NHS being deliberately degraded to push people into tiered private medical care.

[gumdrop]

A conversation with acquaintances came to the conclusion that this Government was allowing the NHS to degrade toward a non functioning

state when Private healthcare suppliers would be able to step in and the customer would be handled in a tier system based on ability to pay.

How likely do you think this is, you will need to be realistic about your response! Ask your friends.

 

[Sad555]

On a recent visit to derriford hospital the privatised cafe was charging astronomic prices for staff and visitors.

[SteveTheElder]

My thinking is that the NHS is moving that way, and the Gov't is unwittingly allowing it to happen rather than it be deliberate. And by 'unwittingly' I mean through a combination of incompetence and a fear of making tough choices that would lose votes (and that applies to successive governments of all colours/persuasions going back decades).

[@Lee]

Blah, blah £350 million a week blah blah, EU, blah, blah, we have a plan for Health and social care, blah, blah, forty new hospitals, blah, blah, vaccine rollout, blah, blah.

All lies.

[Crasher]

You struggle to get treatment for a illness or disease but you can have a sex change or fertility treatment on the taxpayer.

[J.R.]

2 hours ago, gumdrop said:

degrade toward a non functioning

state when Private healthcare suppliers would be able to step in and the customer would be handled in a tier system based on ability to pay.

Too big a jump for it to degrade towards, it will likely be an insurance assisted system like in my country where the state picks up 60% of the cost, 100% for long term illnesses like diabetes for example, and you pay a health insurer for the remaining coverage which extends to premium treatment with dentists, opticians etc.

 

The safeguard is there for low income people, a category I am currently in, to have a free or subsidised (dependant on income level) mutuelle from the health service.

 

When I did not qualify I did not pay for a mutuelle, my costs even after several serious hospitalisations were less than the cost of a mutuelle, of course on average that is true of any insurance.

Edited 27 July, 2023 by J.R.

[ColinD]

I'd say it's already there.

My reasoning for this is thus.

The last few years, for anything that happened outside of an A&E visit,  I've gone to a private source first. Be that a physio, consultation or a scan. With the outcome, we've then taken that to the GP to skip the long wait/dance, with treatment in most cases on the NHS being excellent. Only a couple of instances did we opt for private as we disagreed with the "it will be fine" lower tier choice.

The other week having spent an age trying to get a GP appt I got a quote for private medical. I'm not there yet, but I thought about it. As indicated for minor niggles and injuries I go private now. I can, so my thinking is ok it's £60 an hour, sort it this week, or limp/suffer for 2 weeks to get to GP then wait 12wks for a 15min physio slot. By which time the injury has either sorted itself, caused more harm, or I've gone to my local physio anyway.

For bigger things, like IDK, I break a leg, I'll be in the A&E and processed through that. I don't believe the NHS should be used for a lot of the things it is used for, I also believe it's horribly mis-managed. Problem is we don't see those people, they are not the nurses, doctors, porters who are struggling in the crap pay, conditions, hours and often against the poor management.  So yeah it's already a two tier system, I can bypass it so do if I can. I don't think the NHS will survive another term, it's the greatest ball and chain this country has. We can never get rid of it, we can never fund it to cover every nuance of humanities needs. 

I also feel having the right to die; euthanasia, will relieve a huge burden. I for one fully plan on not having my backside and mouth wiped 3 times a day by a care team, I'll be going private for that day i suspect.

edit: forgot to say the NHS should totally be there to cover those who cannot afford, a health service to keep you healthy or get your the body/mind to be able to at least in part keep yourself healthy where possible.

Edited 30 July, 2023 by ColinD

[mac11irl]

im writing this just to remind myself to respond properly later when i have time... and describe my recent NHS experience as a tourist. and our multi tiered system in Ireland..

 

right Im back -

1) NHS Tourist..

while in Scotland last week i and both spuds ended up with ticks. only noticed when i found one on jr's leg. queue a minor ah **** now what.. followed by googling etc as described in another thread. Then followed by ringing a nearby GP the next morning. registered as temp patients, emailed photos through and later that day a phone consult to advise i need anti biotics, not for the kids unless necessary and we all need blood tests when we get home. local chemist pulled the tick from jr's leg for us. I then went to get the prescription in the other village and happy days. total cost to me a tourist inc the A/B? approx £1.50 for petrol bumbling about to places.

thoughts on the event? quite efficient and well handled. if i asked my chemist at home to pull a tick im confident he would be ringing my go to advise i need a dementia assessment. if i asked my gp to do it, its 50/50 they send me to hospital to waste 6hrs.

do i think i should have had to pay something? yes.

why? because i dont contribute to the NHS, so why should get free cocer as a tourist? even a nominal 10quid charge for the consultation and medication?

