UKC

You'll all be ok. You all obviously have private health insurance and can afford it. I can't.

Did you know a six night stay in a US hospital could cost 55,000 USD ? Yes, 55,000 USD for six nights. That is a fact.

I hope you have access to that sort of money.

Is that a future you want , because that is what we are heading towards when you vote on June 8th and the Tories get elected and we have a hard Brexit that Europe will do everything in their power to block.

In reply to The Ice Doctor:


A six night stay in UK hospital is around £24,000, excluding any treatment. A not inconsiderable sum.


I don't. That's why I pay National Insurance.


I thought Europe also wanted a hard Brexit to discourage others leaving?

I'm also concerned about the NHS, but you're conflating two issues. Also most EU countries have better healthcare than the UK, and they have semi-private models.

In reply to Ridge:


That's quite a statement. Do you have any evidence to back it up?

In reply to planetmarshall:

Try here

https://en.m.wikipedia.org/wiki/World_Health_Organization_ranking_of_health...

In reply to Ridge:

That's because countries like France spend 11% of their GDP compared to our 8 soon to be dropping to 6.5%

On the plus side my wife will be forced into doing a lot more or only private work and will double or triple her salary. Not worth it for what we are losing we believe but the people who will lose out the most seem to accept this.

Cheers

Toby

In reply to Toby_W:

The question is would spending 11% of GDP on the NHS give similar or better outcomes than those in France? I honestly don't know.

What people need to accept is that if you want high standards of healthcare, education and infrastructure it has to be paid for. Sadly as a nation we don't seem to have grasped this obvious concept. The NHS costs something like £2billion a week to run, and if we want more we'll have to pay more, either by increased taxation, private insurance or a mixture of both. The US model is obviously broken, it costs a fortune due to rapacious companies, but the European models don't seem to suffer from that issue. We need something that works.

In reply to MG:


Fair enough, though that table is now 17 years old and puts the UK in overall 10th position in the EU, which would not back up the OP's statement.

In reply to planetmarshall:

http://www.telegraph.co.uk/news/health/expat-health/11384780/Netherlands-to...

In reply to Ridge:

In the last 5 years we've gone from the various health trusts being in surplus or O.K to being in deficit across the whole country. The NHS may not be perfect but it's one of the best in the world for the money and was working, now it's about to collapse, this is not because we can't afford it.
I think it's so sad and I'd pass on any more money to keep it running

Toby

In reply to anybody and nobody in particular:

My rough estimation of when Little Miss Lemming booked into our local Hospital from about 10 years ago was:

£1,200 a night for an Intensive bed. 3 weeks = £25,000
£800 a night in High Dependency. 4 weeks = £22,400
£300 a night general ward. 10 weeks + £3,000

Ten years ago my rough fag packet figure was £50,400

This stuff ain't cheap, and I don't know where I a going with my little rambling.

The NHS won't die but the Conservatives are not making a desperate situation any better at the moment.

I'm also guessing that privatising the NHS would be a bit of a Buzz Kill for the party faithful and a quick recipe to lose voters or even civil unrest on a scale of the Poll Tax demonstrations of yester year.

In reply to The Ice Doctor:



Don't worry because BREXIT was voted in on the strength that the NHS would get £350 million pounds each week.

Trust me, I read this on a big bus.

In reply to Toby_W:


At long last a Party - the Liberals, has had the guts to propose an increase in income tax (a penny in the pound) to help support the NHS and Social Care, something that all Parties have been dancing round and avoiding for years. Nobody is going to like this, but the plain hard truth is that if we want the service we are going to have to pay for it.

There is no painless solution.

In reply to Toby_W:

Is she being forced or is it really just her choice?

The only consultants I know say it is their choice.

One I know does it because her spouse, a partner in a law firm , does not earn enough money .she has 4 children all in private school , house worth £1m , apartment in France .

She is brilliant at what she does for the NHS .but she also enjoys money.

A Paradox.

In reply to Postmanpat:
I think I'd put more stock in the WHO report, rather than one funded by a private health insurance firm and a free market think tank. Interesting findings nonetheless, though (and still doesn't back up the original statement, 14th in that list still puts the UK ahead of most other countries in the EU).

