[Closed] What to cut to fund the NHS?

I can't believe that you still want to compare costs in 1950 with costs in 2020 !

Do you pop down to Tesco with a ten bob note in your pocket to do the weekly shopping?

😆

🙂

Ernie the point is that health care costs are rising at double to treble the rate of growth in the UK economy.

Labour's spending was unaffordable with £90bn a year budget deficit, it had to be addressed of the NHS and the country would have faced a true catastrophe. Tories promised £8bn pa by 2020 and are delivering £10bn. Labour promised only £2bn, that's a rounding error

jambalaya - Member
Ernie the point is that health care costs are rising at double to treble the rate of growth in the UK economy.

There are also many ways to fund it, from collecting exitsing taxes toother initiative. There are also some big changes in organisation needed to make sure it delivers the best it can for the money used.
Just quoting cost figures which do state a doubling in the 2000-2010 section (around the time a huge investment was made in new hospitals and PFI initiatives?) then ignoring that the projected 2010-2020 figures show nothing near a doubling of costs either in total or per person is madness. You have claimed doubling of costs which the UK has managed to absorb each decade until now, this is the first decade where costs are not doubling and you claim it's unaffordable.

Ernie the point is that health care costs are rising at double to treble the rate of growth in the UK economy.

No this is much more the point :

[img] [/img]

Tories promised £8bn pa by 2020 and are delivering £10bn. Labour promised only £2bn, that's a rounding error

"Five MPs led by the Conservative Dr Sarah Wollaston, the chair of the Commons health select committee, have written to the chancellor demanding the government abandon its “incorrect” claims of putting £10bn into the NHS annual budget by the end of this parliament and admit the severity of its financial shortage"

However, the MPs say that May’s £10bn claim cannot be justified. “The £10bn figure can only be reached [b]by adding an extra year[/b] to the spending review period, [b]changing the date from which the real terms increase is calculated[/b] and [b]disregarding the total health budget[/b],” they concluded.

Afaik, the NHS is very efficient, just underfunded.

I believe that too much money is squandered on the transport infrastructure, i.e, forcing people to use cars where it would be as easy to walk or cycle.

To encourage people back to walking, etc you'd have to start eliminating private cars from the city centre and work outwards.

The NHS should have a greater say in transport policy.

cut- an ageing population, obesity and related issues like diabetes and Im sure the NHS would be in better shape

Can the UK afford it? Depends what the priorities are.

The priorities don't seem to be the physical and emotional welfare of those that can't afford private healthcare. So I guess it's a problem then.

Ernie the point is that health care costs are rising at double to treble the rate of growth in the UK economy.

The point has been illustrated to you repeatedly but you keep ignoring it and responding with a meaningless retort.

Give the NHS all hospital car park profits.
Take back all the land from the royal family and frack the buggery out of it. 😉
Turn Buckingham palace and other stately homes into hospitals/theme parks/hotels - offering the royal family zero hour contracts to work/live there. (peppercorn rents obvs.)

I've not read most of the thread, but to answer the OP, I fail to see why someone doesn't just put National Insurance contributions up. I'd gladly pay more.
Also, I'm not knocking the service they provide but by god the NHS is a lumbering beast. I'm currently having some fairly simple treatment and everything has to go through about 3 people and 3 appointments every time. It seems nobody is allowed to make a decision, even through it's fairly obvious to everyone involved.

The percentage of funding coming from tax and NI is alread at a high (>98%) PPwhile paying for services is <2%. It's not rocket science. We have to start contributing more directly in charges. And why not? Nothing is more important is it?

What happens when you raise NI and who loses?

If people want to play at making points with graphs they should see how UK trends in funding/GDP compare internationally (oh, look there's a trend) and ask themselves whether the spike was driven by the numerator or the denominator? Gosh, its 2009/10!!! Alternatively apply for a job at the Daily Wail as a columnist.

+1 for what PP says but if my dad is anything to go by the NHS doesn't stand a chance against a tide of bored internet browsing self diagnosing pensioners

With 60%+ of the population being overweight or obese then we're clearly not are we? We may be trying to, but it's not effective...

Malthusian population crisis backed up by some sort of semi-extinction event should sort that out nicely. Hard to be overweight when you're reliant on catching your own irradiated bunnies for food.

