NHS whats happened?
Discussion
oyster said:
Simple, those using the NHS most are simply not paying their fair share.
10% pay rise with no NICs.
I have to say I agree. It’s time for the NI cap to end at retirement. Maybe a lower amount but it’s ridiculous that you no longer pay it no matter what your income is. 10% pay rise with no NICs.
Also remove the cap on higher incomes of those of working age.
Sorry but we all need to do our bit.
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?I agree that the Tories have increased funding to the NHS in real terms in recent years. But there are those who want even more spent, as I said. That would cost a LOT more than the current £180 billion or so, perhaps another £20 billion to £30 billion annually. The BMA reckon £50 billion!
Now, I think Labour will retain the bulk of the current NHS structure - and here I disagree with 2xChevrons - and will reference things like their non-dom tax reform as evidence that they can fund it 'properly'. But they'll soon have to admit that they can't deliver the sort of funding that is really needed without reform. Because they are wedded to the 'classic' NHS model, they won't reform it either.
Therefore, I think we're in for at least another seven years of what we see today, only a little bit worse each year. Eventually we may reach the point where reform is unavoidable: rather like an alcoholic, we'll have to hit rock bottom first, and we're not there yet.
lrdisco said:
I have to say I agree. It’s time for the NI cap to end at retirement. Maybe a lower amount but it’s ridiculous that you no longer pay it no matter what your income is.
Also remove the cap on higher incomes of those of working age.
Sorry but we all need to do our bit.
According to Aviva there's around 1.4 million working pensioners over the age of 67.Also remove the cap on higher incomes of those of working age.
Sorry but we all need to do our bit.
This report: https://www.gov.uk/government/statistics/pensioner... states a median earned income for pensioners of £347 per week, or £18k annually.
Therefore, at a starting point of £12,570 and a NI rate of 12% the average employed pensioner would pay around £650 NI per year. That's around £1 billion per year for 1.4 million people. There would presumably be some employer NIC's too, although some pensioners might not bother working if you levy NIC's on them.
I can't see that a NIC levy on pensioner earned income would have much fiscal effect. What it would do, is royally annoy a large number of voters. Would any party dare risk losing the grey vote?
oyster said:
Please stop being obtuse.
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.
I'm not being obtuse. That was the first thing I said to ntv and he dragged it out and here we are 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.
An interesting perspective on things in The Economist this week, which is that it's not just the NHS that is in trouble.
"Why health-care services are in chaos everywhere"
Essentially says that healthcare is failing not just in Britain, but globally. Patient confidence dropping faster in Canada and Italy than the UK. Long A&E waits in Australia and Singapore. Etc. Goes on to say the problems aren't caused by lack of cash, but staff/system inefficiency ("hospitals are doing less with more"), demotivated and burned out medics (caused by covid) and most importantly, rising demand (a covid backlog, aging populations, etc.).
To me this was an interesting perspective on things i.e. it's not just "incompetent NHS managers" or "evil Tories" or other tropes causing the problems in the NHS/UK, but instead underlying issues that are affecting healthcare systems globally.
https://www.economist.com/finance-and-economics/20...
(apologies, I can't find a non paywalled version; 12ft ladder doesn't work):
"Why health-care services are in chaos everywhere"
Essentially says that healthcare is failing not just in Britain, but globally. Patient confidence dropping faster in Canada and Italy than the UK. Long A&E waits in Australia and Singapore. Etc. Goes on to say the problems aren't caused by lack of cash, but staff/system inefficiency ("hospitals are doing less with more"), demotivated and burned out medics (caused by covid) and most importantly, rising demand (a covid backlog, aging populations, etc.).
To me this was an interesting perspective on things i.e. it's not just "incompetent NHS managers" or "evil Tories" or other tropes causing the problems in the NHS/UK, but instead underlying issues that are affecting healthcare systems globally.
https://www.economist.com/finance-and-economics/20...
(apologies, I can't find a non paywalled version; 12ft ladder doesn't work):
Did anyone else watch last night's Panorama: "The NHS crisis: can it be fixed?"? I did, and it featured some initiatives that challenged the current model of healthcare.
For example, a team at Oxford's John Ratcliffe hospital who do home visits and treatment. They might visit an elderly person who says she's feeling dizzy and scared of falling. So they adjust her blood medicine, she feels much better, and doesn't fall over and fracture her hip. Win win.
