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Full support from here and I shout loudly for the NHS and the great staff.
If only we chould all get the Boris to fund the false advert £350 million a week to the NHS, it takes the piss that that he can earn a million for 5 after dinner speeches, there is no justice.
Keep up the good work.
The increase in NI for social care (which would be paid by a much larger proportion of workers) didn’t survive the first encounter with the enemy
Precisely because it was seen as unfair, not because it was a tax increase to provide extra funding for social care.
Despite claiming to be huge fans of Adam Smith the Tories initially chose to ignore, as they often do, one of Adam Smith's four canons of taxation - equity.
The National Health Service, and social care, is very much based on the principal of "from each according to their ability, to each according to their need", when it comes to access.
Labour, the SNP, and the LibDems, all ostensibly to the left of the Tories, strongly opposed the proposed increase in NI. Not because they didn't approve of extra NHS funding through taxation, as my above link to Labour's vote winning taxation proposal suggests, but because extra funding has to be provided in a fair manner.
If I didn't make that caveat obvious in my original comment it's only because I thought it was self-evident!
Tax the banks and energy producers, close the tax loopholes, and fund the NHS - it's a certain vote winning policy! But not very Tory.
https://www.theguardian.com/business/2022/aug/02/big-oil-profits-energy-bills-windfall-tax
https://www.ft.com/content/2f643032-5ec0-40c7-bf60-8ac3a6c846ce
I had the same idea and forwarded it to Labour who thought it was shit.
Give tax payers the opportunity to overpay taxes, but they can specify where it goes- NHS, Policing, socia care, give a few nice options.
Say you do your Self Assessment, you’ve had a massive year so you stick £5k extra in for NHS.
The terms and conditions may be, it goes directly into the account, must not then lead to less cash from GOVT, and within 5 years if you have a bad year you can pull half back.
If companies overpay- they could be shout about it.
Thinking about it, who would overpay while the super rich pay **** all. It’s not going to work.
Ambo bod here. I find this thread heartening, thank you. But it’s too late, I fear. We are seeing system collapse in my area as I type. There are many cases outstanding in my area for over 24hrs right now. It’s invariably old people on the floor because our stupid system prioritises young people who have a variety of relatively minor ailments, for reasons no one seems to be able to fathom, or solve, much to our unending frustration. We have multiple resources unable to offload at hospitals all over our region. As I type, a close friend is still waiting to offload a poorly patient since 1000 this morning. Their shift ended at 1845. My colleagues are broken. They no longer feel valued. Motivation and morale are lower than I’ve ever known. We are losing staff to multiple more lucrative, less stressful vocations both in and outside the NHS, and who can blame them? Paramedics who self fund their qualifications end up in £30k+ of debt for the privilege of earning (relative to the graduate market rate) shit money, on relief shifts, working nights and weekends, treated like an expendable bum on a seat rather than a human being and not finishing on time. Ever.
This is just the Ambo story. Poor nurses, doctors and associates in hospitals are broken. There’s no longer any motivation to work fast or smart. Sickness levels are through the roof.
Sunak threatens legislation to provide ‘minimum staffing levels’ during strikes; you know what, minimum staffing levels when there AREN’T strikes would be a good start mate! FFS.
It’s ****ed. The Tories have won.
The Tories have won.
The Tories have been continuously shooting themselves in foot for over a year now.
I don't think the healthcare workers dispute they are currently engaged with is something which they are relishing. Believe me this is not going according to Rishi Sunak's preferred script.
As the Tories stagger from one disaster to the next one thing is certain - the current Parliament will be automatically dissolved in two years minus two days if it isn't dissolved before then.
To hang on to the very end will quite rightly be seen as an act of desperation, which will reflect very badly on the Tories. For that reason it is more likely that a general election will be called in 18 months time.
It is highly likely, to say the least, that there will be no Tory majority government after the general election, much more likely they will suffer catastrophic loses.
As a consequence the Tories's priority for the next 18 months will be to limit the inevitable damage which they will face. The last 'mini budget' had this in mind. The Tories are, despite their huge majority, actually in a significantly weak position.
Another 18 months of Tory government is clearly a grim prospect for anyone working in the NHS, or relying on care from the NHS, but I wouldn't describe it as a victory for the Tories, more digging their own graves.
A functioning NHS is something which effects a huge demographic cross-section of society in a way that not many other issues do.
Ernie, I largely agree with your analysis, except in the assertion that this isn’t going Sunak’s way. I can’t help but think that Sunak et al, knowing full that they are outta here in 18-24months, are hell bent on the ideological destruction of everything that Tories hate. Socialised health care, unions, the spirit and rights of the working (including the working middle) classes. All whilst lining their own pockets and lining up their positions of influence and power in various directorships. They have NO political incentive whatsoever to bring the current widespread industrial unrest to a mutually satisfactory solution, as evidenced by their constant union baiting behaviour. In fact I believe that they think that the worse condition that they leave the country in the better, because the incoming Labour government can then be sniped and attacked and blamed constantly by the puppet media, and most of the population will suck it up, and return a rejuvenated Tory majority in six years time. It’s all so ****ing depressing. Money always wins over humanity.
