The NHS.

Rather than just expanding and expanding the budgets, the problem could be tackled from the other end, to reduce from the incredible diversity of medicine offered down to core treatments. If you want anything that’s not considered core, then you or insurance pays for it.

I doubt there’d be any senior politician brave enough to suggest it, and I’d not want to be the person drawing the line in the sand of core/not core activity but it is an option that never seems to get considered or discussed.

Whats the definition of 'core' though? The problem is if you sit down and think what core is then you inevitably end up with social/old age care being in that list and suddenly you're paying more than what you started without it.

What we need is a radical policy to tackle the demographic timebomb. How about issuing everyone of retirement age with a suicide pill and rewarding them for using it by waiving inheritance tax on their estate? Is that any less cruel or immoral than allowing people to die on a trolley in A&E or the back of an ambulance due to a lack of hospital beds?

On of the challenges is that General Elections can be won or lost on these decision, but the NHS really needs a 20-50 year plan, much longer than the likely life any political administration.

For example, one of the best things we can do is significantly raise retirement age. Keep people working for longer means more tax income and more active older people with fewer demands on H&SC (the best way to reduce demand on H&SC is to keep older people moving and active). But to suggest this would be political suicide.

Our healthcare system is a ‘bad winter’ away from collapse

They’ve been saying that for at least the past 17 years while I’ve been working for the NHS.
Our part of it came very, very close a few years ago but came through it. The only reason we got through it was that we got rid of an utterly incompetent Cheif Exec who was sideways moved into another part of the NHS. Our previous one was almost as bad but was pushed out/left. We currently have a Chief Exec who seems to be very good at the job, doing good things and has huge support from staff.
The NHS needs more people at the top like this.

Won’t a bad winter kill of a lot of the people who are being blamed for the problems! Win Win surely!

Whats the definition of ‘core’ though?

As I said, not a choice I'd make, but social care is, I believe, generally the responsibility of councils, so that's not core NHS. Manchester IIRC has some kind of integrated system under the charge of the metropolitan mayor so an outlier.

For example, one of the best things we can do is significantly raise retirement age. Keep people working for longer

That's alright for the pen pushers not so much fun for the guy digging up the road or climbing up the pylons

(the best way to reduce demand on H&SC is to keep older people moving and active).

…better get out the whips and chains too. That’ll get the lazy bleeders out of their piss stained rise and recline chairs!

First thing I’d do is ban all junk food advertising and put restrictions on the fast food delivery companies. Every other advert is for these services so the spend must be well worth the return. Especially if you can afford the likes of Katy Perry to front them. They exploit the bottom rung of the job market too.

there are any savings over a 3 quid happy meal or the likes

But it's not £3 is it, most people are going for a large Big Mac Meal or the latest limited edition which is nearer £8. A Chinese takeaway for us is £35 and that's 3 mains between 4. Flip side (and I know this is very middle class) is we can have a Gousto box for 4 for 4 meals for £45. We cook from scratch and whilst not exactly health food it's a lot better than a take away. If the same ingredients are bough from the supermarket it would work out a lot cheaper again. We've cut out at least one take away a week which more than justifies the cost of the Gousto delivery.

I know these costs are beyond people who are struggling but it is cheaper to cook properly than buy processed food and take aways which is the core diet of many of the chronically obese. Poor food choices and low income do correlate but one doesn't cause the other. There's another key factor at play.

Won’t a bad winter kill of a lot of the people who are being blamed for the problems! Win Win surely!

That’s what COVID was supposed to do

Won’t a bad winter kill of a lot of the people who are being blamed for the problems! Win Win surely!

That’s what COVID was supposed to do

I'm still rather ashamed of my post on the first page of the Covid thread 🤦‍♂️

Yes, the NHS is massively underfunded, but…

And then look at the amount of money lost (sickness/absence) or paid out as a result of bullying/harassment. The institution has many internal problems, it doesn't help itself.

Really good podcast here from Dr Phil:
https://www.private-eye.co.uk/podcast/73

So if Liz gets in she is going to cut National Insurance contributions. Were they not put up to give more money to the NHS?

And then look at the amount of money lost (sickness/absence) or paid out as a result of bullying/harassment. The institution has many internal problems, it doesn’t help itself.

One of the reasons for all that is that, for the size of the organisation it it, It has a shockingly underfunded, very small and sometimes very bad management. One of the reasons for that is the constant drumbeat of politicians saying things like "This funding must go to front line services" and the general tone of keeping money away from "The Management" Then what you get is either part time managers (seconded mostly from their clinical work) who aren't good at it, don't know what they're doing and are stressed out by having to do a job and a half. Or in my experience, no management at all, I worked as outside (private contractor) having to essentially manage a out patient ward of Ophthalmologists to make sure that the work they did was in line with the work that both the Trust and the CCG wanted (and had contracted) me to do in the community. Or otherwise talented and good managers leaving as soon as anything half decent outside the NHS is dangled in front of them.

So if Liz gets in she is going to cut National Insurance contributions. Were they not put up to give more money to the NHS

Nah thats Brexit.

the defining thing that makes the UK a world leader in social care.

#delusion

#delusion

The NHS is ranked 4th (I think currently) in the world as one of the best healthcare systems. That's perhaps a reflection on other countries rather than how sparkly the NHS is though

Isn't that based on a value for money basis....? Cuba being the "best" with regards to the care vs cost.

I pay much more for my health care in Germany than I would in the UK. However the treatment I receive is much better, especially post op.

Yes, not surprised, Germany's health care is very good. I think there's many ways of measuring it, most use a combination of size of population, cost, the care process (preventative care, patient engagement, and so on) It's noticeable that relatively rich European (and educated) countries with small populations generally come out looking better. Germany and the UK are outliers in that respect having population sizes sometimes 10 times as large as some of the other well performing countries.

It's safe to say that despite it's many short comings, the NHS is better than most

There’s another key factor at play.

Time pressure. The low-waged may well be holding down 2 jobs or working very long hours to keep afloat. They don't want to set to and cook from scratch, cheap fast food fills the need. They may not have the necessary cooking equipment/stove to cook from scratch.

The Angry Chef blog and Jack Monroe are worth a read to get a handle on why fast-food is favoured by the poor. For a first world country we have a lot of third world citizens living amongst us.

Time pressure. The low-waged may well be holding down 2 jobs or working very long hours to keep afloat

For some, not most.

The tories have deliberately underfunded it for so long they should be jailed for what they've done.

Especially due to the pandemic. When it was needed the most it was found to be struggling. This was placed onto the staff many of whom were burnt out by their workload.

I would like it if there was an audit done, showing where, when and by whom it was underfunded. Where the taxpayers money was misspent, and who coined it in off the service.

After experiencing quite a bit of French and Canadian (Quebec) healthcare systems, I can safely say that the NHS provides much better access to care than either of those. The big challenges - shortage of staff, ageing population, budget - are universal, and certainly won't be solved by selling off chunks to the 'efficient' private sector.

What sets the NHS apart in my opinion is the ethos and attitude. There is a real sense of pride in care. The first question problem is 'how can we fix this' not 'who pays the bill?'. This is really worth protecting.

The first question problem is ‘how can we fix this’ not ‘who pays the bill?’.

Only because the NHS doesn't really have a way of charging people and isn't set up to do that. Trust me, the very first questions are either "Are you paying for this treatment?" or "Will you pay me to do this treatment?" (if you're a GP)

Fun fact; It's entirely up to the individual funding area to decide whether it will pay it's GPs to take blood samples. That's why in some places it's a same or next day service, and in others it's a 6 week wait for an appointment.