They also featured a clinic in Hull which was staffed with doctors, physios, social workers and so on, who delivered bespoke preventative healthcare (to elderly patients) designed to keep them away from - very expensive - hospital.
The point is that such initiatives pay for themselves AND are better for patients. The Oxford home visit doctor stated that resistance to change was a big problem in the NHS; I don't doubt him for one moment.
For example, a team at Oxford's John Ratcliffe hospital who do home visits and treatment. They might visit an elderly person who says she's feeling dizzy and scared of falling. So they adjust her blood medicine, she feels much better, and doesn't fall over and fracture her hip. Win win.
They also featured a clinic in Hull which was staffed with doctors, physios, social workers and so on, who delivered bespoke preventative healthcare (to elderly patients) designed to keep them away from - very expensive - hospital.
The point is that such initiatives pay for themselves AND are better for patients. The Oxford home visit doctor stated that resistance to change was a big problem in the NHS; I don't doubt him for one moment.
Brave Fart said:
Did anyone else watch last night's Panorama: "The NHS crisis: can it be fixed?"? I did, and it featured some initiatives that challenged the current model of healthcare.
...
The point is that such initiatives pay for themselves AND are better for patients.
I was just about to launch into why these initiatives are so hard to get going when you're on the back foot financially and operationally....
The point is that such initiatives pay for themselves AND are better for patients.
Then I saw this
Brave Fart said:
Resistance to change was a big problem in the NHS; I don't doubt him for one moment.
Ultimately, I don't know who has the answers.I don't think cabinet level politicans have the depth needed for a genuinely paradigm shifting policy.
I don't think NHS trusts or public health bodies work well enough with the NHS to diagnose, and correct systemic issues.
I think medical staff would see the benefit, but it's wood for the trees with the current backlog.
As was noted on the other thread going into detail on the NHS, it has far fewer managers than it should for its size (Vs comparable private sector organisations).
Change costs money. Private sector would see it as an investment with a payback period. The NHS would just see the investment as the new baseline.
I think it mainly boils down to a few key factors
1, growing population
2 people living longer
3, not enough social care to deal with this
Alot of social care falls at the feet of local authorities and they are working on tighter and tighter budgets
Social worker jobs are not the best paid, dealing with difficult people with health problems and you've got more paperwork Involved than ever to cover your back
Hence why people who don't need to be in hospital are because the social care isn't there to support them
Vicious circle unfortunately
1, growing population
2 people living longer
3, not enough social care to deal with this
Alot of social care falls at the feet of local authorities and they are working on tighter and tighter budgets
Social worker jobs are not the best paid, dealing with difficult people with health problems and you've got more paperwork Involved than ever to cover your back
Hence why people who don't need to be in hospital are because the social care isn't there to support them
Vicious circle unfortunately
Brave Fart said:
They also featured a clinic in Hull which was staffed with doctors, physios, social workers and so on, who delivered bespoke preventative healthcare (to elderly patients) designed to keep them away from - very expensive - hospital.
I was only half watching that but who (ie, what position) was the woman who was asked why they didn't do the Hull thing everywhere?She looked a but stunned and then said something like it's up to local staff to decide what they need.
I hope she wasn't in some kind of strategic role.
Sheepshanks said:
Brave Fart said:
They also featured a clinic in Hull which was staffed with doctors, physios, social workers and so on, who delivered bespoke preventative healthcare (to elderly patients) designed to keep them away from - very expensive - hospital.
I was only half watching that but who (ie, what position) was the woman who was asked why they didn't do the Hull thing everywhere?She looked a but stunned and then said something like it's up to local staff to decide what they need.
I hope she wasn't in some kind of strategic role.
So yes, she is very much in a strategic role and probably the kind of barrier to change that Professor Dan Lasserson, in Oxford, was referring to.
He’s right…
“Sajid Javid has said patients should be charged for GP appointments and A&E visits, as he called the current model of the NHS "unsustainable".”
https://news.sky.com/story/patients-should-be-char...
“Sajid Javid has said patients should be charged for GP appointments and A&E visits, as he called the current model of the NHS "unsustainable".”
https://news.sky.com/story/patients-should-be-char...
