National Health Service? TINA?
Discussion
TINA. There Is No Alternative....
Or is there?
Whenever the subject of the NHS appears in the media it usually carries some reference to Tory attempts to privatise it or suggestions of a secret agenda for privatisation. The word private seems to be unmentionable in conjunction with NHS, but is this a sensible way discuss things? Is every debate to be based on carers nurses and doctors being the only human beings with a social conscience? Does being a Tory mean that you have ice water in your veins? Does being a Tory mean that you would happily watch the sick die in the gutter? Likewise does being a socialist give you a monopoly on caring about society? Or does being a socialist make you blind to the short comings of the public sector and rabid in your hatred of all things not micro managed by the State? What is the centre, sensible ground?
It's clear that:
Some politicians, of all colour rosettes but mostly those on the left, believe that the only way a "free at the point of use, for all" health service can be guaranteed for the future is to preserve it with the funding/control structures that it has today.
Some politicians, of all colour rosettes but mostly those on the right, think that a measure of private sector thinking would improve the efficiency of the system, thereby ensuring better patient outcomes and more bang for the tax payers buck.
But, it is an almost impossible debate to conduct. As soon as the private sector is mentioned it does appear to me that those on the left lose the power to make reasonable arguments, preferring instead to talk about the evils of profits and big business culture being incompatible with a caring society/NHS etc.
Likewise, many of us have had some utterly appalling experiences at the hands of a system that in some cases seems to care more for the hundreds of thousands that it employs than it does for the millions of people who need to use it, so our views may be considered to be skewed too.
One thing many do accept is that accountability, be it for clinical errors that lead to death or disability, be it for the huge sums of money that are clearly wasted every day within the system, or be it for the slapdash way in which many things are run/organised, appears to be completely non existent within the NHS. Oh sure, we get the lessons will be learned speeches when it all goes truly pear shaped, (Mid Staffs for example) but there is a real sense that nothing ever actually changes.
For many, the NHS epitomises both the very best and very worst about the public sector in the UK.
This thread is not about the rights and wrongs of what we have per se, but rather to set the question;
"If we were starting with a clean sheet of paper today, and we wanted to create a free at the point of use for all NHS that provided the best possible care in the most efficient and cost effective manner, what would we do?"
Now, Iit may be that the answer is "the same as what we have now" It may be that the answer is "some sort of insurance scheme with robust safety nets for the weakest and most vulnerable in our society" It may be that the answer is something completely new and radical.
I think that PH has a good mix of clever people of all political persuasions on here. I feel that that mix has the potential to think the unthinkable. What IS the answer?
Can we come up with a blueprint for a top notch 21st century health service that REALLY delivers for the UK?
Lets try to keep it civil and objective.
Or is there?
Whenever the subject of the NHS appears in the media it usually carries some reference to Tory attempts to privatise it or suggestions of a secret agenda for privatisation. The word private seems to be unmentionable in conjunction with NHS, but is this a sensible way discuss things? Is every debate to be based on carers nurses and doctors being the only human beings with a social conscience? Does being a Tory mean that you have ice water in your veins? Does being a Tory mean that you would happily watch the sick die in the gutter? Likewise does being a socialist give you a monopoly on caring about society? Or does being a socialist make you blind to the short comings of the public sector and rabid in your hatred of all things not micro managed by the State? What is the centre, sensible ground?
It's clear that:
Some politicians, of all colour rosettes but mostly those on the left, believe that the only way a "free at the point of use, for all" health service can be guaranteed for the future is to preserve it with the funding/control structures that it has today.
Some politicians, of all colour rosettes but mostly those on the right, think that a measure of private sector thinking would improve the efficiency of the system, thereby ensuring better patient outcomes and more bang for the tax payers buck.
But, it is an almost impossible debate to conduct. As soon as the private sector is mentioned it does appear to me that those on the left lose the power to make reasonable arguments, preferring instead to talk about the evils of profits and big business culture being incompatible with a caring society/NHS etc.
Likewise, many of us have had some utterly appalling experiences at the hands of a system that in some cases seems to care more for the hundreds of thousands that it employs than it does for the millions of people who need to use it, so our views may be considered to be skewed too.
One thing many do accept is that accountability, be it for clinical errors that lead to death or disability, be it for the huge sums of money that are clearly wasted every day within the system, or be it for the slapdash way in which many things are run/organised, appears to be completely non existent within the NHS. Oh sure, we get the lessons will be learned speeches when it all goes truly pear shaped, (Mid Staffs for example) but there is a real sense that nothing ever actually changes.
For many, the NHS epitomises both the very best and very worst about the public sector in the UK.
