Hunt

[Digby]

Probably worth remembering that it's not first come first served at a&e. Those waiting for a long time are likely not in any grave danger.

My Gran waited 8 hours whilst it turns out having a stroke, but they couldn't they claimed get to looking at her as they were trying to deal with any number of drunks, I could make a joke about that being Bridgend but really the cost of then having to look after a person who never got back to being able to look after herself was significant for both the individual and the health and social services she she partook of.

Even if they think they've sorted people by risk they frankly will not know.

[canta_brian]

In many way this simply highlights the challenges the NHS faces in a&e. They generally get it right, but everyone has an example of where it has gone wrong. Obviously for those individuals effected the results of not getting it right can be life altering. It's no wonder that a&e departments tend to have high staff turnover.

[Digby]

Also worth noting much of the extra money Hunt has found for the NHS for ongoing/normal work simply comes from the capital spend budget, and so Hunt is simply stockpiling issues for years to come where at some point someone will have to sign off on the capital spends and during some interim period we'll be paying more for some lesser returns. It is of course easy to paint the Tories as keen to under invest in public services and keen to see public services privatised partly as there seems an inherent belief that something run privately will be better and partly so private firms can get access to taxpayer money, and that's probably true across the party, but they did have some difficult financial choices.

[Sandydragon]

We desperately need to explore funding options. There are plenty of other models out there, how about we stop pretending that the NHS is some sacred cow and look for other solutions.

[Digby]

We desperately need to explore funding options. There are plenty of other models out there, how about we stop pretending that the NHS is some sacred cow and look for other solutions.

I've got no problem paying for the NHS out of general taxation.

[Donny osmond]

Nothing should be treated as a sacred cow, but in the rush to find a fix for the problems, lets not forget just how good the nhs actually is...

http://www.commonwealthfund.org/publica ... ror-mirror

[Sandydragon]

We desperately need to explore funding options. There are plenty of other models out there, how about we stop pretending that the NHS is some sacred cow and look for other solutions.

I've got no problem paying for the NHS out of general taxation.

I'm not sure that's a long term answer though. It would be the quickest fix but in ten years time we could be back to square one.

[Mikey Brown]

Deceitful coward
http://www.independent.co.uk/news/uk/po ... 73546.html

I can't describe how much I hate this cunt.

[kk67]

Private healthcare.....they think they can buy anything. It seems they're right.
It's just blydi queue jumping as they use the NHS services anyway. FFS it's just a middleman creaming off profit. How is this legal..?.

[Digby]

We desperately need to explore funding options. There are plenty of other models out there, how about we stop pretending that the NHS is some sacred cow and look for other solutions.

I've got no problem paying for the NHS out of general taxation.

I'm not sure that's a long term answer though. It would be the quickest fix but in ten years time we could be back to square one.

We might need to limit what the NHS does, especially when it comes to fat and old people, but I don't know why that sees a need to go beyond general taxation as a means to fund and the NHS being free at the point of use. The tax is essentially an insurance scheme that far outstrips what any private health insurer could attain and for all I joined BUPA a long time back I don't think it's especially helpful in the bigger picture, and really if people can pay into a private insurer they can pay more into a general pot

[Sandydragon]

I've got no problem paying for the NHS out of general taxation.

I'm not sure that's a long term answer though. It would be the quickest fix but in ten years time we could be back to square one.

We might need to limit what the NHS does, especially when it comes to fat and old people, but I don't know why that sees a need to go beyond general taxation as a means to fund and the NHS being free at the point of use. The tax is essentially an insurance scheme that far outstrips what any private health insurer could attain and for all I joined BUPA a long time back I don't think it's especially helpful in the bigger picture, and really if people can pay into a private insurer they can pay more into a general pot

That's a valid option. Does the NHS need to do so much? But which services do you cut because I'm sure the papers can find plenty of examples of heart breaking stories.

Something definitely needs to change, the sad thing is that you can't have a debate on it; it's one of those topics where emotion just takes over.