A functioning NHS is something which effects a huge demographic cross-section of society in a way that not many other issues do.
Less so if you are actively trying to create a two tier health system; a basic, no frills starved of funding NHS and a pay as you go, top up if you’re wealthy enough aspirational private health care system.
It’s the ‘aspire to own your own home’ strategy of this generation.
Tax avoidance of the other hand costs the country at least 35 billion a year
Yes a staggering amount that someone really should try harder to obtain.
vs £300 million, I know where I’d rather HMRC and the Govt focus their attention to generate revenue.
£300m isn't too insignificant is it though?
How many extra nurses, paramedics etc would that fund per year?
Not to mention the additional patients that could be treated due to freer beds & resources.
£300mil is actually fairly insignificant, when spread across the service IF it’s even an accurate number. It would cost a significant amount in admin and enforcement to try to collect, it’s likely that many either can’t or won’t pay, hence why they are willing to travel across the globe for frankly, average care (if they could afford to pay there’s much better options) and refusing to treat people would be inhumane. So there are much better uses of resources. Stop trying to incite jingoistic hatred, please; it’s a distasteful, divisive and transparent dog whistle tactic.
As an NHS clinician I’m happy to treat humans in need wherever they hail from originally, it’s the humane thing to do.
Best place to put any additional funding is into social care and free up beds and skilled health care professionals to concentrate on people who need medical care. The problem is those requiring social care is rising exponentially due to increased age, terrible lifestyles, increasing expectations of support, growing population etc. so that may be a temporary solution. Pay rises for current health care professionals aren't going to resolve the current problems and isn't going to relieve the stress on individuals and families (might make life a bit easier in the short term though).
Don't know what the answer is, ever increasing demand needs to addressed somehow.
@v8ninety it's a rough estimate, fluctuates from what I read on the BMJ website. But as you can imagine there's a lot of people who twist the data to suit their agenda.
@dirkpitt74
£300m when you look at the issues around recruitment and retention it wouldn't go far at all. Our trust just spent £40m in the last year on infrastructure issues which were having an impact on staff, patients & service delivery.
@v8ninety - accept my apologies, wasn't trying to incite anything.
@relapsed_mandalorian that's a mental figure!
Goes without saying you have 100% support from me... Very sad that the NHS are in the position they are in, not just as an entity, but the individual employees who are having to fear how the general public will see them! Honestly... As someone who wouldn't be here without the NHS over the last 2 years because of various reasons, I am close to inviting individuals who take issue with the NHS currently for a one on one "conversation"... I am close to smashing heads open I'll be honest, at least I'd be doing the gene pool a service by taking some of the non-thinkers out of it for good! 🤬
Pay rises for current health care professionals aren’t going to resolve the current problems
@stumpyjon it’s not the only answer but it would help. My friend is a consultant surgeon. He is constantly losing staff to work in supermarkets where they can earn the same wage with regular defined hours and manageable stress levels. According to him and other Drs I know, this is genuinely a huge part of the retention issue for nursing staff.
He often has operating lists cancelled due to lack of staff not lack of patients.
In another Govt own goal, He actually is willing to work more hours himself but there’s a quirk in the pension system that means if he does work more he actually takes home less because he’s taxed more. Funnily enough although he cares for sick people, he’s not keen on working for nothing......
Sunak threatens legislation to provide ‘minimum staffing levels’ during strikes; you know what, minimum staffing levels when there AREN’T strikes would be a good start mate! FFS.
Very well put.
What the hell happened to the £350 million brexit bus. I fear they are trying to get the NHS beyond any possible repair, scuppering the next government
I fear that they’ve succeeded.
Less so if you are actively trying to create a two tier health system; a basic, no frills starved of funding NHS and a pay as you go, top up if you’re wealthy enough aspirational private health care system.
My point that a functioning NHS is something which effects a huge demographic cross-section of society, in a way that not many other issues do, is based on the fact that people cannot simply make alternative arrangements which guarantees that they never require a functioning NHS.
People can opt for private education so that they never need to deal with state provided education, or opt for private housing so never need to rely on affordable social housing, or use only private transport and never rely on public transport.
But it is extremely hard for many people to completely opt out of ever receiving any NHS provided care. Are you not a paramedic? Is that not a part of the NHS which provides a care to a huge demographic cross-section of society?
And are NHS institutions not among the most technically advanced in the country? Globally in the case of the Royal Marsden? Do they not often deal with medical situations which the private sector cannot deal with, or have simply screwed up?
Furthermore the care that even very wealthy people sometimes rely on from the NHS is life saving - your bank account balance matters little when you are lying at the side of the road waiting for life saving emergency assistant, or simply pain relief.