In reply to The Ice Doctor:

I think the current term is the UK gets good value from the nhs despite the relatively small amount it's funded. Pay more tax, fund it better and who knows where it could be. Will see how the Libdem 1% tax increase across the board pledge goes down with the voters.

In reply to planetmarshall:

So try this one for size: http://stateofreform.com/wp-content/uploads/2015/11/Healthcare-outcomes-ind...

We've actually been through this many many times before. You can aearch previous discussions.

Whilst the Commonwealth fund report, basically a users' opinion poll, rates the NHS highly, and on value for money other research rates ok (sometimes v well), on outcomes it is consistently low compared to peers.

In reply to Toby_W:

Please don't forget that in France they only cover 70% of your health costs. You either cover the rest yourself or buy insurance.

In reply to neilh:

She's dead against it but more and more services are being put out to private contracts, her clinics are always overbooked and the pressure and conditions are worsening. This is what will push her into a company with the other consultants. Maybe this will work better for the nhs and everyone but I worry with services being rationed people will no longer get access to the best care.
Also this is a devious way of privatising the NHS, we should be having a conversation about this, voting on it as a fundamental issue of all our lives. But I think I'm a fool and should let all this go and look out for my family. Million pound house you say?

Cheers

Toby

In reply to Removed UserMike Rhodes:
But are most people not still able to claim that 30% back as well?
I do think a lot of aspects of the French system work well. I think we needs some serious discussions about all of it.

Cheers

Toby

In reply to Ridge:


My parents live in Germany and have had to use hospitals a couple of times. Both times they said the level of care was awful and they'd take the NHS any day.

Obviously, a very small sample size, but interesting all the same.

I think our NHS is a great service despite being so desperately underfunded

In reply to girlymonkey:
That's interesting to know, thanks.

In reply to Toby_W:

Yes. Well they bought it for £900k and then spent £100 k plus on refurb.

Plus the French apartment.

She is a big fan of the NHS.

As I said a paradox.

In reply to The Ice Doctor:

You're a cheery soul aren't you. Do you ever post anything other than dreary stuff ??

In reply to Removed UserMike Rhodes:


I'm wrestling with that at the moment having just moved to France. Employees can pay about 30% of their salary in social security deductions, then find that this only covers 70% of their health and dental costs. Many take top-up insurance. Add to this that the employer also pays huge amounts (around 40-50% of the employee salary) in social security and it makes the NHS look extremely good value for money for the average UK taxpayer.

In reply to Toby_W:


Really? If you find details of how I can claim back the 30% I'd love to know. I don't think that's possible unless I buy top-up insurance, at a cost of about 2.5k Euros per year for a family of 3.

Which aspects of the French system do you think work well?

In reply to arch:

You don't have to click on his threads if you've formed that opinion of him.

A measure of gloom is suddenly removed from your life.

In reply to 1234None: I thought it was income linked and those on lower incomes could claim it back in it's entirety?

I wonder if having to pay an initial fee that you claim back would help us reduce people going to the doctor and e&e for trivail things. It seems like a good idea but there are negatives too it as well I'm told.

Cheers

Toby

In reply to The Ice Doctor:
Read the NHS constitution (a wonderfully moral document in an increasingly cynical age). Two of its seven principles are - available to everyone, and provided on clinical need ,not ability to pay. I think it would be political suicide for a government to mess with these principles.

What I think is happening is that changing demographics are putting increasing financial pressure on the system and consequently the government are coming up against elements in the upper levels of the NHS who have a very strict definition of these principles.

Basically the government wants to force the NHS into curbing what it sees as excesses in the system. E.g. Treating foreign nationals, cosmetic surgery, pandering to nuisance patients... one woman called out an ambulance 400 times over 3 years at nearly £500 a pop.

I'd happily pay more for the NHS. It's whole ethos is deeply impressive, but I really can't make up my mind as to whether it's a little too all encompassing.

In reply to Postmanpat:


Yes, we have. And while you're right,

- users' opinions are relevant; the best outcomes in the world are irrelevant if you can't access them

- we have no counterfactual; what would 'hard' outcomes for the NHS be if it were funded to the same level as 'better' systems?

I think, given that we're going to have to pay (a lot) more anyway, whatever the system we adopt, it would be worth funding the current one properly to see if we can achieve good 'hard' outcomes and good user satisfaction- something no system has fully cracked yet

In reply to Postmanpat:

"The UK, excluding Scotland, landed in 14th place."