[Digby]

I'm not sure that's a long term answer though. It would be the quickest fix but in ten years time we could be back to square one.

We might need to limit what the NHS does, especially when it comes to fat and old people, but I don't know why that sees a need to go beyond general taxation as a means to fund and the NHS being free at the point of use. The tax is essentially an insurance scheme that far outstrips what any private health insurer could attain and for all I joined BUPA a long time back I don't think it's especially helpful in the bigger picture, and really if people can pay into a private insurer they can pay more into a general pot

That's a valid option. Does the NHS need to do so much? But which services do you cut because I'm sure the papers can find plenty of examples of heart breaking stories.

Something definitely needs to change, the sad thing is that you can't have a debate on it; it's one of those topics where emotion just takes over.

Well I mentioned the other day about the NHS managing to leave my Gran in A&E for 8-9 hours whilst being overrun with drunk people, and that's a crap story which just shouldn't happen. But then I'd also look at some of the work that was put into her post that stroke, much of which saw her spending large chunks of time in a hospital (months of time) as there simply wasn't the social care available to see her discharged given she wanted to stay at her house which was miles from major family, and then she had a number of heart ops when really she was very frail, and it'd broadly imo have been better to move to more palliative care and not spent what must have been a fortune keeping an old lady alive so she could slowly wither barely unable to move, see, talk in the name of health. The amount of money that gets spent on people in the NHS seems to polarise around the first 6 months and last 6 months of life, I'm of course in favour of working to help those in the first 6 months (probably anyway), but I think we've gone a little OTT trying to save people at the other end when they're going to die soon anyway, and we're spending vast sums doing to. I'm not saying just let people die based on age, but there has to be better prospect of a return to a decent standard of living (which doesn't mean able to stay awake long enough to watch Pointless) and if not then we go palliative, albeit much better palliative care than we often have now.

And the good news right now is those I'd be letting die were in the group that voted for Brexit, once this lot are dealt with I'll move on to Sunderland.

[canta_brian]

I'm not sure that's a long term answer though. It would be the quickest fix but in ten years time we could be back to square one.

We might need to limit what the NHS does, especially when it comes to fat and old people, but I don't know why that sees a need to go beyond general taxation as a means to fund and the NHS being free at the point of use. The tax is essentially an insurance scheme that far outstrips what any private health insurer could attain and for all I joined BUPA a long time back I don't think it's especially helpful in the bigger picture, and really if people can pay into a private insurer they can pay more into a general pot

That's a valid option. Does the NHS need to do so much? But which services do you cut because I'm sure the papers can find plenty of examples of heart breaking stories.

Something definitely needs to change, the sad thing is that you can't have a debate on it; it's one of those topics where emotion just takes over.

For me, the first thing that needs to change is attitudinal. Despite the sort of information that Donny posted earlier in this thread, people think Americans receive healthcare of a higher standard than that received through the NHS. If people look at the NHS whilst bearing in mind that it offers great healthcare at incredible value the dialogue might change.

[Digby]

We might need to limit what the NHS does, especially when it comes to fat and old people, but I don't know why that sees a need to go beyond general taxation as a means to fund and the NHS being free at the point of use. The tax is essentially an insurance scheme that far outstrips what any private health insurer could attain and for all I joined BUPA a long time back I don't think it's especially helpful in the bigger picture, and really if people can pay into a private insurer they can pay more into a general pot

That's a valid option. Does the NHS need to do so much? But which services do you cut because I'm sure the papers can find plenty of examples of heart breaking stories.

Something definitely needs to change, the sad thing is that you can't have a debate on it; it's one of those topics where emotion just takes over.

For me, the first thing that needs to change is attitudinal. Despite the sort of information that Donny posted earlier in this thread, people think Americans receive healthcare of a higher standard than that received through the NHS. If people look at the NHS whilst bearing in mind that it offers great healthcare at incredible value the dialogue might change.