 

now.. the Irish worst of both.

we dont have a 2 tier system that you guys are worrying about. we have about a 15tier system.

everyone pays towards "social Insurance". this covers dole and medical care etc however, the cover is means tested. if you are on social welfare or below a set income threshold youll get a medical card. our gps are independent but on fixed contracts to the HSE, so you pay them if not on a med card or the government does if you have a card. all kids under 7 now get a card, but that only came in about 8yrs ago. gp costs 55 to 90 quid per visit plus any test costs depending on where you go. so thats 2 tiers for the gp already but theres another. some employers like mine have GP schemes - ie I pay a bit every month at source and i then dont pay for gp visits.

should you need specialists / hospital - Public or Private options available.. Public means free but there may be admin charges not covered and waiting lists can be months long for all services, even physio or ENT.

private health insurance is a mad mine field of what is ir isnt covered depending on how much can afford to pay thus the several tiers that apply. going private will allow you jump those queues by varying amounts depending on how much cover you have, and what locations are covered. mm - not every insurance company covers every hospital or consultant.

also prescriptions - there is a drug payment scheme, where you pay as a household the first 75e per month of any prescription meds, after that its covered by government. i cant remember if thats means tested for the level of cover or for if you qualify. 

ya know how Calpol and stuff is covered on NHS from chemist? no OTC meds are covered by the drug payment scheme.

 

irs pretty messy, and horrendously run and administered. the HSE is a management heavy and admin centric horror show of inefficiency and stupidity (google the saga about the most expensive building in the world  aka the still unfinished National Childrens Hospital - TLDR : it was tendered with a plan drawn by somebody who was in a hospital waiting room once as a kid on a paper napkin and so the contractor is making a mint on design change claims etc to sokve all the poorly thought out design issues.)

 

 

so, is the nhs being broken on purpose? i dont think so, governments change but the civil servants who really run depts don't change... they are the real shot callers and elected reps are just a face to take the flack imo.

 

Edited 31 July, 2023 by mac11irl

[skomaz]

On 30/07/2023 at 13:33, ColinD said:

The other week having spent an age trying to get a GP appt...

 

I don't believe the NHS should be used for a lot of the things it is used for...

 

I also believe it's horribly mis-managed

 

We can never fund it to cover every nuance of humanities needs. 
 

 

Those 4 quotes seem to have summed up the current position of the NHS quite nicely...

 

1) GPs are causing an issue due to not being able to get an appointment (my mum's is still using the Covid card to put people off making appointments and ours is just plain useless - want an appointment?  How about in a fortnight's time...?)

 

2) The NHS get used for stuff it shouldn't be for (social care??)

 

3) Mis-managed big style - very inefficient - if it was a business it would be out of business with some of the archaic management regimes and practices used but suggest modernising and you get short shrift (albeit granted some areas are excellent - like the eye clinic at Sheffield Hallamshire and Ryegate Children's Centre).

 

4) Funding - it's not all about money - see point 3 above

 

All IMHO of course based on a LOT of experience...

[Aspman]

the thing is, remember, that the NHS is not free. It's "free at the point of delivery". We all pay a significant proportion of our tax just to cover the NHS.
[Rant]

Now the NHS is being starved of funds, and many people are going private (I've personally forked out 5 figures to pay for private ops for both my parents when NHS waiting times were seriously affecting their health).
The current Tory government likes to look at the US model as one that fits its religeous fanatacism with market forces.

Except, in the US they're not taxed as much as us, if my tax was to drop £200 a month then I paid £200 a month for better private healthcare then I think I'd be ok with that. But that is not what is happening.

What we are getting in the UK is pushed into a US model whilst still paying the full tax burden for a non working social health system.

Like everything else in this bloody country.

To fulfill the green agenda we're taxed out of private transport, except public transport has been removed and what remains is unreliable and super expensive. Then the gov calls us all lazy for trying to save money by working from home and not going into the office (on the non-existant public transport network) to prop up their pals commercial property portfolios.