The "deep fried mars bar" effect....

In reply to The Ice Doctor:

You should try paying 40 quid a visit to your GP, as we do here. That would sort things out a bit....

In reply to The Ice Doctor:

This isn't going to help fund the NHS much, is it?


"Labour is pledging not to raise income tax for those earning less than £80,000 a year as part of a "personal tax guarantee" for 95% of taxpayers.
Shadow chancellor John McDonnell will vow to protect low and middle earners by also ruling out rises in VAT and employee national insurance rates.
But he will say the top 5% of earners would pay more to fund public services."

Labour's spending commitments so far include:
Recruiting 10,000 new police officers
Giving NHS workers a pay rise of more than 1%
Reinstating training bursaries for student nurses
Bringing back the educational maintenance and carers allowances
Restoring student grants

Maybe Labour can come up with more of their whacky PFI schemes.

In reply to planetmarshall:

It depends what you mean by "semi private". In much of Europe there is a state operated health insurer you pay based on ability to pay, and that funds treatment which is provided by doctors, hospitals etc that operate independently. Some are for profit, some are the likes of charitable trusts. That concept seems to work well because it reduces the monolithic side of things. I have personal experience of the German system and it was pretty decent - one advantage of it is that if you know what's wrong you can go straight to a specialist, and it is free at the point of use like the NHS.

Of course, the NHS is semi-private.

- Dentists are private for-profit businesses.
- GP Surgeries are private for-profit businesses.

Neither were ever nationalised.

Very few people seem for some reason to know the latter. With regard to either of those the NHS effectively is acting as a state insurer (though funding is more generalised than the German model).

In reply to Stichtplate:

I tend towards the idea that it is in some ways a bit big for its own good. However, I am in favour of a mandatory state health insurer, with the cost based on ability to pay and service free at the point of use. A system based on that would be just as able to meet the 7 fundamental principles of the NHS but possibly also more efficient and modern.

I would also be happier to pay a higher amount of tax towards healthcare. But I do want efficiency improvements - it needs to live in the 21st century with 21st century management approaches and 21st century information technology. It doesn't, not in the slightest, and it can make it at times bewildering to negotiate (depending on local circumstances) and waste an awful lot of peoples' time based on nonsensical and old-fashioned structures and approaches.

The best example of this is that hospitals *write* to GPs with details of treatments given. Write? Really? Where's the integrated IT workflow system that tracks treatment from start to finish? Why, for example, when referred to the hospital do I have to explain the problem again? Why does that doctor not already have a full electronic briefing of what's going on that he's read before he even presses the buzzer? It wastes a huge amount of time, it's costly, and it probably means that a less astute and aware patient will get things missed.

In reply to Toby_W:

I don't know about low income earners claiming it back... if anyone has further info on it I'd love to see that.

I think the real risk with the way things are currently heading in the U.K. is that people who really need treatment might not get it. Standards will drop due to cuts but figures will be massaged to make it all look hunky dory.

As for people not going to the doctor when they don't need it, some decent health and wellbeing education for all kids would be a good start.

In reply to Neil Williams:
>The best example of this is that hospitals *write* to GPs with details of treatments given. Write? Really? Where's the integrated IT workflow system that tracks treatment from start to finish? Why, for example, when referred to the hospital do I have to explain the problem again? Why does that doctor not already have a full electronic briefing of what's going on that he's read before he even presses the buzzer? It wastes a huge amount of time, it's costly, and it probably means that a less astute and aware patient will get things missed.

What you have to bear in mind is that the NHS is truly vast and grew out of a lot of independent organisations being brought together (rather than starting from one organisation that grew bigger). That doesn't just mean that there's a wide diversity of technology in use, but also the policies and the way healthcare is delivered varies substantially between areas, too. Plus you have a need to maintain historical continuity and clinical safety.

A lot of organisations that work within the NHS are not centrally controlled, either, (e.g. GP practices are independent businesses) and they buy their own IT solutions from the market - if you make sweeping changes they want to know who is going to pay for the changes they need to make to their own systems..

