Services that you cannot access despite being entitled
Discussion
donkmeister said:
NHS dentistry has long been a service that is part of the postcode lottery. As taxpayers we're all paying for that service but unless you are lucky to be looking for an NHS dentist at the precise moment an NHS dentist in your area has openings then you are SOOL.
Now the government has announced a load of funding for childcare. Great, but I know even the crap nurseries in my area have an 18 month waiting list. There's simply no places in my town, or any of the towns within 15 miles. So it's not going to get anyone back to work, it's just going to help people already at work.
I suppose my question is, what are you supposed to do when you pay into the system your whole adult life, you are offered x, y and z but there simply is no way to access these services? It's maddening!
Nearly everything you (we) feel entitled to is a bit of a lottery, dependant not only on what you earn or where you live but what illness you have.Now the government has announced a load of funding for childcare. Great, but I know even the crap nurseries in my area have an 18 month waiting list. There's simply no places in my town, or any of the towns within 15 miles. So it's not going to get anyone back to work, it's just going to help people already at work.
I suppose my question is, what are you supposed to do when you pay into the system your whole adult life, you are offered x, y and z but there simply is no way to access these services? It's maddening!
But it has always been so.
Ridgemont said:
donkmeister said:
Ridgemont said:
And one last time.
THEY AREN’T NHS SERVICES.
Jeez.
Yes, they bloody well are.THEY AREN’T NHS SERVICES.
Jeez.
You clearly don't know the difference between a service and a service provider. The service is the whole point of every post here. Not the service providers.
FFS
https://lowdownnhs.info/explainers/how-do-gps-fit-...
GPs/DPs whatever are not employed by the NHS. They are independent and not part of what ‘you pay your taxes for and have a right’.
Neverminding your insane view that government ought to be taking over child care. Sure start was as close as it got to that.
I know that dentists, and nursaries, are private businesses.
I know that locally the waiting lists for joining a dental service as an NHS funded patient is more than two years. Don't know about nursaries as my kids are older.
So considering that part of my tax payments are supposed to be funding an element of dentistry, why am I paying for a service (NHS funded tooth care) that just doesn't practically exist? If it is the case that "dentists are not a part of what you pay taxes for", then why do people In other parts of the country get subsidised dental treatment? What is the difference between their dentist surgeries and the ones local to me?
boyse7en said:
Ridgemont said:
donkmeister said:
Ridgemont said:
And one last time.
THEY AREN’T NHS SERVICES.
Jeez.
Yes, they bloody well are.THEY AREN’T NHS SERVICES.
Jeez.
You clearly don't know the difference between a service and a service provider. The service is the whole point of every post here. Not the service providers.
FFS
https://lowdownnhs.info/explainers/how-do-gps-fit-...
GPs/DPs whatever are not employed by the NHS. They are independent and not part of what ‘you pay your taxes for and have a right’.
Neverminding your insane view that government ought to be taking over child care. Sure start was as close as it got to that.
I know that dentists, and nursaries, are private businesses.
I know that locally the waiting lists for joining a dental service as an NHS funded patient is more than two years. Don't know about nursaries as my kids are older.
So considering that part of my tax payments are supposed to be funding an element of dentistry, why am I paying for a service (NHS funded tooth care) that just doesn't practically exist? If it is the case that "dentists are not a part of what you pay taxes for", then why do people In other parts of the country get subsidised dental treatment? What is the difference between their dentist surgeries and the ones local to me?
But the waiting lists for getting on to a dentist NHS waiting list is probably purely down to profit and loss and local circumstance. They can’t take on too many because everyone wants cheap dental care. But it will vary all over the country and according to practice.
Personally I would rather go private. Same supplier no waiting time. Unless you want a bump of say £500m to sort out the contracts for DPs it might be easier to just bite the bullet.
But the idea that ‘your taxes’ entitles you to optimal care is for the birds.
Ridgemont said:
No they aren’t. I’ll give up shortly but:
https://lowdownnhs.info/explainers/how-do-gps-fit-...
GPs/DPs whatever are not employed by the NHS. They are independent and not part of what ‘you pay your taxes for and have a right’.
Neverminding your insane view that government ought to be taking over child care. Sure start was as close as it got to that.
You do seem to be expertly missing the point which the OP has been very clear about. It’s clear GPs, dentists etc are private practices and thus means you aren’t entitled to care at a specific practice (service providers). But as taxpayers, you are entitled to access NHS general medical treatment and dentistry (the service). A portion of your income funds this.https://lowdownnhs.info/explainers/how-do-gps-fit-...
