More loss of health services in UK because too many people

a reply to: uncommitted

Not adverse to privatisation where it works however here is why I don't think it works for healthcare.

In most industries there are two basic factors to consider. Keeping costs down and keeping customers happy (big simplification but bear with me).

If a parcel delivery company outsources functions to save money, even one that don't affect customers directly, it needs to make sure service is maintained or it will lose customers through knock on affects on customer services.

In healthcare it is very difficult to create adequate competition between providers (the US tries and fails). In the UK the NHS is a monopoly provider for a lot of healthcare.

This means that privatisation is only concerned with brining costs down with little regard for quality of service.

a reply to: ScepticScot

It's an interesting one to be sure, but I'm not sure 'with little regard for quality of service' is something that is guaranteed, if it was, trust me it would soon lead to reduction in business where the privatised service is public facing.

Catering is to a large extent now privatised in the NHS. Is that a good thing or a bad thing? Well, my other half works in the NHS and I do an awful lot of the cooking

If a company is geared to providing a catering service of at least the same level of quality at a reduction in the cost to the NHS for staff, admin overhead, procurement and storage of goods etc., then for a government to not consider it would be considered by some people to be wasteful. The same with overall cleaning and maintenance.

I personally think the fundamental issues with the NHS are much deeper than that - the design is still by and large based on a model 60 years old and if a government of any colour attempts any level of change it will always be attacked harshly for its assault on our 'crown jewel'. I guess we either accept that or take off the rose tinted glasses. If it doesn't happen in the next two or three generations it's possibly going to be too late to carry on regardless.

a reply to: uncommitted

It is not a Utopia. It is the bare minimum I expect having paid my taxes. I do not pay my government so it can buy services from companies. I pay taxes so that it can do the work it needs doing and pay people under its employ to do it. I do not pay taxes so that some git can take home millions in yearly pay and benefits, store them off shore, and get away with it.

I do not pay my taxes so that the money I pay can disappear from the countries economy.

The only people operating government services, should be employees of the state, and that is simply how it has to be.

a reply to: TrueBrit

I do not pay my government so it can buy services from companies

I'm not quite aware why you think you were given that option? Should the state employ builders directly to build hospitals? Metal working factories to build lifts? Pharmaceutical companies to make drugs?

The only people operating government services, should be employees of the state, and that is simply how it has to be.

Say what you like, it's still a socialist utopia. I'm not saying that as though it's necessarily a bad thing, some people would say the government is there to govern, not manage businesses. I'm old enough to remember how some of our national services were frankly third rate.

a reply to: Revolution9

I live in the UK and isnt this madness. I remember hearing not long ago government saying how they will save Britain millions maybe even billions and be able to show it in the next 5 years. Yeah, sure. They go right for the poor, disabled and those in need of healthcare. What kind of sick game are they playing.

The introduction of PIP Personal Independence Payments here in the uk run by Capita and Atos known for making millions of their takeover of assessments. link

Which shows how dark this process is, they are not asking questions designed for illnesses, only the very extreme cases where you cannot move, whatsoever. I know this first hand as my mother went through hell recently and still ended up without her payments.

They want to suck everything from those that cannot argue, as if this was aimed at working people, they would jump at such unlawful charges and changes.

originally posted by: chr0naut
a reply to: Revolution9

Well, the success of the UK's subsidised health system is an ongoing embarrasment for the US, on both sides of big gov.

Could this story be a CIA plant?

It is NOT subsidised, the money for it comes out of taxes, The guy/lady in the street pays 43% of their income in various taxes, The air is free in the UK, and that's it.

originally posted by: PaddyInf
The NHS was set up when a greater proportion of the population were of working age.

Whether you like it or not the biggest problem with the NHS is that we're living longer. Life expectency when the NHS was formed was 66 for men and 71 for women. It is now 77 and 81 respectively. People are living for 10-11 years longer and are increasingly in need of resources each year they live.

There were far fewer healthcare options in 1948 as opposed to the myriad of highly expensive treatments which the NHS pays for now, many of which are cosmetic or through lifestyle choice.

A greater percentage of the people are above pension age and so are not paying taxes. Older people in general terms have greater health needs per head.

You can blame Johnny Foreigner all day, but it is the elderly who are the greatest drain in resources.

Life expectancy is only increasing because people aren't being killed in World Wars. In many cities, the A&E units are being used to treat those injured in alcohol related accidents (falling, tripping) and drug overdoses. We've got two relatives in our family, both of whom liked to drink. Both had strokes and ended up paralyzed and dependent on teams of carers.

Other people are getting ill due to bad eating. Supermarkets in the UK sell so much junk food; crisps, soft drinks, instant meals. The latter is literally toxic. It will make you put on weight even though it's the same weight as a a home cooked meal. That too leads to strokes.

