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May be a contentious subject but none the less a vital one to discuss . Do we think that the degrading of the Health Service is due to Tory ineptitude or a deliberate attempt to prepare it for Privatisation, or a bit of both?
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Neither. There are health systems in other European countries that have better medical outcomes and cost less. But politically no one will take on the cult of the NHS. It’s perfectly safe and will continue to suck up our taxes.
Wigwam you cynic.
Under paid over the last 12-13 years, the weaknesses in the NHS have been brought right into main view. A system setup in a period where bureaucracy was a perfectly effective method of running large organisations it has failed to modernise when industry had absolutely no option. No matter who is in charge the next 10 years will see a significant change in how British healthcare is delivered, whether that’s private, mostly private, a NHS service that has been changed beyond current recognition or something else, we can’t see from here. What does need to happen is that the government of the day needs to step away from it’s running. A cross party working group needs to see how a group of medical industry professionals are coping with achieving targets and budgets set by the government of the day, however, legislation may need to set a minimum %age spend for every year – like defense.
Those medical experts need to actually understand how other systems operate and, more importantly, how they achieve their outcomes without costing stupid amounts of money. That is the starting place, remove the politics, inject some genuine expertise and run it from a completely even cross party group who’s focus is on value for the tax £ and not the details of how that happens.
There are lessons to learn in terms of predictive and preventative measures, information, care (which need to be brought into the new NHS) and treatment. Those lessons need to be formed by the experts and parliamentary group so that a strategy covering not one political cycle but 5, 10, 15 AND 20 year periods. Strategies that initially knock the processes into shape, change structures and improve performance without expecting a single nurse or doctor to do any more than they currently do. Pay, structures, facilities and prevention should all be included, so that we aren’t spending billions training doctors and nurses for the rest of the world. We train them, we pay them a fair wage, we keep them and benefit from the experience and security that retention provides.
I'm Autistic, if I say something you find offensive, please let me know, I can guarantee it was unintentional.
I'll try to give my honest opinion but am always open to learning.Mark
it has failed to modernise when industry had absolutely no option.
Yes, and its failed to modernise in the ways its run since 1948 is why were here today. In 1948 There were around 20,000,000 less people than there are today.
It needs to be run as it’s own organasation with the expertise to do so as part of public services, the government injects cash, but remains a silent partner. Whether that means in part a joint partnership with a private health care provider or not. Or it put in private health care providers hands and based sliding pay scale based on how much you earn and/or NI contributions.
Starmer said yesterday on PMQ’s something on getting a certain part private sector involved, but and only caught the tail end.
Something needs to be done bu,t what that is, I don’t know the answer.
Idealy for me it would be the goverment injecting alot of cash, far more than they ever have before. If this had been done from the beginning we probably wouldn’t be where we are. That said it’s gone to far and would be a massive feat, without the likes of Hunt raising taxes far higher.
@kezo it is my honest belief that throwing billions at the NHS may plaster over the cracks, if there’s enough thrown it might even look successful but it’s still kicking the problem down the line. No single politician is going to care excessively about the long term, it’s inherent in the election process, anything beyond 5 years and their job might have changed. Even at the beginning of a term there’s a period of adjustment followed by policies designed to stamp their particular set of beliefs on the economy. What organisations like the NHS need is long term strategies with hospital management and health care provision skills at the centre of every single decision which can only come from people who have experience in doing exactly that. Funnily enough there is such an organisation – NHS England where senior trust staff have been recruited to look at country wide issues and create bigger picture policies. Put that inbetween a political/cross party management group and the individual Trusts where decisions can be made and enforced.
Then there’s the GP service. A privitised service where a group of doctors own the entire practice and offer a service for a price to the NHS, if priorities need to be changed can that be forced solely through funding?
I'm Autistic, if I say something you find offensive, please let me know, I can guarantee it was unintentional.
I'll try to give my honest opinion but am always open to learning.Mark
Did anyone watch the programme about “Strangeways” prison last nite it was eye opening.
Did anyone watch QT last nite where one of the questions was about the NHS and the Tory on the panel could not bring himself to say/admit that the NHS was in “crisis”.