Plus whatever your personal ability to afford private healthcare it doesn't mean that your sister, or parents, or your friend, can also afford it.
For all those reasons a fully functioning NHS, not a demoralised one on its knees struggling to provide what is expected, has huge potential voter appeal.
The Tories might well want a massive expansion of private healthcare provisions, and ever increasing profit motivated involvement in such a huge area of activity when there is so little else left to privatise - healthcare expenditure in the UK in 2020 was £257.6 billion, but they cannot simply destroy the NHS in the 21st century and expect to survive as a political party.
Ernie, your assertions are all true, of course. But they are not common knowledge to the average Joe with a private health care plan; the amount of times that I’ve been told “err, I have private health insurance, don’tcha know” is comical, along with the crestfallen look when it’s explained that there isn’t an ED at the priory, and they are going to have to wait with the plebs like you and I. However, the distasteful truth is that the real value of a fat wallet is you can buy your way to the front of the queue for life changing treatments utilising NHS services, via a private consultation.
I think that the well meaning error of your argument is that you think that the current crop of Tories are even trying to compete in the next election. I think they’ve already privately ceded 2024, and are scheming to be back, stronger, with a mega populist far right mandate in 2028. That’s why I think they are on a wrecking spree this winter.
Private sector, top rate tax payer here. All strikers NHS and beyond have my full support though I fear the scum in charge are deliberately scorching the NHS.
I think they’ve already privately ceded 2024, and are scheming to be back, stronger, with a mega populist far right mandate in 2028.
How much they lose by in 2024 is massively important to the Tories. Why do you think they got rid of Liz Truss within 44 days? Only because she was such a huge election liability, not because she was determined to reward the rich for being rich.
If Labour gets a two hundred seat majority in 2024 (very unlikely, one hundred is possible though) then the Tories can forget about winning in 2028, no party gets over a hurdle like that in one go.
Furthermore their ability to mount an effective opposition with vastly reduced number of MPs would be severely hampered.
Size does matter when it comes to defeat, which is why Tory MPs made Sunak PM and Jeremy Hunt's budget was nowhere as bad as had been widely feared - he has deferred balancing the books for a couple of years.
The Tories are undoubtedly on a damage limitation exercise although granted it seems hard to believe sometimes as they keep scoring own goals.
The problem is that Sunak is massively out of touch with ordinary people and he can't help behaving like a Tory. The one gift that Boris Johnson had was that he had the showman ability to tap into what his audience wanted. Plus he had no real idealogical commitment to anything other than his own ego.
A really interesting, comprehensive, and informative, article in the FT. Focusing particularly on the ambulance service:
https://www.ft.com/content/5219bbfb-1637-4999-bc6f-9feffcedb93c
I was able to initially read it all without any problem but then I found it was behind a paywall on the second attempt, so possibly everyone gets one free read of it.
A really interesting, comprehensive, and informative, article in the FT. Focusing particularly on the ambulance service:
https://www.ft.com/content/5219bbfb-1637-4999-bc6f-9feffcedb93c
I was able to initially read it all without any problem but then I found it was behind a paywall on the second attempt, so possibly everyone gets one free read of it.
Edit: if you copy the following headline and do a search in Microsoft Bing there isn't an FT paywall there:
Minister to hold crisis talks with unions on ambulance workers’ strike
There are many things I begrudge paying extra tax for, but the nhs isn’t one of them. You all fully deserve a pay rise and do a great job
We spend £5358 per second on the NHS. That’s about £0.46bn per day or £7 per person - about £265 per month. £300m is a mere 15 hours out of the annual spend. The ANNUAL spend. Healthcare tourism is a rounding error in the budget.
Salaries are not a rounding error. But the laws of supply and demand apply to career choice in healthcare as elsewhere. If you can’t fill positions you need to make the job more attractive. Salary is a motivator, working conditions another. Vocation has been overly relied on at the expense of the first two. Hence my support.
@RustySpanner
I'm afraid you seem to have broken STW! 3 pages in and near universal agreement...
The government shouldn't be involved in healthcare outside emergency provision. If the government allocated us all a state provided bike none of us would be happy. If the only way to get the bike we want was to campaign for the government to change the allocated bike we'd have threads exactly like this one.
The only thing the NHS provides that private healthcare can't is 'equality', well you can achieve that by adopting the French system and the government can give us all £x a year toward health insurance. If that's enough for you you're all set. If that's not enough for you, you pay more in yourself. If that's too much for you, well that's a nice problem to have. If you can't pay extra you want to top up with, at least that's down you you, you don't have the frustration of it being someone else's decision.
Literally nobody in this thread has the healthcare they want and instead of going elsewhere you're forced to complain about it on a cycling forum. It's nuts. You can't have what you want if someone else is making your choices for you.
Can you imagine the frustration of a world in which the Baker stopped selling the bread you like and your only recourse was to try to change the national government?