I was at an A&E unit recently (to get an emergency prescription) where there aren't any foreigners. The place was empty mid afternoon. By early evening it was jam packed with families with children. Not a single person had a broken leg, burns, sore tooth or was dripping blood; at most coughs and sniffles. Mainly because the GP's don't work weekends.

Only one elderly person was on a trolley being shuffled from treatment bay to treatment bay - each bay has a particular purpose (eyes, respiratory, general). The whole clan was there to provide moral support.

originally posted by: pikestaff

originally posted by: chr0naut
a reply to: Revolution9

Well, the success of the UK's subsidised health system is an ongoing embarrasment for the US, on both sides of big gov.

Could this story be a CIA plant?

It is NOT subsidised, the money for it comes out of taxes, The guy/lady in the street pays 43% of their income in various taxes, The air is free in the UK, and that's it.

Individual medical costs are paid from the pool collected via tax. As 100% of the population will require some kind of medical services, it makes sense to even out the relative costs and collect the required funds from the general public. It is a way of supporting all citizens rather than the rich and ensures that medicine is still a financially viable industry.

There are third world countries with fairer and cheaper public medicine than the US.

a reply to: stormcell

WW2 ended in 1945. The NHS was formed in 1948. If this was the case then there would have been a noticable dramatic leap in life expectency. There would also have been a more marked difference between men and women, as it was primarily men who went to war. Instead the increase has been slow and steady, and there has been an almost equal growth between the sexes. It is more likely a combination of socio-economic reasons such as access to healthcare, changing employment models, access to nutrition, improving social care etc.

As far as hospitals are concerned, you need to look past the A&E waiting room. Huge numbers of sick elderly people come through the doors with pneumonia, falls, infections, wound problems etc. These invariably need admitting and spend weeks at a time on the ward needing treatment. Bear in mind that the average stay in a general medical ward costs around £400 per bed per night. This does not include any surgical treatment (fractured neck of femurs are particularly common in the elderly following falls).

Elderly people take longer to recover in general, so spend longer on the ward needing active treatment. Discharge is a slow process as they usually need care packages introduced or amended and home adaptions prior to discharge, with follow on OT and social care input, as well as subsequent primary care reviews and treatment from district nurses. I'm not saying this isn't needed but all of this comes at a cost.

Chances are that your long A&E wait is because there are people in the department awaiting a bed on the wards. The most common reason for beds not being available is because they contain elderly people fit for discharge but awaiting care packages being put in place. This is £400 per night for an essentially well person but who's age related needs prevents safe discharge (often referred to as bed blockers).

Many of your chronic illnesses only manifest in older age, and healthcare has improved to the extent that people are living longer with chronic illnesses. These all need treatment. More money.

Yes a large proportion of those going through A&E are drink and drug related. However it is the long term stuff that really drains resources. Pissheads are dealt with in the department and then kicked out, or might get an overnighter if they need it. Yes when you visit hospital this may be what you see in the waiting room, however this is often because the elderly (or those with the serious injuries/illnesses you mention) are brought in by ambulance and straight into the treatment areas rather than through reception.

I'm not advocating mass euthanasia or anything. I'm simply stating that the NHS was set up to deal with life expectency in the 1940s. I have a real soft spot for the NHS but it needs massive overhaul to address modern life. Blaming immigration for all of our woes seems to be the default setting these days. It is a lazy argument and only masks most of the real problems.

a reply to: ScepticScot

You're right, in that healthcare is a very different animal. But why would a government want to provide a better product for consumers, than a for-profit business, in a competitive environment?

a reply to: carewemust

Failings in the NHS are attributed to the government, who in turn need positive public opinion to get voted in at the next election. The NHS is a massive vote swinger in the UK.

originally posted by: carewemust
a reply to: ScepticScot

You're right, in that healthcare is a very different animal. But why would a government want to provide a better product for consumers, than a for-profit business, in a competitive environment?

Because fit is very difficult to have a truly competitive market for healthcare. Reasons include but not limited to

- it is difficult for people to make informed decisions about many areas of healthcare and are entirely led by what doctors tell them.
- one of the most important aspects of competition, the ability not to purchase at all is absent for non elective treatments.
- start up costs are extremely high (no small business is going to set up a new hospital)
- even if choice given at the customer facing level there will inevitably be monopoly providers in the supply chain (hospitals, pharmaceutical companies). Diversification amongst health care providers just weakens the negotiation position with these.

Basically the requirements for a successful market place that actually benefit customers are almost entirely absent in healthcare.

The argument is often made that the problem with US healthcare is too much government involvement. However the US has less government involvement than any comparable country and yet has amongst the worst healthcare overall in almost every single study. It is hard to see how this is an argument for greater privatisation anywhere else.