Did anyone watch the programme about “Strangeways” prison last nite it was eye opening. Did anyone watch QT last nite where one of the questions was about the NHS and the Tory on the panel could not bring himself to say/admit that the NHS was in “crisis”.
I watched QT and actually felt sorry for the poor sap. Clearly briefed that he couldn’t admit the NHS was in crisis and was determined to keep that party line, they lined up 3 healthcare professionals who escalate from (sic) it’s poor to ‘it’s like a warzone’. Then they cut straight back to this poor chap who you could see was completely unwilling to go against his masters’ instructions but was put in a really uncomfortable spot.
All that said, the government really do need to change their tac really, really, quickly before they feed the opposition so much ammunition they’re incapable of a remotely credible defence.
I'm Autistic, if I say something you find offensive, please let me know, I can guarantee it was unintentional.
I'll try to give my honest opinion but am always open to learning.Mark
@kezo it is my honest belief that throwing billions at the NHS may plaster over the cracks, if there’s enough thrown it might even look successful but it’s still kicking the problem down the line. No single politician is going to care excessively about the long term, it’s inherent in the election process, anything beyond 5 years and their job might have changed. Even at the beginning of a term there’s a period of adjustment followed by policies designed to stamp their particular set of beliefs on the economy. What organisations like the NHS need is long term strategies with hospital management and health care provision skills at the centre of every single decision which can only come from people who have experience in doing exactly that. Funnily enough there is such an organisation – NHS England where senior trust staff have been recruited to look at country wide issues and create bigger picture policies. Put that inbetween a political/cross party management group and the individual Trusts where decisions can be made and enforced. Then there’s the GP service. A privitised service where a group of doctors own the entire practice and offer a service for a price to the NHS, if priorities need to be changed can that be forced solely through funding?
Some good suggestions, bt I dn’t know the answer other than its in a mess. Whatever is decided it’s got to cater for all walk’s of life, Rich, poor or in the middle. That it flows between services from Hospitals, ambulances GP’s…..
No poltician is highly bothered, lets be honest they all have private health care and is probably a perk of the job. Even Sunak during PMQ’s “I have access to an NHS GP but, have also gone private”
In England you you can log onto the system and choose to attend a private clinic or hospital and is funded I believe through your local NHS. I’m in Wales now and we don’t have the same system but, my family in Staffs do.
It’s worth looking at healthcare in the Netherlands. Created a completely new system a short while ago. Now considered the world’s best after Norway.
The debate is good, but kinda ignoring the initial question. That was, is the NHS in this state because of malice by tories, or ineptitude.
I would argue that it’s ineptitude.
And make no mistake, while the NHS as a system is flawed, it has worked. It just got progressively worse, and you can put a timeline on it – just look at which point the NHS started to become underfunded. While it may look like it just now imploded, it’s a crisis in the making since 2009, and there really isn’t anyone else but Tories to blame for it.
That said: i don’t think that it was a particularly malicious action – i just think they couldn’t care less even if they tried, because obviously, the party of millionaires with ready access to private healthcare doesn’t really feel the issues.
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Next: we'll see what's available in 2028.It’s not underfunded. It’s inefficient and ineffective. I suggest looking at what the Netherlands did to reform and recreate their health system which is by every measure better, and cheaper than the NHS.
It’s not underfunded. It’s inefficient and ineffective. I suggest looking at what the Netherlands did to reform and recreate their health system which is by every measure better, and cheaper than the NHS.
I just did.
The NHS certainly is inefficient, as most big systems are – but it’s not vastly more expensive as you suggest. The NHS gets 1.4% more money compared to the dutch system. Which btw, isn’t a ground braking revelation – it’s almost the same system germany uses since the 80s. And yes of course it’s underfunded, you can’t just 1-1 compare it to another healthcare system without taking the outside factors (healthier population, better/more modern infrastructure etc pp) into account. Of course a healthcare system runs cheaper and more efficient when you have half the amount of fat people (per 100) compared to another system. There’s much more load on the NHS than there is on the dutch variant.
Note, i’m not saying that the dutch system isn’t better – it is. But the comparison you draw, or rather, the conclusion based on omitting some very important factors is wrong.
