Trampa501

Will The Temptation To Privatise The Nhs Become Too Strong?

183 posts in this topic

I don't think we're at that point yet (I'm not talking about drip-feed measures to involve more private companies). Apart from anything, public opinion is still far too attached to the government run NHS.

But at some point it must be very tempting to sell the right to run a PCT, and tell the new private operator "we will still subsidise you, the same way we do the train companies, but you will be able to keep any money you make through efficiencies, extra charges for foreign patients or for bed & board charges etc."

Do you see this happening anytime soon? Sadly I think it's inevitable within 10 years or so.

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The NHS is a failure.

- It does not make efficient, or even slightly efficient, use of the resources thrown at it.

- It's not been copied as it is crap. Some other Countries may have a similar scheme, but none has anything as inefficient and monolithic as the NHS.

- It consistently provides healthcare results lower than that of other European Nations.

- It is ruled by massive vested interests (Trade Union's of the Doctors and Nurses for a start).

- It has a management system from Hell.

It's crap. Scrap it, copy the French, or German, or Australian, or Irish, or any other bloody system. The NHS is causing unnecessary suffering and premature death for thousands of people each year - It's time for reform, we can't continue to chuck money at it in the hope it will improve, history tells us it will not.

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On the counter side to this the US privatised Health Care system is an even bigger failure as the poor can't afford it.

There is no easy answer to this mess, privatise it and it's a luxury and we can all look to forward to zero tax rebate back from the govt plus as well as still paying the same amount of tax we all then have to find money to pay for health insurance.

There is no easy answer to the problems, although if you could remove the empire builders in the NHS you might make it more efficient.

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It's not that the NHS is a failure, it's that the effective part-privitisation by conservolabour in the last 20 years has filled the NHS with all the wosrt parts of corporatism.

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The NHS is a failure.

- It does not make efficient, or even slightly efficient, use of the resources thrown at it.

- It's not been copied as it is crap. Some other Countries may have a similar scheme, but none has anything as inefficient and monolithic as the NHS.

- It consistently provides healthcare results lower than that of other European Nations.

- It is ruled by massive vested interests (Trade Union's of the Doctors and Nurses for a start).

- It has a management system from Hell.

It's crap. Scrap it, copy the French, or German, or Australian, or Irish, or any other bloody system. The NHS is causing unnecessary suffering and premature death for thousands of people each year - It's time for reform, we can't continue to chuck money at it in the hope it will improve, history tells us it will not.

What utter, utter nonsense.

Can you provide ANY links to any evidence that the NHS is inefficient compared to other systems. e.g. money spent on it versus healthcare outcomes.

http://www.politics.co.uk/news/2011/08/08/surprise-report-nhs-most-efficient-healthcare

http://www.bbc.co.uk/news/10375877

Because I can provide loads of evidence from reputable research which shows it is one of the best around.

Obviously if you are the type who only relies on dogma rather than actual evidence then you might take some persuading.

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It's not that the NHS is a failure, it's that the effective part-privitisation by conservolabour in the last 20 years has filled the NHS with all the wosrt parts of corporatism.

Where and how has the "part-privitisation" been a failure? I think you're just spouting rhetoric. The scale of private involvement in the NHS is nowhere near large enough to explain the current state of the system.

Granted, the US system is a complete nightmare, but having private sector involvement provides much better outcomes for less money throughout much of the continent. Just saying that the US private system (which is a misnomer, as the US gov't spends as much on healthcare per capita as the UK does) is cr_ap is nothing but a strawman.

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Where and how has the "part-privitisation" been a failure? I think you're just spouting rhetoric. The scale of private involvement in the NHS is nowhere near large enough to explain the current state of the system.

Granted, the US system is a complete nightmare, but having private sector involvement provides much better outcomes for less money throughout much of the continent. Just saying that the US private system (which is a misnomer, as the US gov't spends as much on healthcare per capita as the UK does) is cr_ap is nothing but a strawman.

Where give me any examples of a country with lower healthcare costs that is a private system?

The data actually exists and it does not support your arguments.

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Where and how has the "part-privitisation" been a failure? I think you're just spouting rhetoric. The scale of private involvement in the NHS is nowhere near large enough to explain the current state of the system.

A big problem has been the attempts to establish 'internal markets' and various other reforms, more than actual private sector involvement. Essentially, it's a case of 'Let's bring in the least efficient bit of marketised systems without any of the benefits'.