At the very top of the US system they do receive better care, but taken as a whole the NHS likely does outperform many others, it's also available to all which isn't the case in the US, and by dint of allowing bloodsuckers to leech from their system the US actually spends more on their health service than we do to achieve in the main worse results.

[Sandydragon]

I wouldn't use the US as an example. Germany was quoted many times this week by the BBC, yet they do, so I'm led to believe, use a form of health insurance alongside taxation.

I'm all for a nhs which proves free at point of delivery treatment to all. The issue I would look at are funding in general or some of the non emergency work.

[OptimisticJock]

Cancer treatment is not emergency work, how is that funded in Germany?

[canta_brian]

Are national insurance contributions not health insurance?

It seems to come down to whether people feel it is ok for every person to have the same access to healthcare regardless of their level of contribution.

[Sandydragon]

Are national insurance contributions not health insurance?

It seems to come down to whether people feel it is ok for every person to have the same access to healthcare regardless of their level of contribution.

NI payments aren't used exclusively for that purpose. In fact I recall their primary purpose is pensions but even that isn't clear cut anymore.

[Sandydragon]

Cancer treatment is not emergency work, how is that funded in Germany?

Idbput life saving work into the must have category.

The German model seems to involve s higher proportion of private money than here plus mandatory contributions that seem to be directed only to health provision.

[canta_brian]

Are national insurance contributions not health insurance?

It seems to come down to whether people feel it is ok for every person to have the same access to healthcare regardless of their level of contribution.

NI payments aren't used exclusively for that purpose. In fact I recall their primary purpose is pensions but even that isn't clear cut anymore.

Fair enough. So split it out, call it NIH and ring-fence it. Same issue though. There will be people who don't like the idea that their % of income is funding someone else's care. I personally don't mind a huge amount, so long as the funds are not channelled to shareholders of medical companies.

[Sandydragon]

I've just checked and NI has nothing to do with he NHs, just pensions and other benefits.

Perhaps NI could be widened to cover all aspects of social care? Broadly sealing, if you pay a compulsory insurance or a tax dedicated to that one purpose, what is the difference? My big problem with just increasing income tax is that the money can go to a range of areas. I do think we need to get rid of the hang up on private involvement in the health sector, but is it we're a state run insurance/dedicated tax scheme then it would encounter fewer complaints I suspect.

Does that cover us for the long term though? As the population gets older and patients have more complex needs asa result, will there ever be enough money in the pot? I do t think that just spending more is the total solution - hence why I would be keen for a complete review of what the NHS is supposed to do, and how it is supposed to deliver those services. An example is the furore over hospital closures, even though larger specialist facilities can offer much better care.

As part of all this, there is a pressing need to reduce the pressure on A&E which is being abused with a good number of patients who could be treated elsewhere. Also, the provision of social care must be reviewed to ensure that patients can be discharged.

[canta_brian]

I've just checked and NI has nothing to do with he NHs, just pensions and other benefits.

Perhaps NI could be widened to cover all aspects of social care? Broadly sealing, if you pay a compulsory insurance or a tax dedicated to that one purpose, what is the difference? My big problem with just increasing income tax is that the money can go to a range of areas. I do think we need to get rid of the hang up on private involvement in the health sector, but is it we're a state run insurance/dedicated tax scheme then it would encounter fewer complaints I suspect.

Does that cover us for the long term though? As the population gets older and patients have more complex needs asa result, will there ever be enough money in the pot? I do t think that just spending more is the total solution - hence why I would be keen for a complete review of what the NHS is supposed to do, and how it is supposed to deliver those services. An example is the furore over hospital closures, even though larger specialist facilities can offer much better care.

As part of all this, there is a pressing need to reduce the pressure on A&E which is being abused with a good number of patients who could be treated elsewhere. Also, the provision of social care must be reviewed to ensure that patients can be discharged.

Don't disagree with any of that.

The idea that social care is locally funded and the NHS nationally means that there is a financial benefit to local councils in keeping patients in NHS beds rather than in social care.