Taxed out of using gas for heating, except electricity is 4x the price and doesn't suit our homes/climate and so the option to use anything but electricity is therefore removed to force the issue.
Except domestic supplies (60A commonly), generation and the grid can't actually cope with an all electric country. But to fix that would require some investment and joined up thinking.

They call people lazy for not taking minimum wage jobs which don't pay enough for the employees to travel to the work destination or live near their work.
Support decades of below inflation payrises by gaslighting workers into thinking that the world will end via inflation unless they are paid less every year then gets uppity when they can't find anyone to clean their bogs in London for £10 an hour where the average rental is £2500 a month.
 

I can actually see why people believe that there is a grand conspiracy to have everyone work for a basic universal income and a bonus of food. But the thing with conspiracies is that it takes talent, skill and discipline to run a conspiracy. Our political class is made up of inbreeds and the mentally defective who struggle to put on trousers in the morning and spoon food into the right hole without three Spads and a mistress or two..

The UK is Blessed with sucessive governments that like to kneecap the population then accuse it of being lazy and not running fast enough.
[/Rant]
 

Edited 1 August, 2023 by Aspman

[Breezy_Pete]

Excellent rant!

I'm lucky enough to have only good things to say about the NHS, though I think cancer care is probably something of an outlier in levels of efficiency and 'caringness'.

I even have GPs who appear to listen carefully and act wisely.

It ain't all bad everywhere.

 

[J.R.]

1 hour ago, Aspman said:

Taxed out of using gas for heating,

 

Has the VAT rate increased or are there any other taxes on gas that has increased?

 

I have not paid a UK gas bill in 2 decades so I dont know, I do know in my country that gas, electricity and water are cheap but there are so many different taxes added then taxes on taxes that the breakdown spills off the page, they only ever quote the headline unit cost but the actual cost is far higher.

 

I will give you an extreme example, the water here costs maybe €3 per cubic meter, I dont know the exact figure because I use very little and its the taxes, standing charges, environmental levise, sewage charges (even though I am not connected) and taxes (on taxes) on them that are the majority, I paid €400 last year for 3m3 of water consumed.

[Aspman]

1 hour ago, J.R. said:

 

Has the VAT rate increased or are there any other taxes on gas that has increased?

 

I have not paid a UK gas bill in 2 decades so I dont know, I do know in my country that gas, electricity and water are cheap but there are so many different taxes added then taxes on taxes that the breakdown spills off the page, they only ever quote the headline unit cost but the actual cost is far higher.

 

I will give you an extreme example, the water here costs maybe €3 per cubic meter, I dont know the exact figure because I use very little and its the taxes, standing charges, environmental levise, sewage charges (even though I am not connected) and taxes (on taxes) on them that are the majority, I paid €400 last year for 3m3 of water consumed.

I think in all honesty that on climbing my high horese accuracy may have been sacrificed.

UK is on a carbon net zero political path which means that gas boilers for heating homes are being phased out and are (as I understand) going to be banned from being installed from 2030 or some such.
Currently there is a big push for electric heating systems (usually heat pump based). I'll not go into the emotional hole that is the whole heatpump debate but in short (and I do have one of them so I'm speaking from a place of experience) they are not best suited to UK housing stock or climate.
However the main problem with electric heating is that unit for unit electricity is substantially more expensive than gas (3-5x).

So the UK population are being forced by removal of other choices to use a heating system which is arguable less suitable and definitely more expensive. the Government also currently subsidises gas from electricity so it has deliberately engineered its preference of energy source to be the most expensive.

i.e. again the government is saying "you must take this option, and to help we've made it even more expensive for you via tax".
 

[Paws4Thot]

@Aspman You missed the bit where Hector McGlumpher is on benefits, signs off for 6 weeks to harvest crops, then tries to sign back on and spends 12 weeks with no income whilst he raises and files, then the Department of Total Obscurity (formerly "Work and Pensions") processes his "new claim".

[@Lee]

48 minutes ago, Aspman said:

UK is on a carbon net zero political path 

Aye, by expanding oil and gas drilling  

Looks like the unelected Sunak is going back on pledges the party was voted in on. At least to me anyway.

[Aspman]

5 minutes ago, @Lee said:

Aye, by expanding oil and gas drilling  

Looks like the unelected Sunak is going back on pledges the party was voted in on. At least to me anyway.

I'm not sure you'll shock anyone with a headline of "Party dumps manifesto after winning election"