Granted, the US system is a complete nightmare, but having private sector involvement provides much better outcomes for less money throughout much of the continent. Just saying that the US private system (which is a misnomer, as the US gov't spends as much on healthcare per capita as the UK does) is cr_ap is nothing but a strawman.

It's certainly true that you could make the NHS better (although I'm not sure about the 'less money' bit). The problem is that instead of a rational, facts based discussion based around providing the best healthcare for the lowest cost, we have huge behind-the-scenes pressure from large healthcare concerns who want to get their hands on a slice of the NHS budget and as a result, huge suspicion (quite rightly IMO) of any changes whatsoever.

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Where and how has the "part-privitisation" been a failure? I think you're just spouting rhetoric. The scale of private involvement in the NHS is nowhere near large enough to explain the current state of the system.

Granted, the US system is a complete nightmare, but having private sector involvement provides much better outcomes for less money throughout much of the continent. Just saying that the US private system (which is a misnomer, as the US gov't spends as much on healthcare per capita as the UK does) is cr_ap is nothing but a strawman.

I have no problems with the NHS being privatised as long as it is goverment funded, still free at point of use (for UK citizens) , and is run privately as a non profit organisation.

The reason the whole USA system is so awful despite huge government expeniture is that hostpitals and health insurance companies are all run for profit and listed with share holders.

It always must be a huge conflict of interests that to increase profits and grow them, pay dividends for shareholders, the USA healthcare system must be always be either lookinng to increase prices (so the poor can't afford health cover) or reduce the amount actually spent on providing healthcare per person (so some treatments are refused or denied in the hope the patient dies before they are forced to pay out).

For these to reasons alone I can't see how a privatised healthcare system run via insurance run for profit can ever be as equitable as the NHS.

Remember the better off in this country always have the option to buy private medical insurance to avoid long waits for serious operations and this ability / snob factor reduces costs for the NHS.

My wife has full private medical cover for our family via her employer (A huge USA company) but in 6 years we have never yet used it.

I'm sure if privatised with Management paid bonuses with reducing costs through cutting wastage and not over paying for drugs and equipement then the NHS could be run better and cheaper.

M

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Why can't the Bullingdon Boys sell it off to Tesco and pay the entire workforce except the board JSA+expenses?

Seems to work in other wonderfully entrepreneurial, creative, out of the box, fast on their feet, private corps so can't think why it wouldn't work for the NHS.

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Do you see this happening anytime soon? Sadly I think it's inevitable within 10 years or so.

No, people in this country are happy to have shit quality healthcare as long as it has the best deluded intentions.

We do not deserve a decent healthcare system here unfortunately.

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Why can't the Bullingdon Boys sell it off to Tesco and pay the entire workforce except the board JSA+expenses?

Seems to work in other wonderfully entrepreneurial, creative, out of the box, fast on their feet, private corps so can't think why it wouldn't work for the NHS.

Exactly. Can you imagine if instead of Tesco Sainsburys, ASDA, tens of thosands of cafes, restaurants etc, we just had one central government agency that controlled all food production and distribution?

I think we all know the quality of food would be awful, the choice non-existent, and the price paid in taxation far too high.

Rejoice that we DO NOT have a National Food Service (NFS)

Despair that we DO have a National Health Service (NHS)

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I don't think we're at that point yet (I'm not talking about drip-feed measures to involve more private companies). Apart from anything, public opinion is still far too attached to the government run NHS.

But at some point it must be very tempting to sell the right to run a PCT, and tell the new private operator "we will still subsidise you, the same way we do the train companies, but you will be able to keep any money you make through efficiencies, extra charges for foreign patients or for bed & board charges etc."

Do you see this happening anytime soon? Sadly I think it's inevitable within 10 years or so.

A complex issue indeed.

Firstly, I don't agree that the NHS is a complete disaster. We spend less than most economically comparable nations and our healthcare outcomes are broadly comparable in most areas. Services were pretty much collapsing by the late 1990s and standards have improved enormously since. Believe it or not, the best bits are held up as an international model for integrated, low-cost healthcare! Of course there are enormous problems too. When faced with our first healthcare problem (fertility) we entirely self-funded. The cost of a happy outcome was £28 000 - way in excess of the NHS tariff for the procedures, but no wait and better hospitaliity!