[jared_7]

Cancer treatment is not emergency work, how is that funded in Germany?

So having just come from Germany and stayed with a woman who runs her own specialist practice, the German system works like this:

Everyone has to have health insurance, they pay a 7% tax on their income, and their employers match it for a total of 14%.

They can pick from hundreds of insurers offering the "Public option". The government sets the price of all treatments, so basically whenever you see the doctor for whatever you just show your insurance card and the clinic will later charge the government.

If you make more than 60k a year, you have the option to not pay into the public option and get private insurance.

The standard of care there is absolutely amazing, as good as the top end of US healthcare but without the exorbitant costs. I'm not sure that is what the UK should move to buy one thing the woman I stayed with said (and she said the NHS was amazing in her opinion) was she thought it was ridiculous covering tourists (including EU tourists), which they don't do there.

I'm sort of on board with that, I don't know how much it would save (as well as make when they start charging) but I'm open to the NHS only being free for residents, citizens, or anyone paying or who has paid taxes in the U.K. Assume that's everyone with an NI number?

[OptimisticJock]

I've just checked and NI has nothing to do with he NHs, just pensions and other benefits.

Perhaps NI could be widened to cover all aspects of social care? Broadly sealing, if you pay a compulsory insurance or a tax dedicated to that one purpose, what is the difference? My big problem with just increasing income tax is that the money can go to a range of areas. I do think we need to get rid of the hang up on private involvement in the health sector, but is it we're a state run insurance/dedicated tax scheme then it would encounter fewer complaints I suspect.

Does that cover us for the long term though? As the population gets older and patients have more complex needs asa result, will there ever be enough money in the pot? I do t think that just spending more is the total solution - hence why I would be keen for a complete review of what the NHS is supposed to do, and how it is supposed to deliver those services. An example is the furore over hospital closures, even though larger specialist facilities can offer much better care.

As part of all this, there is a pressing need to reduce the pressure on A&E which is being abused with a good number of patients who could be treated elsewhere. Also, the provision of social care must be reviewed to ensure that patients can be discharged.

Don't disagree with any of that.

The idea that social care is locally funded and the NHS nationally means that there is a financial benefit to local councils in keeping patients in NHS beds rather than in social care.

Yup. The amount if times we get called to pick auld "Mrs Miggins" up off the floor is ridiculous. Now I've no issue going round purely to pick someone off a floor who has no injuries but if comm alarm don't give us the full story, ie that they're not injured haven't been there that long the job gets graded much higher and it means we're going there rather than a genuine emergency and all because the social side is woefully underfunded.

It also does start to raise other points about the level of care and confidence nursing homes provide. Taking people into hospital that could be nursed in their nursing home is another bug bear.

[OptimisticJock]

Cancer treatment is not emergency work, how is that funded in Germany?

So having just come from Germany and stayed with a woman who runs her own specialist practice, the German system works like this:

Everyone has to have health insurance, they pay a 7% tax on their income, and their employers match it for a total of 14%.

They can pick from hundreds of insurers offering the "Public option". The government sets the price of all treatments, so basically whenever you see the doctor for whatever you just show your insurance card and the clinic will later charge the government.

If you make more than 60k a year, you have the option to not pay into the public option and get private insurance.

The standard of care there is absolutely amazing, as good as the top end of US healthcare but without the exorbitant costs. I'm not sure that is what the UK should move to buy one thing the woman I stayed with said (and she said the NHS was amazing in her opinion) was she thought it was ridiculous covering tourists (including EU tourists), which they don't do there.

I'm sort of on board with that, I don't know how much it would save (as well as make when they start charging) but I'm open to the NHS only being free for residents, citizens, or anyone paying or who has paid taxes in the U.K. Assume that's everyone with an NI number?

Yeah that sounds workable. As much as I hate "health tourism" I wouldn't deny anyone emergency treatment.

Has anyone been watching "Hospital"? I've just watched the episode concerning foreigners.