GPs/DPs whatever are not employed by the NHS. They are independent and not part of what ‘you pay your taxes for and have a right’.
Neverminding your insane view that government ought to be taking over child care. Sure start was as close as it got to that.
If that service is unattainable, is that fair when you pay the tax for it?
juggsy said:
Ridgemont said:
No they aren’t. I’ll give up shortly but:
https://lowdownnhs.info/explainers/how-do-gps-fit-...
GPs/DPs whatever are not employed by the NHS. They are independent and not part of what ‘you pay your taxes for and have a right’.
Neverminding your insane view that government ought to be taking over child care. Sure start was as close as it got to that.
You do seem to be expertly missing the point which the OP has been very clear about. It’s clear GPs, dentists etc are private practices and thus means you aren’t entitled to care at a specific practice (service providers). But as taxpayers, you are entitled to access NHS general medical treatment and dentistry (the service). A portion of your income funds this.https://lowdownnhs.info/explainers/how-do-gps-fit-...
GPs/DPs whatever are not employed by the NHS. They are independent and not part of what ‘you pay your taxes for and have a right’.
Neverminding your insane view that government ought to be taking over child care. Sure start was as close as it got to that.
If that service is unattainable, is that fair when you pay the tax for it?
Personally private provision aligned to what happens on the continent seems absolutely a non brainier:
https://about-france.com/health-care.htm
Edited by Ridgemont on Saturday 18th March 00:00
Ridgemont said:
Obviously not. But I am largely in favour of a wholesale move to private provision for those who can afford it. That wasn’t the proposal of the OP. Or at least as far as I interpreted him.
Personally private provision aligned to what happens on the continent seems absolutely a non brainier:
https://about-france.com/health-care.htm
I actually think it is what the OP was tilting at. And I tend to agree with you both Personally private provision aligned to what happens on the continent seems absolutely a non brainier:
https://about-france.com/health-care.htm
If govt is using taxation to provide services, those services should be available for all. How they are provided is largely irrelevant to that premise.
I also agree that "to all" will have nuance and should have degrees of means testing to it. Balanced against what the govt should be aiming to provide (the NHS is a great case in point here...it is trying to provide an incredibly wide range of services for "everyone" free at the point of us. Which simply is not a sustainable model).
Whenever I see people supporting the move to private dentistry, I feel it should require a disclosure of whether that's how someone earns their living?
And the first 20 posts had been a perfect example of someine choosing to ignore the opening post and argue about something else instead. How to tell someone your obtuse without saying your obtuse.
Access to density is shocking in the UK, and dental standards are falling.
This is bad, because
- it will cost the UK more in the long run, which is bad for everyone (except dentists.)
- simply, it's not "fair" in a wealthy country
In my view: more money needs spending in the short term and medium term.
Most would agree (even dentists) apart from the most ardent tax payer alliance "I'm alright jack" types. (But they can usually be ignored quite easily, as they tend to forget how their comfortable position was attained on the back of public spending.)
So, how to spend this extra money to get better dental provision?
Ridgemont: people with money spend more on themselves privately, freeing up "subsidised" capacity for the poor.
Wrong! There is no capacity for the poor, because dentists make more by eschewing NHS work altogether (as they are doing in my town). There are huge dentistry deserts across parts of the country.
Plus, it assumes the poor can afford the NHS subsidies rates. Not all can, and there are reports of DIY dentistry coming back.
The OP: the government waves the public spending magic wand, which is spread across tax payers via the existing tax systems for the sake of simplicity.
Option a: (how the op seems to think it works) the government mandate only an "NHS" dentist can do dentistry, and they will jolly well do what they're told, where they're told, or else.
Wrong! The "or else" is we have no dentists any more. In 1948 dentistry remained private, and was never nationalised.
Option b: to increase the NHS rates to a level that can fund private dentists in the way of life dentists have become accustomed to.
Maybe: it does nothing to address capacity in the short term, but might avoid the provison deserts being created. The extra cash might temp some dentists back in from their no doubt comfortable retirement? and will help to draw people in to the sector in time. Hell, maybe we can poach some from overseas?
Option c: the government increase the NHS schedule of rates (carrot) but mandate a certain level of NHS work is carried out each year to get, I don't know, a practising licence?(stick)
So something to address the coverage deserts perhaps, but still retaining a market based / reward based approach.
There probably also needs to be a review of benefits to ensure the very poor can access dentistry.
Kids are already free, but as we've found: there's simply no NHS dentists near who will do it, so we're paying several hundred a year now privately.
There. Sorted.