And that assumes the change of Government will give you what you want? Really? Did 'good' governments like the Scottish government give a 19pc pay rise to Nurses? Will the next Labour Government give a 19pc pay rise to Nurses? Did Welsh nurses get 19pc? No chance. The current system will never makes anyone happy (and in my lifetime never has including when Blair dramatically increased funding, and nurses still threatened to strike in Scotland and still ended up with less that half of what they wanted).
....and the problem with salaries in a massive institution is pay banding. If the last 10pc of staff you need want (say) 20pc more to do do the job, but you have to pay your entire staff that 20pc things get pricey! (and you end up circumventing your own pay banding by the back door with temps.)
People want specific decisions to be made around healthcare but (in the UK) we want someone else to be making those decisions, that will never happen.
The only thing the NHS provides that private healthcare can’t is ‘equality’, well you can achieve that by adopting the French system and the government can give us all £x a year toward health insurance. If that’s enough for you you’re all set. If that’s not enough for you, you pay more in yourself. If that’s too much for you, well that’s a nice problem to have. If you can’t pay extra you want to top up with, at least that’s down you you, you don’t have the frustration of it being someone else’s decision.
So what happens to those who need extra care and can't afford the extra care?
Do we just leave them to suffer once their money runs out?
Utter crap from OoB
If the government allocated us all a state provided bike none of us would be happy.
A new bike, I'd be happy. The rest of your post is bobbins too
@BillMC and @anagallis_arvensis
Any chance of some rational argument as to why its "Utter crap" or "bobbins" ?
Lets have some discussion for a change rather than just reinforcement in the STW echo chamber.
Any chance of some rational argument as to why its “Utter crap” or “bobbins” ?
Don't want to feed the troll.
If you can’t pay extra you want to top up with, at least that’s down you you, you don’t have the frustration of it being someone else’s decision.
If you can't pay you're happy that's it's your decision. Does that need explaining?
RustySpanner - you are so articulate and should try and get this written somewhere for everyone to read. We need to hear these stories from 'the horses mouth'.
My own experience of staying on a trauma ward (nearly 10 yrs ago) was shocking. Only 2 nurses, when there should have been 4 or 5. I was left lying in a full bed pan of urine, because no one was there to help me out or empty it (one needs to drink a lot when on medication). One morning breakfast didn't arrive for ages and I nearly passed out. The blood pressure machine didn't work. The list goes on and on. How on earth are health workers supposed to do their job properly without basic tools?
One of the best GPs I've ever had is taking early retirement tomorrow. It's a crying shame.
Any chance of some rational argument as to why its “Utter crap” or “bobbins” ?
Lets have some discussion for a change rather than just reinforcement in the STW echo chamber.
I would agree only it is difficult to have a rational discussion with someone who is comparing the National Health Service with owning a bike or buying a loaf of bread.
Where would you start, and why would you even bother?
"Don’t want to feed the troll." - I don't think he is actually trolling, rather pointing out that if you are getting poor service from the NHS there is nothing you can do other than complain and we'd not accept that with other services let along one as important as health care.
"If you can’t pay you’re happy that’s it’s your decision. Does that need explaining?" - Yes because you are missing out the important part about the government providing a base level payment into an insurance backed scheme. If this level was set correctly then its not a problem. So yeah it does warrant some level of discussion.
"I would agree only it is difficult to have a rational discussion with someone who is comparing the National Health Service with owning a bike or buying a loaf of bread." - No its not it's a metaphor, the point is you would not put up with it buying bread or bikes, so WHY should you put up with it for something as important as health care.
"Where would you start, and why would you even bother?" - Where to start? discuss insurance backed health care with partial government funding. Why? because the NHS is failing and we need a solution so everyone can get better health care.
No its not it's a metaphor, the point is you would not put up with it buying bread or bikes, so WHY should you put up with it for something as important as health care.
I did smile at that. Earnie didn't really make it clear if he thought food and bikes are more or less important than Healthcare. But assuming he thinks they're less important why would he want to make his own decisions on less important purchases, but let Starmer/Hunt/Sunak/Reeves/Sturgeon make his decisions on more important purchases? And if he thinks food is more important than healthcare why doesn't he want Sunak picking his food? (In fact I could make a *really* good case for state provision of food - the healthiest we've ever been was when the state planned our food intake during WW2!)
As for trolling. Britain does healthcare one way and everyone agrees the result is not fit for purpose but keeps doing it. The rest of the world chooses a different way. Is the entire world suffering inferior healthcare in order to troll the UK?
No its not it’s a metaphor
No it's a ridiculous comparison.
On too many levels to even discuss.
Edit : It is also off topic. This thread isn't about whether the NHS should exist or not, thankfully there is only a tiny minority of people who think it shouldn't, the issue being discussed is fair wages for healthcare professionals working within the NHS.