People have too much money. Are wedded to their cars. Can't be arsed to walk to the shops to buy a pint of milk. Consume too much rubbish literally and figuratively. If you have a society and economy which is fundamentally about encouraging consumption to drive it, what you end up with is a bloated population.

We've been brainwashed into thinking everything is about buying 'more stuff' and endless unsustainable growth to drive share dividends to keep a small number of very rich people very rich.

Taxing sugary drinks more heavily isn't going to change any of that.

We've been brainwashed into thinking everything is about buying 'more stuff' and endless unsustainable growth to drive share dividends to keep a small number of very rich people very rich.

erine's chart is actually more meaningful

No, because if you measure funding against GDP you would conclude that reducing GDP improves the NHS.

The absolute value is the one that matters in terms of what the NHS can do - or even better the absolute value per person who has access to the service.

Once the effects of Brexit hit, you can be sure that we'll look back on the NHS as it is now as the golden years. Enjoy it while it lasts.

We've been brainwashed into thinking everything is about buying 'more stuff'

We haven't been brainwashed - most of us quite like it, so we want to believe that.

The absolute value is the one that matters in terms of what the NHS can do - or even better the absolute value per person who has access to the service.

Afaik, the NHS is very efficient, just underfunded.

Efficiency depends very much on the chosen measure. By some measures the NHS is very efficient, by others it looks pretty poor. There are high excess (i.e. avoidable) deaths for one thing. And efficiency doesn't equal overall capability.

There's almost certainly a mix of inefficiency and underfunding. Pick one depending which side of the political spectrum you are on (which is why it will never get fixed, because only one ever gets looked at at a time).

It's no good, I can't concentrate on work this morning. Ernie's charts have quite upset me. It's a bloody outrage. Under these nasty Tories, health spending as a percentage of GDP is going to go back to the highs recorded (per-crisis) both those bloody Labour folk. If we can't trust the Toires to protect us from Labour levels of spending, who can you trust? The Lib Dems???

It's all ideology and privatisation don't you know....a national disgrace. Where the address for the Daily Mail letters page?

Under these nasty Tories, health spending as a percentage of GDP is going to go back to the highs recorded (per-crisis) both those bloody Labour folk.

ernies's charts show that the UK can afford the NHS, the point being funding needs increasing and management needs to be better. Long term medical outcomes should form the basis of the future of the NHS not political targets and teams there to bend the stats to the target.

Agreed so why all the bllx about the Tories? Ok, Hunt doesn't Inspire confidence I do accept that.

NI should be like actual insurance, the British have shown that they are not responsible enough for proper socialised medicine. I want to see contributions go up based on age and lifestyle factors eg how morbidly obese you are or whether you smoke or drink too much.

how far back are you looking?
The stuff about the tories was their 10bn claim which was properly shot out of the water. Claiming to have given 10bn over a number of years to an organisation with a 116bn budget also shakes a few things up. It's not actually that much money to make a huge difference but as the Brexit stuff showed, once a number reaches a certain size it's assumed it's near infinite. People are impressed but have no idea what difference it will actually make.

I want to see contributions go up based on age and lifestyle factors eg how morbidly obese you are or whether you smoke or drink too much.

Anyway care to explain how the UK has failed to be responsible enough?

"Long term medical outcomes should form the basis of the future of the NHS not political targets and teams there to bend the stats to the target."

Indeed, and that can't happen while Politicians are running it.

...or maybe I mean while voters are running it.

Easy Mike, any sport that reduces public health burden is excempt.

I think we should then just cut tqx on booze and fags like the Russians, to kill as many idiots off as possible.

Tom_W1987 - Member
Easy Mike, any sport that reduces public health burden is excempt.

which sports are they? Looks like it's going to be a tough one to call, how much is a cruciate op? Whats the balance between exercise and injury and long term damage?
I thought you wanted to tax the unhealthy lifestyles of people but now you want to cut the tax?
Are you applying for Jeremy Hunt's job?

Id be happy to pay insurance to cover the risk of DH.

Id be happy to pay insurance to cover the risk of DH.

how far back are you looking?

Not too far, its gets even scarier then. Heaven forbid that we should return to the levels of the mid 2000.

The stuff about the tories was their 10bn claim which was properly shot out of the water.