This thread is not about the rights and wrongs of what we have per se, but rather to set the question;
"If we were starting with a clean sheet of paper today, and we wanted to create a free at the point of use for all NHS that provided the best possible care in the most efficient and cost effective manner, what would we do?"
Now, Iit may be that the answer is "the same as what we have now" It may be that the answer is "some sort of insurance scheme with robust safety nets for the weakest and most vulnerable in our society" It may be that the answer is something completely new and radical.
I think that PH has a good mix of clever people of all political persuasions on here. I feel that that mix has the potential to think the unthinkable. What IS the answer?
Can we come up with a blueprint for a top notch 21st century health service that REALLY delivers for the UK?
Lets try to keep it civil and objective.
Eric Mc said:
It's a bit like "How can we achieve world peace?"
Blimey. As hard as that? Really?Joking aside, if we really do think it's impossible to come up with a better way then I fear for the future of the NHS. It's like a black hole that is voracious in its appetite for money and people. There will never ever be enough resource to feed it so that it burps contentedly
crankedup said:
My principle reason and concern regarding any possible privatisation of our NHS is : (long pause for effect)
suitability of service directly associated with 'making people healthy again'.
The army of bean counters ensuring profit margins and the effect this may have on the service.
The extraordinary range of skill demands each driving for profit not perfection.
Concern that the service will drift into insurance related access only.
Just a few considerations and of course each can be easily countered perhaps.
Some interesting points there Cranky. Let me ask you, would you object to the idea of a profit motive if:suitability of service directly associated with 'making people healthy again'.
The army of bean counters ensuring profit margins and the effect this may have on the service.
The extraordinary range of skill demands each driving for profit not perfection.
Concern that the service will drift into insurance related access only.
Just a few considerations and of course each can be easily countered perhaps.
1. ALL "profits" were to be reinvested in the system (i.e. no dividends to shareholders or such like)
2. The basic emphasis was on securing value for money and efficiency with the resources available rather than returning a profit
3. That the patient and his/her requirements for a healthy life were the focus of the system.
Its interesting that some posters are mentioning a refundable charge for appointments. I can easily see how this would dramatically cut the number of no shows (thereby significantly improving efficiency and reducing waiting times/costs) - in business it is generally understood that free stuff (especially services) is generally undervalued by recipients, whereas stuff that is charged for tends to be valued more. It's that human nature thing. Do people unintentionally "abuse the service" because as far as they are concerned it costs them nowt and is always available for even the most minor stuff? I think that perhaps some people do exactly that.
Fred Clogs belief that there will always be enough money for the NHS so long as we grow the economy fast enough is a bit simplistic. The NHS already gets real terms increases in funding, and it's STILL not enough. Moreover, how do we cope in times of downturn? Gordon did not abolish boom and bust, so we have to face the fact that provision of healthcare needs to continue even at bust times. We cannot have a situation whereby its only the rich who can afford to get sick !
FredClogs said:
sidicks said:
Simply not feasible.
With respect, that's b
ks.Everything that ever made money, created a job or increased scientific understanding in western society anyway started with tax payers money and government spending. They even rescued the banking sector not too long ago. The government don't need to spend less they just need to be more aggressive in claiming a stake in the money they invest in the economy and country as a whole instead of dishing it out under the table as if government spending is something dirty to be ashamed of.
Seriously? Everything? Just have a think about that for a moment pleaserscott said:
andymadmak said:
crankedup said:
My principle reason and concern regarding any possible privatisation of our NHS is : (long pause for effect)
suitability of service directly associated with 'making people healthy again'.
The army of bean counters ensuring profit margins and the effect this may have on the service.
The extraordinary range of skill demands each driving for profit not perfection.
Concern that the service will drift into insurance related access only.
Just a few considerations and of course each can be easily countered perhaps.
Some interesting points there Cranky. Let me ask you, would you object to the idea of a profit motive if:suitability of service directly associated with 'making people healthy again'.
The army of bean counters ensuring profit margins and the effect this may have on the service.
The extraordinary range of skill demands each driving for profit not perfection.
Concern that the service will drift into insurance related access only.
Just a few considerations and of course each can be easily countered perhaps.
1. ALL "profits" were to be reinvested in the system (i.e. no dividends to shareholders or such like)
2. The basic emphasis was on securing value for money and efficiency with the resources available rather than returning a profit
3. That the patient and his/her requirements for a healthy life were the focus of the system.
For example. she's identified a simple change which would reduce costs of one aspect of the business by over £10,000 a year (a tweak to catering purchasing!) yet can't persuade them to even consider examining it, let alone trialling it.
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