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53 minutes ago, NotThePars said:

Law Stud once proposed everyone is given £10,000 a year that they can choose to either spend on their own medical treatment or whatever they want but if it ran out they would be denied medical treatment for that year.

Just have to hope I didn't get sick after the 03rd of January every year especially after the comedown after blowing it on hookers and ching 

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18 minutes ago, NotThePars said:

I might have the figure wrong. It was over a decade ago. I believe one part of his argument was that the amount he gave was what the NHS cost each individual Briton therefore he believed it was better for us to get that money direct and choose how we wanted to spend it. I dunno how you would accurately budget a health service and whether you would actively want people to get sick so you brought more dosh in but it was part of the wonderfully racist and lunatic mind he had. The OP's lazier "take charge of your own health" stuff doesn't hit the same. 

I found this Daily Star article about the cost of NHS operations. It seems appropriate that this discussion should include a Daily Star article entitled “the cost of these NHS operations will shock you”.

https://www.google.co.uk/amp/s/www.dailystar.co.uk/health/nhs-70th-cost-surgery-procedures-16867542.amp
 

Under the new Law Stud Process you have to save up for a couple of years to get brain surgery. On the upside you can get two to five hernia operations and up to twenty vasectomies a year!

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1 hour ago, alta-pete said:

Is it because the NHS is free to all at the point of service that everyone feels entitled to use it and therefore overwhelm the system? Or should there be some sort of means tested arrangement? An annual limit on the services you can use?

 

 

i) Everyone feels entitled to use it and therefore overwhelm the system

I'm not sure where I'm getting this from - I think it might literally be from the last time I was in a GP waiting room up on the wall - but afaik a major problem is from people no-showing appointments and not phoning ahead to cancel. As per your original post maybe someone with more knowledge working in/with the NHS can elaborate. I think there has been the odd campaign from the NHS for more power to charge people for wasting their time by not calling in to cancel or reschedule appointments in the past. Up to a point that's something that is probably worth looking at, but I think if anything as a rule we should try to avoid falling into a trap of "oh well it's just chronically underfunded what can we cut next" and try to look at *increasing* uptake/provision/trust in the NHS as much as possible.

ii) means testing

Nah. Pretty sure that was the whole point of free prescriptions, it'd cost more to try to means test it than just keeping it as universal as possible.

iii) annual limit

Again, not for me. Runs the risk of discriminating heavily against, say, women (pregnancy costs?) or the elderly (chronic health problems later in life, it's depressing just how badly peoples bodies can start to fail them in their later years through little to no fault of their own). Putting pressure on people to have to decide whether to use some kind of limit to treat themselves or take the risk of "meh this lump on my throat/breast will probably just go away on its own" sounds shitty.

 

Edit to add: weren't most private health providers pretty much useless during the early stages of the pandemic? iirc they gave Alan Partridge style shrugs and looked to get out of treating their customers as much as they could.

Edited by Thistle_do_nicely
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One straightforward and cost-effective step would be to simply remove 'Accident' from 'Accident and Emergency unit'; thereby automatically dividing 'wee Kayden needing a stitch for a cut finger' from 'someone having a massive heart attack' into logically separated priority categories from the start. With a truncheon delivered to the face of anyone who fails to recognise the difference. In an ideal world, there really should be community treatment centres rather than hospitals to deal with a lot of minor issues. 

I'm also quite sceptical about whether the demand for paramedic treatment and dispatch to the hospital in a full ambulance stands up to logical scrutiny, considering the huge opportunity cost to those who actually need to use that specialist technology en route. I could be miles out with that one though. 

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I've always found it a bit weird when Americans can't seem to finish a sentence without praising their military. The UK is a bit like that with the NHS.

 

FWIW, I do think universal healthcare that is free at the point of need is a good thing, and I'm glad that we have that available in the UK. Having said that, I think obtaining private medical insurance, if you can afford to, is a no brainer for a few reasons:

 

1. Skipping the queue for non-urgent procedures

2. Being able to see a consultant at the drop of a hat.

3. Possibly a more comfortable hospital experience

 

Essentially I think emergency care, cancer treatment and GP's are best done through the NHS. For other treatments, they are probably better off left to the private sector albeit with the NHS providing the services for those who cannot afford it (but with longer waiting lists)

 

I think the front-line NHS staff are very good at what they do but ultimately they're doing a job the same as you or I. The bureaucrats, on the other hand, are highly incompetent.