Staff wise you have a lot of people whose entire working life has been defined by their NHS work. They know how to use the systems and processes they have now, but some can be unenthusiastic about change, and others can be enthusiastic but just lacking recent experience of how things are done in modern IT. IT efficiency gains have a large potential for making people redundant, too, as the NHS uses some processes so archaic that it isn't just a case of a little retraining and changing role.

I worked as an IT architect on an NHS modernisation project for a short while (before leaving for 50% moral concerns at the amount of NHS money being wasted and 50% desire to just go and work on something of a scale where you could feel actual progress in your day to day job) and the challenges should not be underestimated.

In reply to Big Ger:

'You should try paying 40 quid a visit to your GP, as we do here. That would sort things out a bit....'

No it wouldn't, it would mean that many poorer people would delay going until their condition had become more serious, which would in turn incur far greater costs to resolve. And if that was to be means tested, then that would cots more money to administer than it would recover.

And no I don't care 'it works in Australia', you're not an expert and you're not poor.

There are solutions to the NHS, it's not all doom and gloom. it's just a shame that Jeremy Hunt hasn't a clue about what he's doing. Why the most significant integrated healthcare system in the world is in the hands of someone who thinks homeopathy is 'potentially useful' and doesn't get how morbidity is related to poverty is completely beyond me. We might as well have put someone in charge of education who can't read.

In reply to Neil Williams:

I've had some experience of this. Part of the problem with IT in the NHS is that there is an obsession with data protection and security. I'm not saying these aren't important, of course they are, but they are very hard to reconcile with making information available to everyone who needs legitimate access to it.

There are shadowy figures in the NHS who are paid vast sums to 'advise' on these issues, and invariably their recommendations are a totally impractical counsel of perfection. Management doesn't have enough experience or bottle to challenge their dictats, and if they do they collapse at the first mention of data protection. So some optical practices routinely print out clinical data and fax it to hospitals or GPs because that doesn't count as IT and therefore isn't governed by DP issues!

In reply to Rob Exile Ward:


There is pay for visit in the nordics. It is means tested and also has an annual cap, the same for prescriptions, once over the annual threshold it's free. I don't think the nordics are famed for their lack of equality, unfair society or poor healthcare outcomes.

In reply to The Ice Doctor:
I live in a country that basically has 4 competing private NHSs, sort of health maintenance / insurance companies The money comes much the same as the UK, from a NI tax on employees and compulsory contributions if not employed. It is disbursed by the government to these organizations pro rata according to members. People who are high risk so the companies do not want them are put in a pool and allocated pro rata at random to the companies So the 4 compete on level of service and on efficiency. Every six months you can change companies without penalty. You pay a small copayment for service. Care is provided through local clinics. Doctors / surgeons / nurses / paramedicals etc are employees of these companies, or contract to them. Hospitals and specialty clinics sub-contract to them. They also sell medicine at government controlled retail prices from a predefined list of acceptable medicines.
Care is good but not luxurious. The stats on health and life expectancy are good. Each organization also offers supplenmentary insurance for extras and better care like private beds.
It seems to be good model.

PS this system evolved out of the monolithic NHS single supplier model, so it could work for the UK.

In reply to The Ice Doctor:


Throughout my entire adult life, every time an election has come along, people have said "if the Tories get in that's the end of the NHS". The Tories have got in lots of times. The NHS has never been ended. The worst they've done is not increase the funding to it quite as fast as people might have wanted and Labour might have done.

In reply to Rob Exile Ward:


Except that's incompetence in its own right because it *is*. Only the first Data Protection Act applied only to computers. The more recent one applies to all forms of data in any format. And stuff printed on paper is a hideously insecure format, it basically only provides "security by obscurity" which is very weak.

In reply to Neil Williams:

And the DPA is being replaced this year by the GDPR, which is an even more encompassing piece of legislation that allows fewer loopholes to dodge responsibility.
https://en.m.wikipedia.org/wiki/General_Data_Protection_Regulation

In reply to Rob Exile Ward:


I completely agree. I've never understood the obsessive sensitivity about medical records. People seem completely comfortable with having online bank accounts but not with the scary idea that A&E would be able to check whether they were allergic to penicillin.

Of course security is important but if banks can do it, why not the health service?

In reply to Rob Exile Ward:

Do you believe poor people in Aus do this? Or that the system has checks and balances to prevent that?