I’m afraid you seem to have broken STW! 3 pages in and near universal agreement…
One suspects this is because those with differing views are not participating in the thread due to posts like…
Utter crap from OoB
…and they can’t be bothered to have an argument. STW is a left-wing echo chamber.
"No it’s a ridiculous comparison, On too many levels to even discuss." - I can only infer from that you have no argument against his position. That's OK Just easier to say that though.
The nurses and ambulance drivers are striking for more pay, not better care for patients lets be clear on this. They could go on strike until something was done on providing social care, so that beds could be freed. They are not, so lets get that straight. I am not saying that they don't deserve a pay rise, I am saying the narrative that it's for patient care is disingenuous. Again this is not saying that they don't have sympathy and care for patients in general, just that its not why they are on the picket line.
can only infer from that you have no argument against his position.
You can infer what you like. I consider buying a loaf of bread from the bakers and accessing healthcare to be a ridiculous comparison.
If I don't offer an argument explaining why it's because I don't feel there is a need to, and I simply can't be arsed.
Thankfully justification for the existence of the NHS is not an issue for the overwhelming majority of people, so why discuss something that isn't an issue on a thread which is about another issue?
The nurses and ambulance drivers are striking for more pay, not better care for patients lets be clear on this
Don’t you see the linkage between pay + conditions and better patient outcomes?
From TiRed up there 👆
the laws of supply and demand apply to career choice in healthcare as elsewhere. If you can’t fill positions you need to make the job more attractive. Salary is a motivator, working conditions another. Vocation has been overly relied on at the expense of the first two.
This thread isn’t about whether the NHS should exist or not, thankfully there is only a tiny minority of people who think it shouldn’t, the issue being discussed is fair wages for healthcare professionals working within the NHS
The two go hand in hand.
People will never be happy as long as pay is banded nationally, because a Nurse in a wealthy area are with full employment is going to get the same money as a nurse in a poor area with massive unemployment. (Or on a bloody remote island FFS.)
...and if you make healthcare a national monopoly you end up with national pay banding and you can never get rid of it with the inevitable resulting misery and staff shortages.
Also it's not a tiny minority. 70 million people have our system - just us. The other 7 billion choose different systems.
If you want French healthcare, then you will need to pay for it. We spend 9.8% of GDP (it was lower before Blair’s famous off the cuff desire to exceed EU median) and France spends 11.8%. The US spends 16.9%. French and British GDPs are the same to within £500 per person (1%). The usual argument for maintaining the NHS is that we do well for what we spend, not that we spend enough or do well enough. Ignore the political hyperbole.
The total tax take in the UK is 1/3 of GDP. So to match France we would need to increase this to 35%. France is 45%. Income tax and NI are about half the total tax take, so a rise in total income tax and NI take of 4% is needed. We didn’t raise NI by 1% for social care. People want to pay more, but they aren’t told just how much more.
The nurses and ambulance drivers are striking for more pay, not better care for patients lets be clear on this.
Those I know understand that understaffing leads directly to worse care for patients. Continually lowering real wage levels for a decade does nothing to help with recruitment and retention of staff.
"Those I know understand that understaffing leads directly to worse care for patients. Continual lowering real wage levels does nothing to help with recruitment and retention of staff."
Then strike for incentives for subsidising training and increased pay for newly qualified personnel.
Edited to add
Or just be honest and say that they feel that their skill levels are worth more than they are currently paid and the fact the NHS is a monopoly employer prevents their wages from being driven by the the shortage of highly skilled people in their profession.
And retention?
The government shouldn’t be involved in healthcare outside emergency provision. If the government allocated us all a state provided bike none of us would be happy. If the only way to get the bike we want was to campaign for the government to change the allocated bike we’d have threads exactly like this one.
The only thing the NHS provides that private healthcare can’t is ‘equality’, well you can achieve that by adopting the French system and the government can give us all £x a year toward health insurance. If that’s enough for you you’re all set. If that’s not enough for you, you pay more in yourself. If that’s too much for you, well that’s a nice problem to have. If you can’t pay extra you want to top up with, at least that’s down you you, you don’t have the frustration of it being someone else’s decision.
Literally nobody in this thread has the healthcare they want and instead of going elsewhere you’re forced to complain about it on a cycling forum. It’s nuts. You can’t have what you want if someone else is making your choices for you.
Can you imagine the frustration of a world in which the Baker stopped selling the bread you like and your only recourse was to try to change the national government?
+1
You can’t have what you want if
someone elseyour budget is making your choices for you.
If you want French healthcare, then you will need to pay for it. We spend 9.8% of GDP (it was lower before Blair’s famous off the cuff desire to exceed EU median) and France spends 11.8%
Great!
Clearly the government isn't going chip in the extra 2pc so under a better system the govt gives me the 9.8pc and I chip the rest in myself. That's whe whole point. If, in the future, the government increase spending by 2pc I drop it back down. Result bliss.