 

I find the "our NHS" stuff cringey tbh

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1 hour ago, alta-pete said:

I've been tempted to start a discussion on this for a while but with BoJo's NI rise and a derailment on the Covid Thread, now seems apposite.

Over a number of years I have had direct interaction with the NHS at both beginning and end of life care and I found every experience of dealing with the staff involved to be equally humbling and awe inspiring, leaving me hugely grateful that we have such skilled professionals to look after us and our loved ones when things get to the genuine life and death stage. 

However, to me, the real problem area is the bit in the middle where I, as a consumer of their services, seem to made to feel about as welcome as a fart in a spacesuit. Now that I'm creaking into middle age, I am becoming more involved with our primary healthcare providers and, in my experience, I'd struggle to find a more disinterested bunch of jobsworths - and that was before Covid. I suspect this is because they are frankly jaded by dealing with a significant cohort of the general public (bad enough as a whole in their own right IMO) that is disproportionaletly made up of the geriatric population, malingerers, the addicted, the mentally unwell and other patients that they can never properly cure but just patch up and send home until they present themselves next time for more treatment, all the while being choked by chronic underfunding for such sectors of the commuity by a management that doesn't really understand the front line.

I am also fortunate enough to have private health insurance. How they are able to run the service they do for the money their customers pay in I also find equally astonighing. Equivalent to a phone contract or a modest dinner out, the monthly amount to take personal responsibilty of your own health seems a no-brainer to me. Is it because the NHS is free to all at the point of service that everyone feels entitled to use it and therefore overwhelm the system? Or should there be some sort of means tested arrangement? An annual limit on the services you can use?

Health is fully devolved to SG so I can't see that there can be a legitimate 'but Toarries' argument but I'm sure that won't stop some. And BoJo's NI rise actually directs further funding to our NHS beyond what we, as a Scottish population, are contributing through NI. And, of course, if SG are opposed to the NI increase, they have the power to shift PAYE rates to counter the total tax take from individuals. 

I know we have some health professionals on here, @Tynierose being prominently eloquent. Any views on how the PnBHS should be run?

 

Geek alert: Your point about PAYE rates compensating for NI rises is a bit off in that pensioners and landlords would benefit as much as workers and (i think) the larger revenue loss would be ring fenced for Scotland. 

 

I'd expect a large part of the reason that private health insurance seems comparatively cheap is that you are healthy and relatively well off. 

If you'd a pre-existing condition you'd pay for it (or not be covered).  Well off people tend to have fewer health issues, with causality running both ways. So if you can afford the premiums you're less likely to need it. 

It seems really unlikely that it's an efficiency saving on a like for like basis. 

I'd be interested to know what happens when a pvt policy comes up for renewal if the insured person has developed something serious, chronic or terminal. Honestly don't know but i'd expect a large slice of tough shit to be involved. 

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1 hour ago, Donathan said:

I've always found it a bit weird when Americans can't seem to finish a sentence without praising their military. The UK is a bit like that with the NHS.

 

FWIW, I do think universal healthcare that is free at the point of need is a good thing, and I'm glad that we have that available in the UK. Having said that, I think obtaining private medical insurance, if you can afford to, is a no brainer for a few reasons:

 

1. Skipping the queue for non-urgent procedures

2. Being able to see a consultant at the drop of a hat.

3. Possibly a more comfortable hospital experience

 

Essentially I think emergency care, cancer treatment and GP's are best done through the NHS. For other treatments, they are probably better off left to the private sector albeit with the NHS providing the services for those who cannot afford it (but with longer waiting lists)

 

I think the front-line NHS staff are very good at what they do but ultimately they're doing a job the same as you or I. The bureaucrats, on the other hand, are highly incompetent.