The OP mentioned nursery costs too, but having already solved dentistry this morning, I might wait until this afternoon to solve early years provision.
And the first 20 posts had been a perfect example of someine choosing to ignore the opening post and argue about something else instead. How to tell someone your obtuse without saying your obtuse.
Access to density is shocking in the UK, and dental standards are falling.
This is bad, because
- it will cost the UK more in the long run, which is bad for everyone (except dentists.)
- simply, it's not "fair" in a wealthy country
In my view: more money needs spending in the short term and medium term.
Most would agree (even dentists) apart from the most ardent tax payer alliance "I'm alright jack" types. (But they can usually be ignored quite easily, as they tend to forget how their comfortable position was attained on the back of public spending.)
So, how to spend this extra money to get better dental provision?
Ridgemont: people with money spend more on themselves privately, freeing up "subsidised" capacity for the poor.
Wrong! There is no capacity for the poor, because dentists make more by eschewing NHS work altogether (as they are doing in my town). There are huge dentistry deserts across parts of the country.
Plus, it assumes the poor can afford the NHS subsidies rates. Not all can, and there are reports of DIY dentistry coming back.
The OP: the government waves the public spending magic wand, which is spread across tax payers via the existing tax systems for the sake of simplicity.
Option a: (how the op seems to think it works) the government mandate only an "NHS" dentist can do dentistry, and they will jolly well do what they're told, where they're told, or else.
Wrong! The "or else" is we have no dentists any more. In 1948 dentistry remained private, and was never nationalised.
Option b: to increase the NHS rates to a level that can fund private dentists in the way of life dentists have become accustomed to.
Maybe: it does nothing to address capacity in the short term, but might avoid the provison deserts being created. The extra cash might temp some dentists back in from their no doubt comfortable retirement? and will help to draw people in to the sector in time. Hell, maybe we can poach some from overseas?
Option c: the government increase the NHS schedule of rates (carrot) but mandate a certain level of NHS work is carried out each year to get, I don't know, a practising licence?(stick)
So something to address the coverage deserts perhaps, but still retaining a market based / reward based approach.
There probably also needs to be a review of benefits to ensure the very poor can access dentistry.
Kids are already free, but as we've found: there's simply no NHS dentists near who will do it, so we're paying several hundred a year now privately.
There. Sorted.
The OP mentioned nursery costs too, but having already solved dentistry this morning, I might wait until this afternoon to solve early years provision.
I’m afraid the answer is, write to your MP and vote for someone who is willing to fund these services at a level where the service providers can actually run.
As it stands the nursery/early years provision is going to get worse. The government have not confirmed the details but the calculations that have been done by the likes of the early years alliance, based on the overall budget they have announced, show they still won’t be paying enough to cover costs. At the moment nurseries use 1, 2 & 3 year olds to subsidise the grant funded children. Nurseries are either going to close or going to have to stop offering government funded places of the government don’t pay more. This is something you really should be lobbying your MP about.
As it stands the nursery/early years provision is going to get worse. The government have not confirmed the details but the calculations that have been done by the likes of the early years alliance, based on the overall budget they have announced, show they still won’t be paying enough to cover costs. At the moment nurseries use 1, 2 & 3 year olds to subsidise the grant funded children. Nurseries are either going to close or going to have to stop offering government funded places of the government don’t pay more. This is something you really should be lobbying your MP about.
Dermatology (NHS)
My little one is 7, and in early February we noticed a raised / red / inflamed mole, that didn't seem to get better after a week.
Eventually managed to get GP to check him out, who issued an urgent referral to Dermatology at the children's hospital. The letter we received said we'd be seen in 2 weeks.
Various phone calls to the unit, visits to ask the GP to do something, turning up at the unit in person unannounced etc.
Weve finally got the service to agree to look at him.....on the 28th April
My little one is 7, and in early February we noticed a raised / red / inflamed mole, that didn't seem to get better after a week.
Eventually managed to get GP to check him out, who issued an urgent referral to Dermatology at the children's hospital. The letter we received said we'd be seen in 2 weeks.
Various phone calls to the unit, visits to ask the GP to do something, turning up at the unit in person unannounced etc.
Weve finally got the service to agree to look at him.....on the 28th April
Previous said:
Dermatology (NHS)
My little one is 7, and in early February we noticed a raised / red / inflamed mole, that didn't seem to get better after a week.
Eventually managed to get GP to check him out, who issued an urgent referral to Dermatology at the children's hospital. The letter we received said we'd be seen in 2 weeks.
Various phone calls to the unit, visits to ask the GP to do something, turning up at the unit in person unannounced etc.
