NHS whats happened?
Discussion
Spare tyre said:
Sadly this time last year I was told I had cancer and needed treatment
Got the diagnosis then nothing for weeks and weeks, kept ringing and chasing up was really weird
It wasn’t until I became a pest I finally got the name of the surgeons PA and eventually got squeezed in - even on the day it was not certain if I’d get my op, my life was kind of on hold and wife in bits etc
The cynical part of me thinks it’s the tories making it such a bad service that only privatisation will seem like the next steps, so they can divide the best bits up to line their pockets
I will take my foil hat off now
Hope your op went well and you got well and stay well.Got the diagnosis then nothing for weeks and weeks, kept ringing and chasing up was really weird
It wasn’t until I became a pest I finally got the name of the surgeons PA and eventually got squeezed in - even on the day it was not certain if I’d get my op, my life was kind of on hold and wife in bits etc
The cynical part of me thinks it’s the tories making it such a bad service that only privatisation will seem like the next steps, so they can divide the best bits up to line their pockets
I will take my foil hat off now
DBSV8 said:
interested on thoughts what exactly is going on with the NHS
an example we had a friend who had an accident at work fall from height and fracture of his leg ....It was an obvious break , not a potential sprain. femur . Ambulance was called , went to Poole hospital in Dorset .
remained in the ambulance for 14 1/2hrs ............. He was told its not life threatening . subsequently he had the leg set , put in one of those leg braces and was sent on his way
Now i know casualty is busy ... but What is the reason , for such a wait
Shortage of doctors
Too many patients
not enough beds .................this didnt require a bed
poor assessment triage
or is there a darker reason , NHS going slow due to pay deals ?? political; reasons unions etc
no idea but this needs fixing
I haven't read all 8 pages but specifically for this problem I can say too many people are going to A&E for things that aren't Accidents and/or emergencies. an example we had a friend who had an accident at work fall from height and fracture of his leg ....It was an obvious break , not a potential sprain. femur . Ambulance was called , went to Poole hospital in Dorset .
remained in the ambulance for 14 1/2hrs ............. He was told its not life threatening . subsequently he had the leg set , put in one of those leg braces and was sent on his way
Now i know casualty is busy ... but What is the reason , for such a wait
Shortage of doctors
Too many patients
not enough beds .................this didnt require a bed
poor assessment triage
or is there a darker reason , NHS going slow due to pay deals ?? political; reasons unions etc
no idea but this needs fixing
It's not just people going to jump the GP queue for minor issues but GP clinics themselves sending people to A&E for what should be routine, scheduled appointments.
pavarotti1980 said:
oyster said:
That's quite astonishing, if true.
Personal allowance has gone up 0.56% from £12,500 to £12,570
Allowance withdrawal has gone up 0% from £100,000 to £100,000
Higher tax rate threshold has gone up 0.54% from £50,000 to £50,270
Additional tax rate threshold up 0%
Class 4 NICs up from 9% to 9.73% (and from 2% to 2.73% above the upper limit)
So unless you have had less than a 0.54% pay rise over the last 3 years, you will be paying more income tax as a percentage of your income.
Oh and presumably you pay utilities and motor fuels. So you'll be paying a lot more VAT on those, unless your salary has gone up by an equivalent amount? Oh hang on, if it has then you're paying more income tax.
So it's not 20%/40% tax at PAYE?Personal allowance has gone up 0.56% from £12,500 to £12,570
Allowance withdrawal has gone up 0% from £100,000 to £100,000
Higher tax rate threshold has gone up 0.54% from £50,000 to £50,270
Additional tax rate threshold up 0%
Class 4 NICs up from 9% to 9.73% (and from 2% to 2.73% above the upper limit)
So unless you have had less than a 0.54% pay rise over the last 3 years, you will be paying more income tax as a percentage of your income.
Oh and presumably you pay utilities and motor fuels. So you'll be paying a lot more VAT on those, unless your salary has gone up by an equivalent amount? Oh hang on, if it has then you're paying more income tax.
You know full well that rising salaries with frozen thresholds equals higher rates of taxation for individuals.
To even claim tax hasn’t gone up is disingenuous and untrue.
It’s being obtuse or innumerate, only you know which.