Indeed. No harm in pulling the Tories up for false claims. Happy with that.

Let the people who supply the cover (that we will all end up having) compete for ways to incentivise us- they will be the innovators not politicians. It already happens - in all places - in the life (yes life) insurance market for HIV positive people in SA. But that required good old private equity to fund that brilliant model. Not Zuma "Have a Shower"!

Our first born had a serious and rare condition that no doubt cost the NHS a lot of money to treat (in fact there was some uncertainty that the second lot of treatment would even be signed off). It was genetic, so we had to think carefully about having more kids. Long story short, we have 3 wonderful children and, although the first child still has some challenges, they are healthy and well.

I often wonder how different our life would be under a different health care system to the NHS and I will be eternally grateful for everything they've done for us over the years.

I often wonder how different our life would be under a different health care system to the NHS and I will be eternally grateful for everything they've done for us over the years.

My experience of the NHS has been awesome, too, but the majority view is it's crap because it's run & funded by Government which never allocates sufficient resources to it. (Many people say for malicious reasons!) That view has been unchanged throughout my lifetime. The only way to keep everyone happy is to take it out of Government hands, then everyone gets exactly the quality of service they want.

outofbreath - Member

erine's chart is actually more meaningful

No, because..............

Really? Are you sure that it's not more meaningful than a chart which shows no spending at all for the first ten years of the NHS, or that makes no distinction between costs in 1950 and costs in 2020?

Do you also go shopping with a ten bob note then?

Really? Are you sure that it's not more meaningful than a chart which shows no spending at all for the first ten years of the NHS,

You're being a little obtuse. Nobody's saying it was zero, it's just doesn't show on the graph. It would be easy to produce the same graph on a different scale.

or that makes no distinction between costs in 1950 and costs in 2020?

You can factor that out/in yourself if you wish. (Although why would you, costs aren't fictional items, they should be included.)

Comparing to income is mental. By that measure my car becomes twice as good if my salary halves!

The only way to keep everyone happy is to take it out of Government hands, then everyone gets exactly the quality of service they want

Do they? Surely cost then becomes an issue that the individual has to worry about rather than the government. My fear of a privately run health care system where you pay a premium based on risk is that, in our circumstance, the risks of having more kids would have been deemed too high by someone in an office with a spreadsheet and hence our premium would have been unaffordable. I know this is all pure speculation, but our health is not always completely in our control.

You're being a little obtuse. Nobody's saying it was zero, it's just doesn't show on the graph. It would be easy to produce the same graph on a different scale.

Have you not had a debate (sic) with Ernie before?

Dont worry most people understand scaling and if they dont

http://www.ukpublicspending.co.uk/spending_chart_1940_2020UKb_16c1li111mcn_10t

here's the data source for Jambas chart

Nobody's saying it was zero, it's just doesn't show on the graph.

Which obviously makes Jamba's graph even more meaningless than mine, ie, there was clearly spending for the first ten years of the NHS.

I'm glad we've got that sorted out - thank you.

Carry on.....

Which obviously makes Jamba's graph even more meaningless than mine, ie, there was clearly spending for the first ten years of the NHS.

...but Earnie, aren't you just proving my point. You don't trust me to assess the resources going into the NHS. Yet I'm one of the voters who are determining the resources dedicated to your healthcare.

Much better for you to take me out of the equation and provide it for yourself, then you get *exactly* what you want.

Which obviously makes Jamba's graph even more meaningless than mine

Dont undersell yourself Ernie - your graph is a stark warning that we cant trust the Tories not to return us to Labour levels of spending. That's a valuable message, thank you.

teamhurtmore - Member

Have you not had a debate (sic) with Ernie before?

I gave up attempting to have sensible debates with you THM as the result of silly and puerile comments such as this :

teamhurtmore - Member

I know people don't like this Hunt bloke, but he must be really bad if he thinks that underfunding a business and running it into the ground would make it attractive for privatisation? Is this some new kind of strategy for preparing a company for the market? Still haven't seen any prospectus yet though? Even odder still......

Posted 1 day ago

Dont undersell yourself Ernie - your graph is a stark warning that we cant trust the Tories not to return us to Labour levels of spending. That's a valuable message, thank you.

It doesn't matter which party it doing the harm.