Weve finally got the service to agree to look at him.....on the 28th April
That is a very odd story. What did the mole turn out to be?My little one is 7, and in early February we noticed a raised / red / inflamed mole, that didn't seem to get better after a week.
Eventually managed to get GP to check him out, who issued an urgent referral to Dermatology at the children's hospital. The letter we received said we'd be seen in 2 weeks.
Various phone calls to the unit, visits to ask the GP to do something, turning up at the unit in person unannounced etc.
Weve finally got the service to agree to look at him.....on the 28th April
Ian Geary said:
...
In my view: more money needs spending in the short term and medium term.
Most would agree (even dentists) apart from the most ardent tax payer alliance "I'm alright jack" types. (But they can usually be ignored quite easily, as they tend to forget how their comfortable position was attained on the back of public spending.)
...
Most people don't seem to agree to want to pay more tax.In my view: more money needs spending in the short term and medium term.
Most would agree (even dentists) apart from the most ardent tax payer alliance "I'm alright jack" types. (But they can usually be ignored quite easily, as they tend to forget how their comfortable position was attained on the back of public spending.)
...
Most/all people agree that someone else should pay more. But that's different
We are still running a deficit and have a stonking national debt. Unless you can persuade everyone to pay more tax, whether you want nice teeth, free nursery care, more soldiers or a sextuple locked pension, you're s
t out of luck. Maybe getting those to pay for services they need if they can afford it (due to the public services provided...perhaps), then the tax they pay can help those who cannot afford it, isn't that bad an idea. But if the residual isn't enough to cover those who cannot afford it, more tax it is (or less service elsewhere).
For me, as a working person, the GP service is inaccessible. When you ring the phone is rarely answered with 45 mins + on hold, and when you do get through at our surgery it goes like this:
"Hello, XXX Street Surgery"
"Hi, I'd like to make an appointment to see a Doctor"
"Are you under 18, on our priority list or retired?"
"No, none of them."
"Well then the first appointment is in 3 weeks for you... If it's urgent you can go to A&E..."
"Err, OK, thanks."
It's fantastic that the Vikingettes always get seen same day, but the working population effectively has no access to Doctors.
I'd even argue that early morning/late afternoon appointments should be given to school children and workers, so that they can go onto school/work or come in from there. Those who are retired/long-term sick can come in later.
"Hello, XXX Street Surgery"
"Hi, I'd like to make an appointment to see a Doctor"
"Are you under 18, on our priority list or retired?"
"No, none of them."
"Well then the first appointment is in 3 weeks for you... If it's urgent you can go to A&E..."
"Err, OK, thanks."
It's fantastic that the Vikingettes always get seen same day, but the working population effectively has no access to Doctors.
I'd even argue that early morning/late afternoon appointments should be given to school children and workers, so that they can go onto school/work or come in from there. Those who are retired/long-term sick can come in later.
julian64 said:
Previous said:
Dermatology (NHS)
My little one is 7, and in early February we noticed a raised / red / inflamed mole, that didn't seem to get better after a week.
Eventually managed to get GP to check him out, who issued an urgent referral to Dermatology at the children's hospital. The letter we received said we'd be seen in 2 weeks.
Various phone calls to the unit, visits to ask the GP to do something, turning up at the unit in person unannounced etc.
Weve finally got the service to agree to look at him.....on the 28th April
That is a very odd story. What did the mole turn out to be?My little one is 7, and in early February we noticed a raised / red / inflamed mole, that didn't seem to get better after a week.
Eventually managed to get GP to check him out, who issued an urgent referral to Dermatology at the children's hospital. The letter we received said we'd be seen in 2 weeks.
Various phone calls to the unit, visits to ask the GP to do something, turning up at the unit in person unannounced etc.
Weve finally got the service to agree to look at him.....on the 28th April
It seems to have gone down a bit, and not getting any worse.
Wish I still had family private health, but moved jobs a while since then and new employer doesn't offer it.
NHS dentistry… no easy fix.
Current contract is not great so many professionals decide not to work on that environment which is hard from a business point of view. It’s like a fast food joint. Perhaps some dentist don’t want to flip burgers and prefer more interesting work where you need more time, better materials, labs (costs) and have a more rewarding day (not necessarily financially).
I have done it many years ago… the prospect to fitting 30 treatments in 7.5h with no time to do high quality work is depressing. Not for me anymore.
There is a shortage of doctors, dentists, etc. I can only talk as a dentist but NHS work is not rewarding at all you are run to the ground and work like a dog. Good for the youngsters, as you progress in your career and skill you are not doing it.