Spare tyre said:
<edited for brevity>
The cynical part of me thinks it’s the tories making it such a bad service that only privatisation will seem like the next steps, so they can divide the best bits up to line their pockets
I hear this accusation a fair bit, and to me it makes no sense. As another poster observed, why would a political party deliberately pursue a massively unpopular policy?The cynical part of me thinks it’s the tories making it such a bad service that only privatisation will seem like the next steps, so they can divide the best bits up to line their pockets
Of course, if it is a dastardly plan by the Tories, we would see a wonderful healthcare system in Wales (Labour), Scotland (SNP) and NI (er, well, um). But we don't, despite both Wales and Scotland have tax raising powers. But yeah, grrr Tories.
Brave Fart said:
I hear this accusation a fair bit, and to me it makes no sense. As another poster observed, why would a political party deliberately pursue a massively unpopular policy?
Of course, if it is a dastardly plan by the Tories, we would see a wonderful healthcare system in Wales (Labour), Scotland (SNP) and NI (er, well, um). But we don't, despite both Wales and Scotland have tax raising powers. But yeah, grrr Tories.
I don't think that it's a deliberate, formulated, planned, dastardly scheme by the Conservatives to run down the NHS and then sell privatisation as the only solution. But I do think that they're so inherently, ideologically committed to free market forces, to the belief that private profit should be extracted from as much of society as possible, that many of them stand to gain so much (personally and financially) from further privatisation, and they would be insulated from any negative consequences that they don't really mind privatisation being an outcome. On the other side of the coin, they fundamentally don't believe in the NHS as a socialised, nationalised, single-payer comprehensive healthcare provider - at heart they don't agree with it in principle and they think it shouldn't (or can't) work in practice. So they're never really going to make the policy and funding decisions necessary to preserve that model. Of course, if it is a dastardly plan by the Tories, we would see a wonderful healthcare system in Wales (Labour), Scotland (SNP) and NI (er, well, um). But we don't, despite both Wales and Scotland have tax raising powers. But yeah, grrr Tories.
You're right that 'big bang privatisation of the NHS (in the mold of BT, British Gas or the railways - where one day it is all sold off to private hands while the government pockets a big cheque) will never happen because it would be a massive vote lower (although the state of the Service and the narratives around it are changing that - see the undercurrents right here on NP&E about radical change to introduce private provider/insurance models or even 'burn the whole thing down and start again').
But it'll never come to that, and doesn't need to to serve the same end. You simply need to turn the NHS into a commissioning body and outsource actual service provision to private entities. It'll be "Your NHS: Provided by Serco in association with Kaiser Permanente". There'll be a lot of guff about consumer choice and profit motive and lots of reassurances about how treatment will remain free at point of delivery...but you'll see the introduction of small (£10, £20) charges for appointments and admin, increased prescription charges and token charges for ongoing long-term care. All these will, in theory, be able to be claimed back by means testing, but only by some byzantine process via a bit of the .gov.uk website (run under contract by ATOS).
There will be compulsory insurance paid by employers (essentially beefed-up NIC) not individuals, so as far as the ordinary person in concerned it remains 'free at delivery' and with the added bonus of tying healthcare to employment (one of the main unfulfilled ideological goals of neoliberals in the UK). There will be an 'NHS Essentials' providing universal coverage of A&E and whatever other services are deemed acceptable, but the hospitals providing NHS:E will be distantly spaced requiring either ambulance service (£20...) or long, expensive drives into ULEZs (£12) and paying for parking (£10), plus a £15 charge if your problem is deemed self-inflicted (alcohol, drugs, sports injuries [but only working class sports - cricket, rowing and dressage injuries are rare enough to be exempt...])
The system will effectively be exactly what we've got on the railways - a state-managed, non-commercial system with on-the-ground provision by private for-profit interests, with minimum service (and income for the provider) guaranteed by government subsidy, bolstered by costly public access charges. And the result will be the same - service levels will go down, outcomes will decline, costs to the Treasury will go up, dozens of private enterprises will make huge profits by sticking their hand in the till, users will be paying far more to access inferior services and anyone who is able to will avoid the service like the Black Death. Except that it's not just a case of people taking the car because the trains are so useless and expensive - this will be people's health, well-being and lives.
I genuinely believe this is the future the NHS is heading for in the next 10 years or so. Because it's what's happened with every other British public service that has been felled by neoliberalism. We won't get anything a psychotic as the American system, and we won't get something as functional and equitable as a European social-insurance model. It'll be a British fudge that maintains a veneer of universality but actually just provides a worse service at greater cost while making those involved a lot of money by transferring public money into private hands.