The whole problem is that I'm told our healthcare is a disaster and nurses are grossly underpaid for the sake of 2pc. But I can't top up that 2pc, I'd have to completely buy duplicate provision (but keep paying for the state provision!) or campaign for the government to increase it for and everyone else. Both of which suck.
At the moment we can't directly choose add that 2pc. It could be simple and elsewhere it is!
Other than OP I haven't read the rest, so apologies if this has been said already.
There is plenty of money in the UK, the standard tory tactic is to heave as much of it off to their mates as possible, see PPE scandal, Track and Trace, privatisation etc etc. when i say tory, I also include the Blair years as he embraced a lot of this so that he could get elected.
The point of this exercise is to get us to argue amongst ourselves over the crumbs whilst they rinse us.
So it is time we started pushing together, and the strikes are the first step.
"And retention?"
I would argue getting rid of pay banding and allowing people to negotiate what they are worth would go a long way to fix that.
You can’t have what you want if someone else is making your choices for you.
When I walk into a baker's I know exactly what the problem is and I know exactly what the solution is.
The problem is that I need a loaf of bread and the solution is a crusty loaf.
When I walk into a GP surgery suffering from, say severe hip pain, I don't necessarily know what the problem is nor do I necessarily know the solution.
Choices that might exist in bread buying exercises do not necessarily exist in healthcare accessing exercises.
Furthermore whilst I am fairly relaxed about the baker being primarily profit motivated when solving my bread buying issues I am somewhat less relaxed about a healthcare provider being primarily profit motivated when solving my medical issues.
I’d have to completely buy duplicate provision (but keep paying for the state provision!)
You can't buy duplicate provision in the UK. There is no private healthcare that will keep you away from state healthcare in all events. Without the state provision, if you fall ill in the wrong way, you are screwed. And all this "choice" nonsense ignores that any insurance system also takes choices away from the patient. Or if you're talking about funding the actual costs direct, rather than through insurance, then then for 99% of the population that's just a gamble that you're not going to fall ill within anything ruinous.
All power to the people!
The thing is, those missing out on care are also those who for years have voted for governments that are running the system into the ground, so sod em.
"Furthermore whilst I am fairly relaxed about the baker being primarily profit motivated when solving my bread buying issues I am somewhat less relaxed about a healthcare provider being primarily profit motivated when solving my medical issues."
Yay thats a bit better.
You do know what you want though, you want the best medical outcome for yourself.
"I am somewhat less relaxed about a healthcare provider being primarily profit motivated when solving my medical issues." - So you prefer it to be motivated by your GP not being able to offer the best possible treatment because its not available due to lack of resources?
I am not saying that OOB has all the answers, I am just saying that the almost religious defence of the NHS in its current form is not helping fixing it.
I am saying I don't want a system where people on benefits and limited income get a crap service.
At the moment you can't even get a GP appointment in a reasonable time. It's broken and I think its beyond just pouring more money in.
Double post
And all this “choice” nonsense ignores that any insurance system also takes choices away from the patient.
30 seconds in :
And all this “choice” nonsense ignores that any insurance system also takes choices away from the patient
Yes
The NHS is essentially health insurance that is compulsory and can't be topped up. We're told that we need to pay 10.8/9.8 more in for it to work properly. (Currently the premium is about £3k per person, so if you could you'd top up with £300PA and you'd be happy.)
I'm saying get rid of the compulsory state insurance system and let us choose our own with a basic state subsidy for the first "9.8pc" component. Then we can choose our own cover and top it up.
That way we all get the cover we want and if we want to change it we change it effortlessly instead of complaining on a cycling forum about how crap our state provided health cover is.
My evidence this is a good idea is that everyone in the UK agrees the NHS is a disaster (and could be fixed with a tiny top up which never comes) and everyone abroad chooses a different mechanism to us.
Perfect isn't available. But a solution that gives us each the best we can have without binning the "state funding for fairness" component is easily available. ....and we can take the emotion and politics out of things and just concentrate on the best heath outcomes possible. (...if your car insurance is crap, do you campaign to the government, post on Singletrack or just quietly sort it?)
This morning, when I dropped Mrs Baron off for work at Stoke Royal, there were 15 Ambulances queued up outside.
It is not unusual to see such a splendid display of idling ambulances.
'Parrently the crews now get Uber Eats et al to drop takeaways off.
I have to drop her off because she's had her 2 NHS MRIs, come to the end of her "we'll put you in a wheel chair" MICATs sessions and is "too difficult to diagnose".
However, the private sector offerings have pretty much been similar.
TBH, if the paramedics and nurses wanted to riot or indeed conduct an armed uprising, I'd be hard pushed to "meh", never mind condemn them.
The thing is, those missing out on care are also those who for years have voted for governments that are running the system into the ground, so sod em.
And those who are also missing out on care but didn't vote for the governments that have ran the system in to the ground?
Are they just collateral as well?