That still doesn’t matter since it’s not answering the question in the first place. The question wasn’t whether the NHS should be reformed (which i’d agree to). It’s whether or not the crisis is deliberate or stupid.
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Next: we'll see what's available in 2028.Wigwam said
“It’s not underfunded. It’s inefficient and ineffective. I suggest looking at what the Netherlands did to reform and recreate their health system which is by every measure better, and cheaper than the NHS”.
That statement is just untrue as is the inference that the NHS is inefficient. Up until 2012 the funding of the NHS compared favourably with that of other comparable European Countries. At that time the approval rate for the service was 70% and the NHS was the most efficient health service in the world (mainly because all of the population received treatment free at the point of need). There was still the lack of Capital investment into new Buildings and other infrastructure as well as the lack of investment in training enough qualified staff and retaining existing staff.
Since 2012 under the control of Conservatives the funding has slipped from the European average to just 80% of that figure. So over that decade in comparison to our European neighbours the NHS has lost 2 full years of funding and the approval rate has slipped to 36% whilst the service has slipped to 4th in efficiency compared to our peers. The efficiency figure has also been affected by the privatisation by stealth instigated by the current government and sadly in part by the Blair government.
Coupled with the deliberate degradation of the Social Care sector (the government cut the funding to local Councils forcing them to sell off care homes to the private sector) and although I agree the current government is guilty of worrying ineptitude, it seems to me to be a deliberate precursor to privatisation by stealth. MPs who supported Brexit like Edward Lee, are already putting forward the idea that we should follow the system operated in the USA which is frighteningly expensive. The Amerìcans pay twice per head of population than we pay into the NHS and if you dont have insurance this is an example of the cost of treatment, for a bypass operation either $227,394.75 upfront or by payment plan $3789.91 per month for 60 months.
Believe me Ive worked in the NHS since 2012 and because of the implementation of low pay, (our Staff are the lowest paid in Europe) as well as woefully low levels of Health professionals per head of population, again deliberately implemented by Tory governments, it’s easy to conclude a deliberate plan is in place.
Dont forget that Trump insisted that the NHS would have to be on the table if the UK wanted a trade deal with the USA after Brexit. Please dont be taken in by right wing rhetoric demeaning the NHS. The biggest problem with the NHS is a hostile government starving it of resources, lacking the will or desire to make the changes needed, busy getting it ready for privatisation.
You obsess with privatisation, Daf. No-one would sensibly compare healthcare in the USA with anything. The reality is when you look at health outcomes in the best performing nations we are poor and have been for years. The NHS is the problem. The only answer is to get rid of it and start again using the best of the European models. The envy of the world? Never was and no-one of course copied it.
Wigwam Most of the British public dont think like you, they regard the NHS even in its depleted state as the greatest gift we have given to the world.
I cannot believe that the deliberate privatisation of particularly the English section of the NHS has been done by accident.
I do not regard the deliberate withholding of funds from the NHS is an accident.
I do not believe the deliberate degrading of the funding of Councils and as a result the collapse of Social care is an accident.
To answer my own question I believe these actions have been taken as a precursor to privatisation and if we allow that to happen the NHS will be replaced by a USA type private insurance scheme.
Basic healthcare insurance in the Netherlands cost roughly 100 euro’s a month for over 18’s. Anyone under 18 is covered on the adults insurance, plus you pay a yearly fee what is known as an “own risk” of around 380 euro’s a type of excess a month for over 18’s. This is refunded if you don’t have any medical treatment in that year. Anyone under 18 is covered on the adults insurance. Your employer also pays some towards you basic cover – I know this because my cousin moved there about 25yrs ago.
Every adult must have what is known as basic cover and the standard of cover is set out by the government and covers GP visits, some specialist care, hospital stays, medication, maternity care etc.
On top this you can take out optional insurance to cover you for the bits not covered in basic care. The cost for this varies.
The Netherland healthcare is government and privately run. Each person also pays around 17% of their salary towards their state pension.
In the UK your employer pays around 12% of your NI and rest is taken from your pay packet. Lets say you earn £3000 gross per month, you will pay around £258 a month or £3100 a year at 2022/23 rates.
