minutes free Patient choice. Link to comment Share on other sites More sharing options...
Sith Happens Posted October 31, 2017 Share Posted October 31, 2017 8 hours ago, Phoenix said: Disturbing incident yesterday. Still in shock, of sorts. Got back from the gym to find the wife flat out, unconscious on the floor, Could get no response, foaming at the mouth, bleeding (Bit her tongue it turned out). Phoned 999. Lady talked me through several questions (breathing pattern etc.) In what seemed only 5 mins, the paramedics were knocking on the door. She slowly came round, didn't know where she was, who she was, who I was, but after about 10 mins had eventually got her memory back. The paras put her in the ambulance and told me to follow on with a change of clothes, toiletries etc, as they sped off to the Leicester RI. Except they didn't. They went to Walsgrave (Coventry), a decision they made 'on the hoof' in the ambulance unbeknown to me). As luck would have it my step-daughter ( a nurse) was on a day off, so I picked her up and we drove to Leicester and eventually managed to park (LRI is a renowned nightmare). A long walk to A&E reception revealed(after a plolonged search) she wasn't there. Stepdaughter happened to have phone number of both Nuneaton (No, not here) and Coventry (Oh yes, she's here. Where are you, thought you'd had an accident on the way). WTF. Two hours and more wasted. Upshot was, she'd had a seizure. They'd done a brain scan and revealed no abnormality, but told her she mustn't drive (time unspecified) dont lock the bathroom door and don't be unattended. Any road up, got her home in one piece, very frightened. My observations are that the NHS works very hard and very well, but is overwhelmed with sheer volumes. The A&E departments (both) were crammed, with estimated waiting times of 2 1/2 hours+. The queues of trollys in the corridors had to be seen to be believed. My step-daughter said that it was about normal, it's much worse at busy times! If it wasn't for the blip in communication of destination (perhaps unavoidable) I'd give them 10/10. Hope all OK. Link to comment Share on other sites More sharing options...
Gritstone Ram Posted October 31, 2017 Share Posted October 31, 2017 I recently had an operation as a day patient at Chesterfield hospital. I have had a couple of operations before so I would say the care in the hospital was pretty standard. Very good but I would say that is the standard. I was pushed out at the end of the day and sent home with a load of pain killers and told to ring 111 if I had any concerns. The after care took a bit of sorting out between the district nurses and the surgery but I am quite fit so managed to get to the surgery for dressing changes etc. In a nutshell I must say my experience with the NHS has been excellent and I have nothing but praise for the doctors and nurses. I do think if they could cut out the time wasters and charge people who don't turn up for appointments it could cut out some waste. Link to comment Share on other sites More sharing options...
Sith Happens Posted October 31, 2017 Share Posted October 31, 2017 9 minutes ago, MrsRam said: I work in the NHS - just moved to a big department seeing over 150 patients a day (not me obv) and the one thing that annoys me more than anything is the people that don't turn up. The ones that phone an hour before their appointment time, what is that all about? You probably moaned to me that you had to wait about 4 weeks for your appointment in the first place - we could have filled that four times over. One woman phoned about ten minutes before her appointment saying she couldn't make it because the hairdresser had just put a colour on her hair, she was running late...........WTAF - could she remake it for tomorrow anytime after 12? Err, no. A fortnight is the first one - isn't there anything sooner - YES, there's one in about ten minutes free Patient choice. This, I hate when I read stats about missed appointments etc. One of the big differences with the NHS now is the attitude of a lot of the general public, don't give a toss about anyone but themselves. If people used the NHS properly it would run smoother, don't make appointments you don't need(its a cold you don't need to see a doctor), turn up to those you do make. Charge those that don't show... Link to comment Share on other sites More sharing options...
Sith Happens Posted October 31, 2017 Share Posted October 31, 2017 The NHS must waste loads of money on stupid prescriptions. My mum recently had to be prescribed aspirin...aspirin ffs...she was moaning how long it took to dispense them, I told her go buy them next time they are only 20p a packet. Anything you can buy for pennies from Morrison's or wherever should not be available on prescription. Link to comment Share on other sites More sharing options...
MrsRam Posted October 31, 2017 Share Posted October 31, 2017 People like free things (I don't mean your mum Paul) and they like to get their moneys worth. We have a poster up at work £900,000 a month on missed appointments in our trust - that's nearly a million pounds (for those of you who don't know lol) EVERY MONTH. Makes me weep. Link to comment Share on other sites More sharing options...
Gritstone Ram Posted October 31, 2017 Share Posted October 31, 2017 1 minute ago, MrsRam said: People like free things (I don't mean your mum Paul) and they like to get their moneys worth. We have a poster up at work £9000,000 a month on missed appointments in our trust - that's nearly a million pounds (for those of you who don't know lol) EVERY MONTH. Makes me weep. That is terrible and we are all paying for these missed appointments. It needs clamping down on and the people who miss them should be ashamed. The problem is because it doesn't cost them directly they aren't bothered. Link to comment Share on other sites More sharing options...
Sith Happens Posted October 31, 2017 Share Posted October 31, 2017 1 minute ago, MrsRam said: People like free things (I don't mean your mum Paul) and they like to get their moneys worth. We have a poster up at work £9000,000 a month on missed appointments in our trust - that's nearly a million pounds (for those of you who don't know lol) EVERY MONTH. Makes me weep. Ha its OK, I think half the problem is my mum is knocking on 80 and thinks if the doc prescribes it then she has to get it from them. Just tell people if they need paracetamol or whatever to go buy some. I'm with you its shocking what people do. Fine them £100 that will stop them. Link to comment Share on other sites More sharing options...
MrsRam Posted October 31, 2017 Share Posted October 31, 2017 I agree, we should do what dentists do and charge them twenty quid for a missed appointment. I know you pay for dentists but something should be brought in. Link to comment Share on other sites More sharing options...
Gritstone Ram Posted October 31, 2017 Share Posted October 31, 2017 Just now, Paul71 said: Ha its OK, I think half the problem is my mum is knocking on 80 and thinks if the doc prescribes it then she has to get it from them. Just tell people if they need paracetamol or whatever to go buy some. I'm with you its shocking what people do. Fine them £100 that will stop them. I know a pensioner who got a prescription for some paracetamol and travelled 5 miles to pick them up rather than buy some at the supermarket. The funny thing about it is they live in a £500k + house and has a pension as good as most peoples salaries. Link to comment Share on other sites More sharing options...
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