 

I find the "our NHS" stuff cringey tbh

I could see a fully privatised British healthcare turning in to the equivalent of taking your car to the garage and wondering if your car really needs half the work they are quoting.

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The real problem in the NHS is wastage; I had to write off 8 small boxes of medicine (each box contained 1 vial) that totalled more than £7000 in total because they ran past their use by date, whilst more medicine was ordered which was the same, had a longer date on them and was more expensive. Other than medicine waste, there are other areas where waste could be monitored better and controlled. However, the actual service provided to patients (I've been one myself) is absolutely incredible. You can't fault the care that is provided, free at the point of contact. It's a modern wonder in that respect. 

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2 minutes ago, KnightswoodBear said:

@Shandon Par is the most accident prone man on the planet. 

I was hanging off a satellite dish earlier and managed not to do a Rod Hull. Only have a burst rib and black eye right now. Not been to a&e for months.

Edited by Shandon Par
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9 minutes ago, Bigmouth Strikes Again said:

It's all fucked, Mrs, has been a nurse for 40 years, made it to Snr Charge Nurse, bailing out next year. I needed the NHS couple of times, every time these front line staff have been amazing. It's the morons in control that are the problem.

Thank you.

There's always several levels of pointless management in every department.

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52 minutes ago, SweeperDee said:

 However, the actual service provided to patients (I've been one myself) is absolutely incredible. You can't fault the care that is provided, free at the point of contact. It's a modern wonder in that respect. 

Glad you've had that wonderful service. Unfortunately it's not a universal experience.

I've had endless unsatisfactory interactions with NHS services, unresolved issues, encounters with staff with no apparent motivation or interest in doing their job, met consultants in my professional role, who, if they had shown the same contempt for me that they had for my perfectly reasonable service user I'd have been immediately firing a complaint in about. They sent my mother home three times when she was doubled over in agony with a twisted bowel, dismissing her as playing up over a mere IBS attack. The consultant who finally dealt with the issue made a formal complaint himself about other primary care staff. They left my grandfather completely unattended for hours in a ward, half-naked and gasping for breath because he couldn't reach his oxygen mask. My partner has had ongoing thyroid issues for years and she is completely dismissed because NHS thresholds for thyroid treatments are absurdly high, therefore she's palmed off with endless 'go home, do more exercise, lose weight' advice, which is about as much use as a chocolate teapot. 

I'm not going to say what I actually think about our 'wonderful' NHS because it's clearly an emotive topic that raises hackles, but suffice to say that I don't regard it as a 'modern wonder', or anything remotely close.

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I worked in NHS financial management for quite a few years and whenever bores tried to tell me the NHS was failing or whatever my line was always; show me another organisation with a budget of ~£15 billion, rapidly increasing demand year on year, savings targets of >5% every year with a no redundancy policy, in a heavily politicised environment where if you get it wrong people die, and you are legally unable to overspend. Everyone knows the clinical/operational staff do a heroic job but given the circumstances I was always pretty impressed with the management as well tbh. 

Also if you criticise the NHS model you are a Tory - I don't make the rules. 

Edited by ThatBoyRonaldo
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6 hours ago, alta-pete said:

I can't but it's an idea that I'm fairly sure I'd seen mooted somewhere in the past so I was throwing it out there for discussion. But if you think 'that's the most bat-shit mental thing I've ever heard', I'd suggest you probably either need to get our more or, maybe more likely, turn down the hyperbole a wee touch? 

As for the cost of the dinner argument, of all the shite and tat that we consume every month, I find it slighly bemusing that a huge proportion of the population that can perfectly well afford it, instead choose to abdicate responsibility for their families' health to a system that is plainly creaking at the seams.

Cost isn't the issue.

It's dealing with private healthcare insurers who will pull every stunt in the book to deny paying out because their business model depends on doing that to people.

Good luck to anyone trying to get private health insurance with a history of health conditions.

What you are describing might work for the ultra-healthy with a clean record.

Given the vast numbers of our population considered "clinically vulnerable", I'd suggest many wouldn't have such as easy time as you.

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