I think this will happen regardless of the party in charge - if anything I think it will happen more swiftly and more thoroughly under a Starmer-led Labour government. Labour in their present form are just as in thrawl to the free market, are just as compromised by being in hoc to lobbyists and donors from the private healthcare industry (vis: Wes Streeting) and, as an organisation, are just as lukewarm on the NHS as a principle. Mark my words; it'll be sold as a Only Nixon Could Go To China moment. Starmer and Streeting will make a solemn, sad-face speech about how the NHS has been permanently broken by the Tories and it is beyond the means of the state to fix. So, because they're so pragmatic, prudent and sensible, they have no choice but to bring in the private sector to provide capacity and lead reform...but don't worry, Labour is The Party Of The NHS, we created it 80 years ago and you can trust us to build it back better and renew it to make it fit for the next 80 years...but there will be some Tough Decisions ahead...now here's the new CEO of NHS England, straight from the boardroom of Ascension Health in St. Louis, Missouri, to explain why there's no option but to charge everyone £20/month on their payslip to Fix Our NHS...
That's the heart of the matter as I see it, and it's my response to the "what about Wales/Scotland?" point - that presumes that those parties in those devolved governments are, at heart, any more dedicated to fixing the NHS as a one-payer comprehensive provider than the Westminster government is, or if they are that they remotely have the political testicle to be honest with their electorates about what it would cost. Far easier to take the lobbyist money, take the ministerial salary, pull some sad faces for the press, head off to your Nuffield health centre and blame Westminster for it all.
Brave Fart said:
I hear this accusation a fair bit, and to me it makes no sense. As another poster observed, why would a political party deliberately pursue a massively unpopular policy?
Of course, if it is a dastardly plan by the Tories, we would see a wonderful healthcare system in Wales (Labour), Scotland (SNP) and NI (er, well, um). But we don't, despite both Wales and Scotland have tax raising powers. But yeah, grrr Tories.
It’s not a plot to run it down in order to privatise, but there have been very real policy failures by central government over the last 13 years that have contributed a great deal to what’s now happening.Of course, if it is a dastardly plan by the Tories, we would see a wonderful healthcare system in Wales (Labour), Scotland (SNP) and NI (er, well, um). But we don't, despite both Wales and Scotland have tax raising powers. But yeah, grrr Tories.
2xChevrons said:
But it'll never come to that, and doesn't need to to serve the same end. You simply need to turn the NHS into a commissioning body and outsource actual service provision to private entities.
With the reversal of Section 75 of the 2012 act policy is moving (belatedly) away from this approach.BobToc said:
It’s not a plot to run it down in order to privatise, but there have been very real policy failures by central government over the last 13 years that have contributed a great deal to what’s now happening.
Indeed; incompetence, rather than malice, I'd suggest.2xChevron's analysis is as thoughtful and well written as ever, but I find it deeply cynical. My view is that Labour will enter government with the intention of gradually restoring NHS funding but with a few reforms (such as local health centres as an alternative to GP's). I don't agree that they wish to move towards the sort of model we see in our railways, because the likes of Starmer, Rayner and others hold the current model of the NHS very close to their hearts.
However, the problem they'll have is lack of economic growth. There simply won't be the money to provide French or German levels of funding - we're talking extra funding of £30 billion per annum or more for several years. It can't come from income tax, or NIC's, or VAT when folk are reeling from inflation and historically high interest rates. Perhaps they'll try to borrow it but the bond markets might not allow that. Especially if they're already borrowing £22 billion for their Green Energy Fund or whatever it's called.
Brave Fart said:
2xChevron's analysis is as thoughtful and well written as ever, but I find it deeply cynical. My view is that Labour will enter government with the intention of gradually restoring NHS funding but with a few reforms (such as local health centres as an alternative to GP's). I don't agree that they wish to move towards the sort of model we see in our railways, because the likes of Starmer, Rayner and others hold the current model of the NHS very close to their hearts.