(and could be fixed with a tiny top up
It’s not a tiny top up. It’s an increase in budget of 20%, and given that the distribution of payments through NI and taxation is not based on utility (pensioners pay little NI or income tax), the cost to those who do pay is politically impossible.
It’s not a tiny top up. It’s an increase in budget of 20%, and given that the distribution of payments through NI and taxation is not based on utility (pensioners pay little NI or income tax), the cost to those who do pay is politically impossible.
You said 10pc earlier. From 9.8pc of GDP to 10.8.
...but even if you think it's 20pc you've got more chance of finding an extra £600 yourself than convincing over 50pc of voters and a government that they should raise your tax by £600 and spend it on your health.
...and as you say it wouldn't go down like that - you'd be hitting your tax payer baseload with a massive hit.
finding an extra £600 yourself
That £600 isn't going very far.
20% is the absolute increase in budget 11.8/9.8 = 1.2). France just spends a lot more on healthcare than we do for what is basically the same sized but high tax take economy. Of course spending more on salaries would be castigated by politicians as that is not buying more scanners or treatments. Missing the point that you need people to run the scanner and administer the treatments.
That £600 isn’t going very far.
If you didn't think it's worth it you wouldn't have to pay it. That's the beauty of making your own choices rather than getting Sunak to take these decisions for you.
My evidence this is a good idea is that everyone in the UK agrees the NHS is a disaster
That sounds very much like Suella Bravermans claim yesterday that 'the vast majority of people' support deporting people to Rwanda
Absolute twoddle, in other words
I'd say that its a small but vocal minority who would describe the NHS as 'a disaster' and I'm sure its purely coincidental that those very same people support privatisation
If you didn’t think it’s worth it you wouldn’t have to pay it. That’s the beauty of making your own choices rather than getting Sunak to take these decisions for you.
You misunderstand. You as an individual choosing to pay X more will not have a transformative effect on healthcare in the same way as a government choosing that we pay X * 30,000,0000 more as a country. It might help you jump queues to access the treatments available... but it won't do anything to increase the number or quality of treatments available in the UK as a whole.
Nursing should be seen as a profession to aspire to and be proud of. If you compare to salaries of say an optometrist, it’s no where near, yet the responsibility and breadth of knowledge seems to me far more for the nurse. My recent stay in hospital confirms nearly all were from overseas. They were all incredible, but if uk kids don’t want to join, then simply, they aren’t paid enough. If the overseas talent steal ended there would be no-one left.
Getting the right numbers of staff in place would streamline all other parts of the puzzle, and have a positive effect on costs.
As for the cost, it’s all going straight back into the economy anyway.
Uk Healthcare spending as a % of gdp is 11.9%, France is 12.4% according to OECD figures.
Thankfully justification for the existence of the NHS is not an issue for the overwhelming majority of people
From Nye Bevan, 1948, talking about the BMA opposing the implementation of the NHS:
We are not now dealing with a body which is seeking to bring about the modification of principles in what they consider to be the legitimate interest of the members of the medical profession. We are dealing with a body organising wholesale resistance to the implementation of an Act of Parliament.
Also in the same speech he had mentioned the BMA's lack of toleration of previous Health Ministers:
I am a Welshman, a Socialist representing a Welsh constituency, and they find me even more impossible. Yet we are to assume that one of the reasons why the doctors are taking up this attitude is because of unreasonableness on my part. It is a quality which I appear to share in common with every Minister of Health whom the British Medical Association have met. If I may be allowed to make a facetious transgression, they remind me of a famous argument between Chesterton and Belloc. They were arguing about the cause of drunkenness, and they decided to apply the principles of pure logic. They met one night and drank nothing but whisky and water, and they got drunk. They met the next evening and drank nothing but brandy and water, and they got drunk. They met the third night and drank nothing but gin and water, and again they got drunk. They decided that as the constant factor was water it was obviously responsible – a conclusion which was probably most agreeable to Bacchic circles.
Let's remember that people with money, even the BMA, didn't want us to have an NHS from the very start! 😀
Keep it up, NHS staff. You're doing good things, in every sense.
Uk Healthcare spending as a % of gdp
That page shows $5387 per capita for UK, $6115 for France... so that's about 14% more per a person. Mostly state mandated still in France as well (higher per a head than UK)... so much for choice. Ultimately, we need to put more total money in, and paying around with "top ups" is more about the rich "choosing" to jump queues and get preferential treatment... and they can already do that in the UK anyway... so many calls for reforms are just about trying make it more tax efficient to use your own money to jump past those without the same means... dressed up as "choice".
How much more does the nhs need then. Forget 19% as thats never going to be possible after covid, brexsjit and kamikwaze.
In terms of ££££ per week. Staff, beds hardware, drugs, new wings, pay rises, Consultants
Amd then, that amount we need, as a percentage of weekly spend now.
Eg each person's drain on the pot as an average is say £5500, but we need £6000 per patient for staffed, efficient system.