If you have a system where the key decision maker is deliberately sabotaging something, you need to take them out of the equation and do in another way. BUPA might not be perfect, but at least they're not actively trying to provide bad healthcare!

If there were two coffee shops in town, one where a succession of owners are deliberately doing it badly for malicious reasons and one where the guy is doing the job with the sole aim of getting more customers so he can cream off profit it's clear which one's gonna be better.

I gave up attempting to have sensible debates

True, and you dont like having false points exposed either!

how about "silly and peurile" comments such as no spending at all.....sensible debate???? no really!

still always amusing to see the ingemar stenmark of internet debating in full flow.

Is it me or is this thread turning into this?

[img] [/img]

No it's not just you.......that's me on the left in red.

Is it me or is this thread turning into this?

That GIF is considerably more entertaining than watching Tae Kwon Do at the Olympics

The idea that contributions to the NHS should be based on lifestyle is a slippery slope (regardless of the statistics mountain biking is perceived as an extreme sport and would be one of the first to attract a premium even if its statistically safer than more main stream sports or activities).

It also assumes that everyone has an equal choice in their lifestyle. The past 30 years has seen a vast increase in jobs which combine poor pay, little security, and irregular hours, which leave a lot of people without a control over a routine into which to fit family life let alone regular sport or activity.

The NHS needs to decide what its for (what are its priorities and what are its boundaries) and social care needs to be more closely aligned and funded from the same pot so it can be better coordinated. This is a debate which politicians have been ducking for years because if its an honest debate no one is going to come out of it without scars.

I'm no great fan of the military, or how politicians have taken to using it to increase their toughness credentials, but at the moment under current trade rules its one of the few ways a government can subsidise high tech domestic research and manufacturing.

The most important thing about NHS spending is that it is MUCH higher under the Tories than Labour proposed at the 2015 GE. The increase under the Tories is 5 times greater.

The idea that contributions to the NHS should be based on lifestyle is a slippery slope

Yes I do get that however we buy sports insurance which say covers only on piste skiing and more expensive which covers off piste

As I posted before we in the UK pay far less in terms of personal / private health cover than the rest of Europe.

As I posted before we in the UK pay far less in terms of personal / private health cover than the rest of Europe.

Any party which stands on a platform of "you need to pay more" isn't going to do very well.

Such is the nature of the British voter (same for most other countries).

It's easy to say we can spend more money, finding it is a bit harder. Even here, someone said earlier you could cut MP's expenses but I don't think that even amounts to a drop in the ocean compared to NHS costs. The scale of most things passes by your average voter.

It also assumes that everyone has an equal choice in their lifestyle. The past 30 years has seen a vast increase in jobs which combine poor pay, little security, and irregular hours, which leave a lot of people without a control over a routine into which to fit family life let alone regular sport or activity.

Many of them still find the money to drink and smoke though. Perhaps they could jog to the newsagents and the offy?

If they did neither, they'd be fitter, and the NHS would be a bit better off too.

Yes I do get that however we buy sports insurance which say covers only on piste skiing and more expensive which covers off piste

The thought of private health insurance working this way terrifies me. Life would become full of decisions based on whether you could financially afford the consequences based on what level of cover you have.

Try my local road gap? No, I'm not covered for that activity and can't afford the medical bill if I stack it. Solo that VS I've done dozens of times before at the local crag? Nope, if I fall I'm not covered and I'll have to sell the house to pay the medical bills. Take my lad on the Fort William downhill track? etc

I'm sure many people would argue that this is entirely right and fair, but it would be a huge change to become accustomed to when all I'm really trying to do is keep my mind and body healthy.

The most important thing about NHS spending is that it is MUCH higher under the Tories than Labour proposed at the 2015 GE. The increase under the Tories is 5 times greater.

It would be interesting to see the data behind that conclusion.

Whats the problem with charging based on lifestyle?

My wife pays thosuands more to use the NHs than you lot simply because she's an immigrant, even though shes a higher band taxpayer and has private cover.

Totally fine to tax the **** out of immigrants but not the fat jobless ****s that are the ones placing a burden on the system.

[u]NI[/u] should be like actual insurance, the British have shown that they are not responsible enough for proper socialised medicine. I want to see [u]contributions[/u] go up based on age and lifestyle factors

but not the fat [u]jobless[/u] ****

I'm thinking you didn't quite think this plan all the way through

Tom_W1987 - Member

Whats the problem with charging based on lifestyle?

