UKC

(Well, I thought it was time we reverted to discussing something other than Boris and Brexit.)

Anyway, my plan is this. It should be taken out of direct government control, and instead run something like the BBC - a board of governors representing all stakeholders, a Chair and a Chief Exec to provide continuity and leadership. The government's role to be to set the budget and contribute to the selection of governors and staff.

That's it, really. What's the next problem you'd like me to solve?

In reply to Rob Exile Ward:

the BBC

In reply to Rob Exile Ward:

Nice idea, but how do Tory MPs make loads of money out of it?

In reply to Rob Exile Ward:

Curious about what this solves?

In reply to Rob Exile Ward:

What you really want is an insurance based scheme.

In reply to baron:in what way? Genuine question

In reply to baron:

It'd need to be a large one. We could perhaps call it 'National Insurance'.

In reply to MG:

Lack of leadership. Short termism. Too much interference from MPs concerned with local issues rather than the bigger picture. Stop govts making half baked decisions because of looming elections. Stop ministers coming in every2/3 years with no more idea than to make a headline or 2 - then move on to their next job. Clearly defined budget, not subject to endless tweaking and spinning...

In reply to Rob Exile Ward:

I see the merit in a lot of that but is it credible that government would stop taking an interest, particularly if there were some sort of crisis?

In reply to Rob Exile Ward:

It wouldn't work.  What happens if hospitals over-spend or run out of money close to the end of the financial year (as they usually do)?  The NHS would then say to the government, "either you bail us out, or we cancel all admissions and patients die on our doorstep in front of the media".   

It would indeed be nice to make the NHS a-political, but the reality is that it costs too high a fraction of the national budget to divorce it from politics. 

In reply to MG:

It keeps bl**dy politicians out of it. There is room for this sort of approach in many, many areas, the last thing we need is tribal politicians sticking their oars in.

In reply to Ridge:

Better make it Mandatory too in order to pool the risk. I'd also take it direct from payroll before it hits someone's bank so they don't miss the money. 

In reply to FreshSlate:

By Jove, I think you are onto something!

In reply to wbo:

Sorry it was a comment made to get a predictable response - as seen by the number of dislikes my comment gained.

For some the NHS is untouchable and should be given any amount of money it demands.

In an ideal world this would be wonderful but any reasonable debate gets shut down with cries of privatisation, all our doctors and nurses are angels, etc

Meanwhile the NHS trundles on, sucking up money and failing many, like the elderly, when they need it most.

If an insurance scheme could alleviate even some of the NHS’s problems then surely ideology shouldn’t stand in its way?

In reply to Ridge:

NHS budget - £127 million

Nat ins contribution £143 million 

and still the NHS needs more money.

Something is going wrong with your plan!

In reply to baron:

How would insurance alleviate the financial issues? I've never heard an explanation that doesn't end up looking like an  increased tax on the rich. How does insurance become a magic money tree?

In reply to baron:

Something  is wrong with your figures. You seem to be shy three zeros.

In reply to baron:

Ignoring your obviously false numbers... pensions come under NI? 

In reply to MG:

I don't think he's deliberately said millions instead of billions. More likely a mistake. 

In reply to FreshSlate:

I'm sure, it was the obvious detachment from reality I was remarking on. 

In reply to Rob Exile Ward:

I'm not advocating an insurance system here but I assume it would make the NHS a get what you pay for system.

Take the expensive platinum policy and you get first class care and priority care, take the cheepo value package and you get a no frills service and join the back of the que.

It'll never run out of money because it'll only provide what client's pay for.

In reply to FreshSlate:

Yes, sorry, thanks for that, should have been billions,  oops!

In reply to MG:

Care to explain or should I just file it under snide remarks?

In reply to baron:. Yes, but how would going to a private insurance system help.  There's no evidence they're more cost efficient. 

To LordAsh - really? Really? If you compare contribution s to cost of care provided I'd guesstimate 95% of the population would get a significant cut in quality of care

In reply to wbo:

Like the BBC , perhaps the NHS could adopt a policy of restricting free access to the over 75s? Should save a few quid.

In reply to Rob Exile Ward:

Good general idea, but doesn't solve the main problem that's it's too big for anyone to get their head around. So break it up.

Here's my tuppence. 

The Cuba solution. Start with the idea that there is no money. Get rid of GPs. See your local chemist for colds and minor ailments. Allow them to do front-line triage, in the same way that optometrists do for eye conditions, dentists for oral health etc.

Scrap A&E. Ok, you can't do that, but get the idea across that A&E is for medical emergencies, not for grandad fell over again or I cut my thumb. The only way you get into hospital is by referral.

Put some of the money thus saved into a completely separate organisation for social care and mental health. That gets funded, and hospitals. Nothing else.

In reply to freeflyer:

Some interesting ideas there - what exactly DOES a GP do? We've got a great practice near us, but it feels like a comfort blanket a lot of the time.

On the other hand, what do pharmacists do? I dutifully try and use them but invariably get told to see my GP. 90% of what they seem to do clerical, , so why not employ clerks?

In reply to Rob Exile Ward:

Excellent!  Now can you do Schools, Higher Education and national transport planning/infrastructure?  Only if you've got a few spare minutes tomorrow morning of course ; )

In reply to freeflyer:

"The Cuba solution. Start with the idea that there is no money. Get rid of GPs. See your local chemist for colds and minor ailments. Allow them to do front-line triage, in the same way that optometrists do for eye conditions, dentists for oral health etc."

The Cuba solution involves nearly 3 times as many doctors per head of population, and a primary healthcare, i.e. GP, focused system.

In reply to Rob Exile Ward:

Pharmacists train for 5 years.

If they’re only being used as clerks then that’s a waste and a chance to take some of the pressure off GPs.

I wonder why that doesn’t happen?

In reply to freeflyer:

Doesn’t Cuba benefit from a more intrusive health service? A vast network of community nurses, much more compunction to follow government health initiatives. Not necessarily a bad idea, but people in the UK moan if the government suggests they eat the odd vegetable. 

there have been trials that suggest almost the opposite is true. Having a doctor as the gatekeeper to a&e  means people get sent to the right place immediately. It cuts down waiting, cuts costs, but may well require more doctors. 

I think nhs care homes may help. There seems to be a big issue with bed blocking where people stay in £800 a night beds when they could be in £200 a night care. 

In reply to mik82:

Fair point, I admit that the "Cuba" part was based on a TV documentary I saw a good while back rather than any half-way decent research, and the idea was to focus on minima rather than an unattainable pipe-dream. It always seems odd to me that we make highly trained professional GPs do the job they do, which I'm sure I don't need to describe. Of the dozen or so that I know socially, each one is totally committed to their profession, but there are very few good words said about the system they work in.