Cynical, moi? Yes. I'll admit I am deeply cynical about Labour, especially under Starmer. I feel not without decent reason, though.As for the bit in bold, I see no actual evidence for this. They may say it occasionally, but Starmer's duplicity (and outright lies) about his pledges and policies with regard to the NHS, his refusal to give clear answers in the present as to what he believes the NHS's operating model should be and his evasiveness and vacuousness when it comes to outlining specific health policy, plus Wes Streeting's ideas for the NHS's future and his ties to various health lobby and interest groups make me very cynical slash suspicious.
As I said before, they'll pull crocodile tears and profess a love for the classic NHS model in principle, but then say that it's just not viable and that, with a heavy heart, the private sector has to be brought in to operate it. They'll blame the state of the Service on the Tories, but they don't actually want to fix it as it is and don't actually believe it's fixable within what they deem as an acceptable political spectrum.
Spare tyre said:
Sadly this time last year I was told I had cancer and needed treatment
Got the diagnosis then nothing for weeks and weeks, kept ringing and chasing up was really weird
It wasn’t until I became a pest I finally got the name of the surgeons PA and eventually got squeezed in - even on the day it was not certain if I’d get my op, my life was kind of on hold and wife in bits etc
The cynical part of me thinks it’s the tories making it such a bad service that only privatisation will seem like the next steps, so they can divide the best bits up to line their pockets
I will take my foil hat off now
Sorry to hear of your health issue and hope you continue on steady progress to good health.Got the diagnosis then nothing for weeks and weeks, kept ringing and chasing up was really weird
It wasn’t until I became a pest I finally got the name of the surgeons PA and eventually got squeezed in - even on the day it was not certain if I’d get my op, my life was kind of on hold and wife in bits etc
The cynical part of me thinks it’s the tories making it such a bad service that only privatisation will seem like the next steps, so they can divide the best bits up to line their pockets
I will take my foil hat off now
My own situation regards health also had me receive a cancer diagnosis, however once I had got past the G.P. I found myself on a ‘two week pathway’ of further diagnosis and then treatment program. I have nothing but highest praise for the NHS in the treatment that I received via my local hospital (West Suffolk) and Addenbrookes. Shows how patchy the services are.
2xChevrons said:
As I said before, they'll pull crocodile tears and profess a love for the classic NHS model in principle, but then say that it's just not viable and that, with a heavy heart, the private sector has to be brought in to operate it. They'll blame the state of the Service on the Tories, but they don't actually want to fix it as it is and don't actually believe it's fixable within what they deem as an acceptable political spectrum.
It’s just not credible to suggest Starmer and Streeting don’t want to fix the NHS.On the subject of private involvement I don’t see a near term solutions to elective waiting lists that doesn’t involve utilising private capacity, but I’m all ears to the alternative.
2xChevrons said:
But it'll never come to that, and doesn't need to to serve the same end. You simply need to turn the NHS into a commissioning body and outsource actual service provision to private entities. It'll be "Your NHS: Provided by Serco in association with Kaiser Permanente". There'll be a lot of guff about consumer choice and profit motive and lots of reassurances about how treatment will remain free at point of delivery...but you'll see the introduction of small (£10, £20) charges for appointments and admin, increased prescription charges and token charges for ongoing long-term care. All these will, in theory, be able to be claimed back by means testing, but only by some byzantine process via a bit of the .gov.uk website (run under contract by ATOS).
There will be compulsory insurance paid by employers (essentially beefed-up NIC) not individuals, so as far as the ordinary person in concerned it remains 'free at delivery' and with the added bonus of tying healthcare to employment (one of the main unfulfilled ideological goals of neoliberals in the UK). There will be an 'NHS Essentials' providing universal coverage of A&E and whatever other services are deemed acceptable, but the hospitals providing NHS:E will be distantly spaced requiring either ambulance service (£20...) or long, expensive drives into ULEZs (£12) and paying for parking (£10), plus a £15 charge if your problem is deemed self-inflicted (alcohol, drugs, sports injuries [but only working class sports - cricket, rowing and dressage injuries are rare enough to be exempt...])
The system will effectively be exactly what we've got on the railways - a state-managed, non-commercial system with on-the-ground provision by private for-profit interests, with minimum service (and income for the provider) guaranteed by government subsidy, bolstered by costly public access charges. And the result will be the same - service levels will go down, outcomes will decline, costs to the Treasury will go up, dozens of private enterprises will make huge profits by sticking their hand in the till, users will be paying far more to access inferior services and anyone who is able to will avoid the service like the Black Death. Except that it's not just a case of people taking the car because the trains are so useless and expensive - this will be people's health, well-being and lives.