My wife pays thosuands more to use the NHs than you lot simply because she's an immigrant, even though shes a higher band taxpayer and has private cover.

Totally fine to tax the * out of immigrants but not the fat jobless * that are the ones placing a burden on the system.

Sometimes I look at a post and really feel that I want to say something, but the whole post is so ridiculous that I just don't know where to start.

In the end I can't be bothered.

This is a good example.

Ok. Fat, lower tax band, lower NI contributing Northern Brexiteers that shit out too many kids.

Oh you're upping the pleasantries, how nice.

Whats the problem with charging based on lifestyle?

Can you think about how it would work for 20 seconds and then come back and tell us what you think the problems trying to implement it would be.

Tax aircraft fuel and put VAT on airline tickets.

Tax aircraft fuel

Problem with that is that other countries don't. If you start doing it, all your short haul flights will arrive in the UK with half full tanks and not take any on. And aircraft routings will be adjusted to limit the amount of UK fuel used.

Changing taxes mostly changes behaviours and only sometimes raises money.

Also, drop in the ocean compared to NHS funding.

Also, drop in the ocean compared to NHS funding.

Are you sure? IIRC a few years back it was calculated at being worth £10bn per year, which would give the NHS a very healthy boost.

[i]Problem with that is that other countries don't. If you start doing it, all your short haul flights will arrive in the UK with half full tanks and not take any on. And aircraft routings will be adjusted to limit the amount of UK fuel used.[/I]

The idea proposed that resulted in this answer is yet another in a long list of reasons for why you CANNOT allow the general public to be involved in actually policy decisions - otherwise you end up with ideas like this, Brexit and no doubt capital punishment. 😉

if you want a healthier society you need a fairer society.
We seem to be going in the opposite direction.
Wasn't it midday last Wednesday when ftse 100 ceo's had earned the same as their employees will earn all year?
And to all the healthy middle class educated folks banging on about penalising poor fat smokers for their lifestyle "choices", google "social determinants of health". Not everyone has the same choices to make, and if you are one of the unlucky ones, there is f-all you can do to change that.

Kerley, Sweden is already trialling it in a way by not paying for certain operations until the patient has lost weight.

I don't see why I should be paying for other peoples poor choices or bad genetics, seeing as Britain has collectively decided to punish me and my wife financially because I married a foreigner. And I damn well don't see why I should be paying for hospital maternity bills if people argue it's because we increased the population of the UK.

Theresa May has been calling for an end to division in the UK, well her voters voted for division by giving them a mandate to bring in discriminatory immigration policies. Why is sivision only bad if its poor white people that feel hurt?

The cheapest way to deliver healthcare is to do it instantly without too much prevarication like conditions to treatment or charging arguments (before or after the treatment) but of course that becomes expensive when it collides with charged model like the drug businesses that are global and interact with different methods

If we wanted to pay for the NHS and all the other stuff we do on the cheap (schools, prisons, transport) we need to take an axe to the tons of daft tax laws that exist only to provide economic stimulus to business sectors (which is daft anyway) but all it does is provide loopholes for the likes of Barclays wealth to create tax dodge schemes. Hence everything is avoidance and HMRC are never confident of the line between avoid vs evade.

You mean the drug development model that requires crap loads of capital and investment to produce new types of drugs? Yeah sure, that could be nationalized world wide....hahah.....also.....Britain doesnt like experts so I doubt they'd like to see more government money ploughed into those ivory tower timewasting academics.

Separation of public health from NHS has not helped - health prevention is now driven by councils not NHS - cheaper to prevent many problems than treat.

Separation of health and social care budgets not bright - incentive to keep elderly in hospital to save budget but at a far greater cost to UK plc.

Lack of joined up working doesn't help - competition and the internal market has not helped in many ways as that market has to be administered.

Ultimately though, the issue isn't just an NHS one - healthcare for the whole of planet earth is predicted to become unaffordable if current trends continue - arguing over which country then becomes irrelevant.

Problem with that is that other countries don't. If you start doing it, all your short haul flights will arrive in the UK with half full tanks and not take any on. And aircraft routings will be adjusted to limit the amount of UK fuel used.