Tgen you have to buy insurance to cover the cost of the nhs you want, as opposed to the nhs we have, with ambulance queues of entire shifts, bed blocking oldies who arent discharged as they lie waiting for a prescription and a lift home.
Then actuarial persons get involved and you have to pay an insurance co £9 per person per month or pay the £555 direct top up fee. Cant pay, or chose not to pay, then its coming out of your benefits weekly, child benefits or pension or jobseekers allowance.
Then if you use the system you want, get an ambulance within 12 minutes and a nice nurse and a bed in a clean, warm hospital it has to cost. Now we already pay in direct and in direct taxation but its not enough. And the government wont tax the 20 million or so taxpayers heavily enough to cover the needs of the patients / potential patients.
So the ultimate end users havevto top up their stay or buy insurance should they need to be hospitalised. Not a percentage of treatment cost, but a lump sum toward the running of the system on a day to day basis.
All the pan clangers who were out there showing solidarity will have to put their hands in their pockets.
Unpopular, unwanted, unaffordable, unworkable but unfortunately necessary.
@mefty my figures were their 2019 data. The GDP has had some “issues” due to a severe health event since then. Spending on healthcare didn’t change though.
My personal view is that social care is the challenge that’s clogging up the flow of patients, causing a challenging working environment that’s not worth the salary and stress. This feeds into poor retention, emergency cover from bank and inflated prices for labour services. And we don’t want to spend on social care.
For balance il also takes weeks to see a gp in France, queues in AE are longs, and it takes months to see a specialist gp.
And we pay gp then get the money back later. To get 100% back you need a private insurance.
My personal view is that social care is the challenge that’s clogging up the flow of patients, causing a challenging working environment that’s not worth the salary and stress. This feeds into poor retention, emergency cover from bank and inflated prices for labour services. And we don’t want to spend on social care.
My aunt has been working in social care for 15 years (she used to be military and then NHS)... and our attempts to force the caring professions to accept lower real term wages, and the resulting understaffing and reliance on agency workers, is much the same story there as it is in the NHS. We take advantage of the caring nature of people who go into these careers, and if we don't turn that around there is no way to improve the care system or the NHS. But there's Sunak... trying to make paying nurses a wedge issue to turn around his political fortunes... "Labour's strikes"... and all that nonsense, rather than addressing the effects of his own party's decision to suppress wages.
I’d say that its a small but vocal minority who would describe the NHS as ‘a disaster’
Pre-covid, ie 2019, the UK apparently ranked 4th highest globally for satisfaction in its healthcare system:
https://www.statista.com/statistics/1109036/satisfaction-health-system-worldwide-by-country/
It is hard to discribe that as a "disaster".
If there has been a significant change in global ranking in the last 3 years then responsibility must ultimately lie with the government - it is they who have been making the decisions which affect healthcare provisions.
And as outofbreath helpfully points out it is Sunak who makes the choices.
The problem is the government not the system.
The solution is obviously to replace the government, not the NHS.
Just to support Ernie's post:
https://www.kingsfund.org.uk/blog/2022/03/public-satisfaction-nhs-falls-25-year-low
Pre-covid, ie 2019, the UK apparently ranked 4th highest globally for satisfaction in its healthcare system:
Well that's great it's all gone brilliantly all along. 🎉
Not sure what all that grumbling was about.
Oh dear:
the basic problem is that 12 years of neglect has left the UK with a system that isn’t fit for purpose and is increasingly intolerable to work in.
NHS Strikes…..an appeal.
Just do whatever needs to be done after all NHS workers are also human.
As for blaming the current govt or political parties I think that is shortsighted. They are not the only one to be blamed even when they have been in power for a while. Not saying they, current govt, have done a good job but all the previous governments are also part of the problems.
The system really needs revamping. Incremental change/"improvements" can only last so long before the entire system needs to be updated. Then after a while it will return to the same incremental process until such time as an entirely new system is in place again.
The situation of NHS is not unknown in other countries and although they may look as if they have a better system, they just have not faced the "critical mass" or the breaking point yet.
In SE Asia, people just find alternative ways of dealing with their own illness and by relying on traditional remedies or knowledge to cure themselves and in cases where the traditional remedies do not work they just suffer a slow death if their illness is life critical. Life is short and the only hope for the people there is for quick and peaceful death.
It strikes me that this stuff about only paying for a basic service, and then paying an optional topup is real fairyland stuff.
If you don't pay your 600 extra or whatever what are you prepared to give up? Mental health care - not a basic service? Physitherapy when you have a big stack ? Long term care when you get cancer aged 30 and then find you can't afford treatment? Or are you thinking that would be a good time to opt back in. Healthcare only works if you're in or out.
The issue isn't migratnts, or the famous middle management (bacuase god knows every other multibillion industry dones't need managers.).. the basic problem is that 12 years of neglect has left the UK with a system that isn't fit for purpose and is increasingly intolerable to work in.