It doesn't.


Obviously you don't care that it works, a solution would deprive you of your ability and joy in complaining.
Oh and I work with some of teh most poor and deprived people in society*, so don't let your bias and bigotry blind you.

*30% of my caseload are indigenous, despite them only being 2% of the local population.

In reply to The Ice Doctor:
Stop all treatment and surgery that isnt life threatening ie boob jobs, tummy tucks etc etc im sure there are lots that the NHS do that we don't know about that costs hundreds of thousands if not more.
If they dont pay national insurance they pay for treatment.
We need to change the culture in the country that allows anyone to get exoensive treatments because theyre unhappy or treatment traveller.
Its impossible to make something completely free when you have a capped pot of money which a limitless population can take from.
You dont need to be a expert to see that.

In reply to Big Ger:
'your ability and joy in complaining.'

Wrong target, mate, I'm the one who keep posting that the NHS is pretty good and has the potential for being much better.

'Oh and I work with some of teh most poor and deprived people in society*, so don't let your bias and bigotry blind you.' So, a policeman then? At last we know. Though judging from your posting record here, whoever pays your wages isn't getting much value for money.

In reply to Big Ger:


Genuinely interested here, are there any studies of what does actually happen if one introduces a fee to see a GP?

In reply to payney1973:

I do agree with your comments however, with privatisation, there is a lot of money to be made out of cosmetic surgery.

The biggest challenge we have is the ageing population and how the country cares for them, people living longer, who may no longer be economically active. As life is all about economics these days, I have to as myself the question, what is the point of being old, if you cannot contribute to society and only drain on its resources.

In the cold light of day, when things come down to figures, pounds, shillings and pence, that is what CEO's are getting paid massive salaries for- to make these hard nosed decisions. Lets face it the Tories are the ones who are selling themselves as the party to trust. I am not sure sure I trust any corporation, let any many politicians, who sit on the boards of the corporations and have vested interests. FACT!

Viable, alternative, solutions, can often be blocked in house by politics, actual meaningful change and transformation can be difficult to adopt. You cannot change a culture overnight it takes years. My experience is that people are totally ruthless, that is the world in which we live in and as humans we generally dislike change.

In reply to The Ice Doctor:
I do agree but is it fair to say to an old person that has worked and contributed for 50+ years that they cant get treatment because theyre old then in the same breath treat a non national/non contributor for free??
The system can never be fair!

In reply to payney1973:
It is not based on what you have contributed, nor should it be.

Treatment is provided based solely on your need for treatment.

Payment is made based solely on your ability to pay.

The two are not, and should not be, connected.

In reply to Neil Williams:
Well I disagree, right or wrong I dont care, if a person has worked all their life they should be able to more than use it and not be blamed for it demise!

In reply to payney1973:
Who's blaming who?

I simply said that in the NHS payment (via taxation) and treatment provision are totally unconnected, and long may that be the case.

If you are ill, you are entitled to treatment.

If an EU citizen who has just started working in the UK is ill, they are entitled to treatment.

How much either of you has paid is totally irrelevant.

In reply to Neil Williams:

Those of you that think the NHS is safe under privatisation, what do you think of this?

https://tompride.wordpress.com/2017/05/01/scandal-as-nhs-plasma-supplies-so...

Do you think it's acceptable?

In reply to The Ice Doctor:

https://www.google.co.uk/amp/s/amp.theguardian.com/business/2013/aug/25/uk-...

So it's an old story and have plasma supplies dwindled?

In reply to Neil Williams:
It is commonly reported that the reason the health service is struggling is because everyone is getting older and living longer, is that not correct????
All i am saying is that a sysrem that was designed to meet the needs of its population ie the Uk that is then put under pressures of serving the greater Euro if not world population can never be financially viable.
I dont really care which party gets in because none of the can solve that conundrum.

In reply to payney1973:

I heard one senior nhs staff describe it as; when it formed in the 50s we treated an illness when it appeared and stopped the pain when folk were dying at a ripe old age of 60 something. Now we prevent illness before it's even begun and we extend life through treatment by 20 plus years. Only the structure and scale of funding haven't kept pace with the progress made medically, it's like sticking a Ferrari engine in an Austin minor body and wondering why you don't get maximum performance.