The idea proposed that resulted in this answer is yet another in a long list of reasons for why you CANNOT allow the general public to be involved in actually policy decisions - otherwise you end up with ideas like this, Brexit and no doubt capital punishment.

Doh! I'd never thought of that 🙄
Suppose it could be achieved if we were in an international trading and political organisation with the same rules and where most of the short haul flights began and ended ...now there's an idea 😉 Wasn't the EU being praised in the Brexit thread for deregulating the national airline cartel/monoplies?? CBA checking back.

Suppose we should give up on trying to regulate tax avoidance and offshore tax havens too because countries will never agree to that either.

or we could just give in to vested business interests to the detriment of the world's environment

Getting shot of a load of inert 'managers' in the public sector in general would help. (As TJ inferred)
Don't get me started on made up jobs in the prison service.

Stop hospital treatment for anyone over 80. Maybe have a big tar pit to throw them into on their 80th birthday.. Big celebration, big send off party and into the tar pit you go old people.

Maybe fat people can be sacrificed and rendered down to heating oil if they top 30 stone. Right flashy.. You knew what would happen if you carried on eating at Gregg's.. Into the rendering plant you go to keep the racing snakes warm.

I have more if anyone is interested.

Separation of public health from NHS has not helped - health prevention is now driven by councils not NHS - cheaper to prevent many problems than treat.

Separation of health and social care budgets not bright - incentive to keep elderly in hospital to save budget but at a far greater cost to UK plc.

It's like anything, spending more and more brings increasingly dimishing returns in terms of advancing lifespan. We now have loads and loads of old people, who can live for two decades of needing care. I have a gran who had mild alzheimers and she had anti-cancer drugs thrown at her, she survived cancer but she had basically lost it by the time the treatment finished...whyyyy?

What we need to do is spend the serious money on improving peoples quality of life and useful working lifespan. Society needs to think about death more, realize that they are one day going to die and spend more time thinking about how their lives could be improved instead of always trying to delay the inevitable.

The thought of private health insurance working this way terrifies me. Life would become full of decisions based on whether you could financially afford the consequences based on what level of cover you have.

Understood. The alternative is taking little or no responsibility for your actions (in extreme). Eat as much unhealthy food as you want and the state will pay for the consequences. Life insurance works this way too, there is a questionaire it's reasonable for them to decline you if you are a BASE jumper. Anyway in practice we would just have proper health insurace allowing pre-existing conditions and working together with the State provision.

Tom yes indeed. Elderly care is something we really need to think about. Also the type of health care people are offered. If you step back and look at costs without emotion a huge amount is spent on treatments at end of life which offer no real extension of life and/or no improvement in quality. In many cases the patients don't really want them.

This is the charity which my neighbour who is an ex nurse aProfessor and CBE works with

http://myhomelife.org.uk

What about cutting the salaries of the chief exec's and stopping the supply chain from ripping off hospitals and doctors surgeries. This issue has two sides, it needs proper funding but it also need s good and responsible management. I feel we are part way on the first step but a long way off the second and until that's addressed we are just putting more and more money into the hands of people that waste it on our behalf.

The ceo is one of the positions that I would really want some of the best in. It's the key leadership role of the organisation.
How are the supply chain ripping people off? Big paharma are not rolling in cash from drug development these days.

Charge drunks for their treatment in A&E. Not alcoholics, but people who go out get rat-arsed and have a fight.

How are the supply chain ripping people off? Big paharma are not rolling in cash from drug development these days.

+1

My old company, developed a first of it's kind drug - Imlygic - a genetically modified herpes virus designed to infect and kill skin cancer cells - really bleeding edge stuff.

Oh but after decades of research, it turns out that it's not very good at extending lifespan (last time I checked, as they didn't have enough data on patients with lower grade more survivable skin cancer). Thus, I'm not sure whether they will actually ever turn a profit on the drug - getting these lofty treatments to market is a massive, massive risk financially to companies.

Then the drugs that we do manage to get out there, get pissed up the wall by governments, clinical staff and the general public - through poor or over use - eg antibiotics - we even have people on here who demand extended treatment for lyme disease who cannot show any evidence of it's efficiacy and who don't mind that by using these drugs they are contributing to their eventual obsolesence. Whilst we have millions throughout the world who don't have access to good healthcare or antibiotics?