Edited by chemistry on Saturday 21st January 11:56
chemistry said:
He’s right…
“Sajid Javid has said patients should be charged for GP appointments and A&E visits, as he called the current model of the NHS "unsustainable".”
https://news.sky.com/story/patients-should-be-char...
He's wrong.“Sajid Javid has said patients should be charged for GP appointments and A&E visits, as he called the current model of the NHS "unsustainable".”
https://news.sky.com/story/patients-should-be-char...
Charging people to access the primary entry points to health services is always wrong.
Charging to visit a GP or A&E is going to be a difficult sell to the UK electorate/public/media. There are charges for healthcare elsewhere (prescriptions, medicines, equipment, social care, dentistry) but we do appear to have convinced ourselves those two (GPs and A&E) are special and different. I suspect charges for these services in other comparable countries will also be ignored or downplayed.
To be honest I’m surprised he’s come out to suggest or support the idea.
To be honest I’m surprised he’s come out to suggest or support the idea.
scenario8 said:
Charging to visit a GP or A&E is going to be a difficult sell to the UK electorate/public/media. There are charges for healthcare elsewhere (prescriptions, medicines, equipment, social care, dentistry) but we do appear to have convinced ourselves those two (GPs and A&E) are special and different. I suspect charges for these services in other comparable countries will also be ignored or downplayed.
To be honest I’m surprised he’s come out to suggest or support the idea.
Even if there was a charge, I can’t see them including children and old people. 90% of prescriptions are free, so it’s going to be the same sort of ratio of use.To be honest I’m surprised he’s come out to suggest or support the idea.
Sheepshanks said:
Even if there was a charge, I can’t see them including children and old people. 90% of prescriptions are free, so it’s going to be the same sort of ratio of use.
I suspect it’s a non-starter in any case tbh but if we did start a public conversation even about the concept of charging in the UK I would anticipate excluding children and the elderly to feature. Heavily. Remind me which sections of society typically consume NHS provision?As above, I’m surprised he’s even publicly suggested the idea. He’s just making himself appear even more of a horrible NHS hating Tory, isn’t he?
pquinn said:
He's wrong.
Charging people to access the primary entry points to health services is always wrong.
Make it optional and easy. Install visible contactless payment machines at every Medical Centre and Hospital entrance and promote widely that every contribution helps. Charging people to access the primary entry points to health services is always wrong.
It would raise more than people think.
272BHP said:
pquinn said:
He's wrong.
Charging people to access the primary entry points to health services is always wrong.
Make it optional and easy. Install visible contactless payment machines at every Medical Centre and Hospital entrance and promote widely that every contribution helps. Charging people to access the primary entry points to health services is always wrong.
It would raise more than people think.
No one wants to properly implement charging for people with no entitlement at all yet now they're keen on the idea for a different group? To manage a demand problem that isn't related to it being 'free'?
Bet it wouldn't be a blanket charge either and there'd be all sorts of 'deserving' exclusions including no doubt all sorts of public sector types especially those inside the NHS. Because that would be 'fair'.
Sajid is a double moron for piping up on this and I really can't see why he felt the need.
Bet it wouldn't be a blanket charge either and there'd be all sorts of 'deserving' exclusions including no doubt all sorts of public sector types especially those inside the NHS. Because that would be 'fair'.
Sajid is a double moron for piping up on this and I really can't see why he felt the need.
scenario8 said:
Charging to visit a GP or A&E is going to be a difficult sell to the UK electorate/public/media. There are charges for healthcare elsewhere (prescriptions, medicines, equipment, social care, dentistry) but we do appear to have convinced ourselves those two (GPs and A&E) are special and different. I suspect charges for these services in other comparable countries will also be ignored or downplayed.
To be honest I’m surprised he’s come out to suggest or support the idea.
I'd pay to see a GP right now; it beats the current service of not paying and not being able to see a GP. I've got something that I'm concerned about, probably nothing but might be something serious and I can't get past "all appointments are gone, try again tomorrow haha", there's not even an effective triage for if you think you have something bad, it's just "all appointments gone, computer says no". I guess I'll just wander into a&e when I can afford a half-day.To be honest I’m surprised he’s come out to suggest or support the idea.
The real pith take is I'm watching the snooker and every single ad break has an NHS commercial telling me "if I don't feel right, speak to someone". They're using our contributions to effectively gaslight us at this stage it seems.
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