More money would help some stay in for me no money would make me consider going back unless you could do a good job and for that you need more time per patient.
Saying that I know a few colleagues that ‘dedicated’ their life to NHS dentistry and good for them. I work hard as any but I want to do nicer work that is outside the scope of the NHS.
Agree with OP that access should be easier but not sure how to fix it. Nationalised dentistry would cost more than current funding by a huge factor.
Current contract is not great so many professionals decide not to work on that environment which is hard from a business point of view. It’s like a fast food joint. Perhaps some dentist don’t want to flip burgers and prefer more interesting work where you need more time, better materials, labs (costs) and have a more rewarding day (not necessarily financially).
I have done it many years ago… the prospect to fitting 30 treatments in 7.5h with no time to do high quality work is depressing. Not for me anymore.
There is a shortage of doctors, dentists, etc. I can only talk as a dentist but NHS work is not rewarding at all you are run to the ground and work like a dog. Good for the youngsters, as you progress in your career and skill you are not doing it.
More money would help some stay in for me no money would make me consider going back unless you could do a good job and for that you need more time per patient.
Saying that I know a few colleagues that ‘dedicated’ their life to NHS dentistry and good for them. I work hard as any but I want to do nicer work that is outside the scope of the NHS.
Agree with OP that access should be easier but not sure how to fix it. Nationalised dentistry would cost more than current funding by a huge factor.
We moved house 10 years ago, but had to keep the same dentist as there is no one near the new place taking on NHS patients. It's a 40 mile round trip, so could be worse. I have had to pay them to get private treatment for the hygienist and an extraction though.
We have got a local doctor, but getting anything apart from a phone appointment is impossible. If it's urgent, they just refer you to A&E. I used to see a diabetic nurse for an annual check up, but that is now done by phone, with no plans to return to normal. Blood tests are done quite quickly, although the surgery is deserted when you go down there, which still feels a bit wierd.
Any other health issues I tend to go private for, as we get healthcare through work, which is exceptionally good.
We have got a local doctor, but getting anything apart from a phone appointment is impossible. If it's urgent, they just refer you to A&E. I used to see a diabetic nurse for an annual check up, but that is now done by phone, with no plans to return to normal. Blood tests are done quite quickly, although the surgery is deserted when you go down there, which still feels a bit wierd.
Any other health issues I tend to go private for, as we get healthcare through work, which is exceptionally good.
vikingaero said:
For me, as a working person, the GP service is inaccessible. When you ring the phone is rarely answered with 45 mins + on hold, and when you do get through at our surgery it goes like this:
"Hello, XXX Street Surgery"
"Hi, I'd like to make an appointment to see a Doctor"
"Are you under 18, on our priority list or retired?"
"No, none of them."
"Well then the first appointment is in 3 weeks for you... If it's urgent you can go to A&E..."
"Err, OK, thanks."
It's fantastic that the Vikingettes always get seen same day, but the working population effectively has no access to Doctors.
I'd even argue that early morning/late afternoon appointments should be given to school children and workers, so that they can go onto school/work or come in from there. Those who are retired/long-term sick can come in later.
Quite a long time ago, in Kennington, south London, I called the surgery for an appointment and they asked whether I worked. When I confirmed I did, they said “use the right hand queue, so you are seen first” on the logical assumption that those that didn’t work had more flexible schedules."Hello, XXX Street Surgery"
"Hi, I'd like to make an appointment to see a Doctor"
"Are you under 18, on our priority list or retired?"
"No, none of them."
"Well then the first appointment is in 3 weeks for you... If it's urgent you can go to A&E..."
"Err, OK, thanks."
It's fantastic that the Vikingettes always get seen same day, but the working population effectively has no access to Doctors.
I'd even argue that early morning/late afternoon appointments should be given to school children and workers, so that they can go onto school/work or come in from there. Those who are retired/long-term sick can come in later.
When the doctor saw me, and realised I am one of those stupid men who let things go too far before making an appointment, he said “if you feel you need to come for anything again, tell the receptionist I said it was fine to get a booking immediately”.
donkmeister said:
And that is back to the start... As a taxpayer I'm paying for NHS services that I cannot access. Going private does not mean I cease paying for the services.
Excellent trolling, top class, I'll leave it there.
You're possible one of the many on PH who is a "Net Contributor". Unfortunately there aren't enough people like you which means that our Public Services are chronically underfunded. If we funded them better by collecting more in taxes then more people would be able to access them. We get what we pay for.Excellent trolling, top class, I'll leave it there.
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