In reply to payney1973:

'I dont really care which party gets in because none of the can solve that conundrum.'

a) It would be a problem, certainly, if it were true; but it isn't. The un-recouped costs of treating non-EU overseas visitors in the UK is a tiny fraction of the NHS health budget, and stopping it completely would be a drop in the ocean.
b) The cost of treating EU citizens here is offset by the fact tat we enjoy reciprocal rights in the other 27 nations in the EU.

In reply to payney1973:
EU people aren't the issue. If anything quite the opposite, as immigrants tend to be young and thus taxpayers and relatively healthy.

It is an issue that we are all getting older - that's why final salary pensions had to end - they were simply non-viable.

There may be a similar issue with the NHS. If there is, it will be necessary for us all to pay more tax to cover it. Simple as that.

In reply to Rob Exile Ward:
a) I never said it would solve the problem, i merely said you shouldn't lay the responsibility for a failing health service at the feet of the old.
b) emergency care should rightly be given free in whatever country you go to in the EU however its not all emergency care that is given in the UK.
c) while I have skied and climbed in Europe in some cases the EHIC has been asked for first, treatment given once paid for then claimed back through insurance, hardly reciprocal treatment!
d) whats the answer then? Poor more money in which will inevitably lead to greater taxation?

I at no point have said I agree with one side and disagree with another, the parties need to work together to find a solution (altough they like to use the NHS as a beating stick too much) or we will lose it and be worse off all round.

In reply to payney1973:

I think you aren't understanding the system.

EHIC entitles you to be treated the same as the locals in any given country.

In some countries, that involves pay-and-claim.

In some countries, that involves an excess payment, i.e. not all costs are covered.

For balance, in some countries it means free dental treatment, unlike the UK.

In reply to The Ice Doctor:


It's quite possible that the US company added £600m value to the organisation before selling it. To suggest that it "cost the taxpayer £600m" is utter garbage. It's on the same level as bleating about what your house is allegedly worth when you have no intention of selling it.

Should it have been sold? I have no idea. But once it has been, what then happens to it is really of little relevance.

In reply to Neil Williams:
At no point have I said that the EU is the problem, my point from the start has been it would be unfair to not treat the elderly after years of contributing and in the same breath treat some one who is a non contributor.

I have however said that is impossible to fund something when you have no gauge or control on who uses it.

Yes it seems the heavier taxation will be the answer and I am happy and will pay more taxes for the health service we have in a heart beat, but you watch the back lash at whatever party imposes said taxes.

In reply to Neil Williams:
Lol this is licking me out!!

You've strengthened my point mate, so what would happen if i was penniless in what ever country where you had to pay first then claim later???????
Someone stated that we give treatment to EU members as we get reciprocal treatment in their country???
Having to pay up front then claim back is hardly reciprocal?
I also know people who have been laughed at on producing their EHIC.

In reply to payney1973:

Proper prior planning prevents (etc). When going abroad, research the system before you do. If the system isn't workable, take a (premium) travel insurance policy who will sort it for you. If you can't afford that, you can't afford the holiday.


Yes, the reciprocity is that we get what locals get. Sometimes that's vastly better than here (e.g. Germany), sometimes it's not quite as good.


Like in the UK some countries also have private providers who will not take it.

In reply to Neil Williams:
You keep tip toeing round the arguement mate, fact is If a person comes to the Uk and has an accident or just fancies some buckshee treatment they will be treated fully at no cost to themselves, no money up front etc etc , in most euro countries this wouldnt happen so to claim both services are reciprocal is misleading, hence why our NHS is so appealling.

I have no doubt that you will come back with another twist on the discussion, we quite obviously have different opinions and we will both probably be paying for private health care in the coming years. Have a good un!

In reply to Neil Williams:


That's just a bit of falderal,* that he's pushing, it's pitiful. As I said in the other thread;

Plasma Resources UK turns plasma - the watery fluid in blood that carries the white and red cells - into life-saving treatments for immune deficiencies, neurological diseases and haemophilia. Since the firm was created by the Labour government in 2002 to maintain a steady supply of blood products, all plasma has been collected from US donors because of the theoretical risk of contamination with variant Creutzfeldt-Jakob disease, the human form of BSE, which cannot be reliably tested for.


*lies, bullsh!te, nonsense, utter carp.