It never worked with the railways as there was little genuine competition. There will be compulsory insurance paid by employers (essentially beefed-up NIC) not individuals, so as far as the ordinary person in concerned it remains 'free at delivery' and with the added bonus of tying healthcare to employment (one of the main unfulfilled ideological goals of neoliberals in the UK). There will be an 'NHS Essentials' providing universal coverage of A&E and whatever other services are deemed acceptable, but the hospitals providing NHS:E will be distantly spaced requiring either ambulance service (£20...) or long, expensive drives into ULEZs (£12) and paying for parking (£10), plus a £15 charge if your problem is deemed self-inflicted (alcohol, drugs, sports injuries [but only working class sports - cricket, rowing and dressage injuries are rare enough to be exempt...])
The system will effectively be exactly what we've got on the railways - a state-managed, non-commercial system with on-the-ground provision by private for-profit interests, with minimum service (and income for the provider) guaranteed by government subsidy, bolstered by costly public access charges. And the result will be the same - service levels will go down, outcomes will decline, costs to the Treasury will go up, dozens of private enterprises will make huge profits by sticking their hand in the till, users will be paying far more to access inferior services and anyone who is able to will avoid the service like the Black Death. Except that it's not just a case of people taking the car because the trains are so useless and expensive - this will be people's health, well-being and lives.
The basics of what you are describing sound very similar to many European health systems. The state guarantees access to healthcare for all, though the exact financing varies according to circumstance, and healthcare providers earn money by providing treatment. It puts the patient at the centre of it all rather than as an inconvenience.
The problem with the current system is that it relies on the altruism of all involved to be an efficient well run system and maybe forty years ago that was enough, back in the days when GPs paid home visits late in the evening to sick children. These days you need a better structure and until one is in place little will change.
Even Starmer is planning to pay for more private sector operations to clear waiting lists.
TCX said:
gazza285 said:
Brave Fart said:
My view is that Labour will enter government with the intention of gradually restoring NHS funding...
Restoring? Why, when did it drop?272BHP said:
Why call an ambulance for a fractured leg?
Why could someone not get him in a vehicle and off to A&E?
Because you'd be in far safer hands with a paramedic in attendance with the knowledge and correct medical equipment.Why could someone not get him in a vehicle and off to A&E?
Say the guy is big, hard to carry, the bone pierces an artery, you drop him etc
Ambulances aren't a driver and a porter anymore, as I had with one in a Greek island once, after a heart situation, they are life saving highly trained medics.
2xChevrons said:
You simply need to turn the NHS into a commissioning body and outsource actual service provision to private entities. It'll be "Your NHS: Provided by Serco in association with Kaiser Permanente".
That already happens to some extent. Family member was tuped out of her NHS clinical role and is now employed by some random company, totally funded by the NHS.The firm is supposed to be an expert in the field and have loads of support resource available, but they’re not and they don’t.
croyde said:
Because you'd be in far safer hands with a paramedic in attendance with the knowledge and correct medical equipment.
Say the guy is big, hard to carry, the bone pierces an artery, you drop him etc
Ambulances aren't a driver and a porter anymore, as I had with one in a Greek island once, after a heart situation, they are life saving highly trained medics.
Of course but you have to weigh that up against the risks involved in waiting forever for them to turn up.Say the guy is big, hard to carry, the bone pierces an artery, you drop him etc
Ambulances aren't a driver and a porter anymore, as I had with one in a Greek island once, after a heart situation, they are life saving highly trained medics.
In January 2023 I would make plans to move them yourself.
Sheepshanks said:
croyde said:
Ambulances aren't a driver and a porter anymore, as I had with one in a Greek island once, after a heart situation, they are life saving highly trained medics.
They’re trained, but they’re not all highly trained.Then it all stopped as the 'highly trained' doctor walked in and asked if I smoked. No was my reply.
'Well this isn't a heart attack then' and he walked off.
I spent about 7 hours stuck on a trolley in A&E until I was then admitted to a cardiac ward. I had no idea what was going on but the nurses said that my heart beat was dangerously low.
The next day, guess who was surprised to see me. Yes! that same arrogant doctor who had to try and get a stent into me. He was unsuccessful btw.
Oh, 2009, this would have been under Labour I think.
Doesn't really matter what party is in power to be honest.
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