So when you compare to what we pay over our life time there is not such of a massive gap. Fair enouth 17% pension contribution in the Netherlands is hefyy but you get more pension when you retire – A single pensioner gets up to 70% of the net minimum wage. A pensioner couple gets the equivalent to 100% of the net minimum wage (50% each).
Thanks for the information kezo. Worth noting that In the UK 80% of the cost of the NHS comes from general taxation so the public cannot see what they are paying. Looking at performance, in the Netherlands it is normal for GP referrals to specialists to be seen within 4 weeks and waiting time for surgery is also usually no more than 4 weeks.
Thanks for the information kezo. Worth noting that In the UK 80% of the cost of the NHS comes from general taxation so the public cannot see what they are paying. Looking at performance, in the Netherlands it is normal for GP referrals to specialists to be seen within 4 weeks and waiting time for surgery is also usually no more than 4 weeks.
I found this link in English that probably gives a better overview. I also think this simplifies what I believe your suggesting.
“The Dutch health insurance system
In contrast to many other European systems, the Dutch government is responsible for the accessibility and quality of the healthcare system in the Netherlands, but not in charge of its management.”https://www.iamexpat.nl/expat-info/insurances-netherlands/dutch-health-insurance
On average you can expect to be seen by your GP and receive some specialist treatment in 4-5 weeks. As far as I’m awre the Swiss healthcare is one of the best in Europe but, I’m not sure of the in and of it.
There’s a wiki article about how the Swiss system operates.
Quoting from it :
“In the 2018 Euro health consumer index survey Switzerland was placed first overtaking the Netherlands, and described as an excellent, although expensive, healthcare system”
I visited someone in hospital post-op in a hospital in Vilvoorde, Belgium a few years ago. What was particularly noticeable was that on a board in reception was a notice listing all the doctors and medical professions – over 60 of them – apart from one Chinese name and one Italian, they were all French or Dutch names.
Well I have read through the Many different comments on here and believe me there are Different Opinions. What people on here need to remember is that We are Governed by a Party who are Not on the side of Disabled people so I would look Very Carefully on any issues regarding Health and Social Care when they are still in Power. There is A Lot of Money to be made in Healthcare you only have to look at Agency Nurses being paid much more than Normal NHS Nurses to see that. There are reports of Tory MPs having connections to these companies too. So Any Privatisation would bring Big Money for certain People. And costs to others. We are of an age where it may not affect us but you can be sure Privatisation Will bring A Lot of money in to the Bank Accounts of Many Already wealthy people who seem to thrive on Filling their Banks Accounts. Look no further than PPE Scandal. And there are Many out there who dont like The Motability Scheme too.
@wigwam – Like I said previos. Starmer mentioned something in PMQ’s that sounded very much like the how Dutch system is run, in getting part private scector to soley manage it. Nothing was mentioned about health insurance or whether NI or taxes would pay for it,
The problem is they all act like Banksy’s picture or kindergarden children in parliment, how they slag one another off. Sunak new what Starmer was saying but, just stood up laughing and said “you dont want us and accuse us of wanting toprivatise the NHS yet you saying the same thing”, then you get what sounds like a roaring crowd at a football match, when a side has scored a goal. But of course Starmer was suggesting that.
Rather than the political point scoring and slagging off the other side, putting words in their mouth needs to stop. On public sevice’s all parties should put an idea forward and the best one voted for or at least bloody work together.
Well I have read through the Many different comments on here and believe me there are Different Opinions. What people on here need to remember is that We are Governed by a Party who are Not on the side of Disabled
I would agree Ian. As I have just said on my previous comment – its about time all parties work together on sevices like the NHS etc.
Needs an independent commission with an open brief to look at how healthcare should be provided effectively and efficiently for the next 50 years and a government that would carry out its recommendations without political interference.
I’ve been accused (rightly) of being a cynic. Does anyone think any government would agree to such a thing?
Needs an independent commission with an open brief to look at how healthcare should be provided effectively and efficiently for the next 50 years and a government that would carry out its recommendations without political interference.
I agree which ever way, it needs no political interference.
Just come across this opinion by the Gurdianrag on the NHS. Make of it, what you want, just thought it’s worth a read if nothing else!
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