Has anybody looked at the Singapore healthcare model? I personally think it's an excellent example of a universal, centrally-planned and comprehensive service. I'm no expert, but can summarise the key features as I understand them: everybody has an individual, tracked saving plan that accumulates over time via compulsory individual and employer contributions. On becoming ill, the savings are billed to subsidise the cost of the healthcare expenditure, but there is always an associated charge, no matter how small the intervention. An individual can choose the level of subsidy to suit their current circumstances. Furthermore, they can chose their facility to match their budget - so if 'hotel' services are important and they have the appropriate budget then they may go for a more expensive option. This creates true competition between providers for their own 'niche', from budget to exclusive. The government subsidy varies according to the condition - for example, if somebody needs a bone marrow transplant then their savings plan just won't cover it and the subsidy would be large. The management overheads are said to be low and healthcare provision is excellent.

Unfortunately I suspect that it would be impossible to implement here, but if we were starting from scratch then it looks like good value.

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Exactly. Can you imagine if instead of Tesco Sainsburys, ASDA, tens of thosands of cafes, restaurants etc, we just had one central government agency that controlled all food production and distribution?

I think we all know the quality of food would be awful, the choice non-existent, and the price paid in taxation far too high.

Rejoice that we DO NOT have a National Food Service (NFS)

Despair that we DO have a National Health Service (NHS)

Most people are capable of making an informed choice about food.. although the existence of mass obesity calls this into question. Still, you have to generally assume that people are responsible for their actions.

However, the amount of information required to make an informed choice about medical treatment is much higher, and it is not always obvious that the right choice has been made. This makes an effective healthcare market an extremely hard thing to arrive at. As an example, homeopathy still exists in the market despite being repeatedly shown to be completely ineffective. A bit like a TV still selling that only showed static..

Obviously I expect that a dogmatic free-marketeer will refuse to understand the concept of a market not working.

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Exactly. Can you imagine if instead of Tesco Sainsburys, ASDA, tens of thosands of cafes, restaurants etc, we just had one central government agency that controlled all food production and distribution?

I think we all know the quality of food would be awful, the choice non-existent, and the price paid in taxation far too high.

Rejoice that we DO NOT have a National Food Service (NFS)

Despair that we DO have a National Health Service (NHS)

And yet the system delivers as good outcomes for a lot less money than the private systems used elsewhere.

A point you seem to ignore.

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The NHS is a failure.

- It does not make efficient, or even slightly efficient, use of the resources thrown at it.

- It's not been copied as it is crap. Some other Countries may have a similar scheme, but none has anything as inefficient and monolithic as the NHS.

- It consistently provides healthcare results lower than that of other European Nations.

- It is ruled by massive vested interests (Trade Union's of the Doctors and Nurses for a start).

- It has a management system from Hell.

It's crap. Scrap it, copy the French, or German, or Australian, or Irish, or any other bloody system. The NHS is causing unnecessary suffering and premature death for thousands of people each year - It's time for reform, we can't continue to chuck money at it in the hope it will improve, history tells us it will not.

NHS performance is actually halfway between the best and the worse (Adjusted for resources available).

Singapore who spends about 4% of GDP and yet has a longer life expectancy but has higher cost on those who have expensive to treat diseases vs those in the US where it spends around 15% of the GDP on healthcare and yet has a shorter life expectancy than the UK (UK 80.1 vs US 78.1 vs Singapore 81.3)

NHS Core is still working ok once you get pass the gatekeepers (GP etc), the services is reasonable, albeit sometimes the waiting time is rather long.

Is NHS absolutely rubbish? No. It is among the best, No. Can NHS improves a lot and spend less? Yes.

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NHS performance is actually halfway between the best and the worse (Adjusted for resources available).

Singapore who spends about 4% of GDP and yet has a longer life expectancy but has higher cost on those who have expensive to treat diseases vs those in the US where it spends around 15% of the GDP on healthcare and yet has a shorter life expectancy than the UK (UK 80.1 vs US 78.1 vs Singapore 81.3)

I don't think it is fair to compare Singapore - it is a city state of 5m people and has central planning that would drive people mad here.

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The NHS is a failure.

- It does not make efficient, or even slightly efficient, use of the resources thrown at it.

- It's not been copied as it is crap. Some other Countries may have a similar scheme, but none has anything as inefficient and monolithic as the NHS.

- It consistently provides healthcare results lower than that of other European Nations.

- It is ruled by massive vested interests (Trade Union's of the Doctors and Nurses for a start).

- It has a management system from Hell.

It's crap. Scrap it, copy the French, or German, or Australian, or Irish, or any other bloody system. The NHS is causing unnecessary suffering and premature death for thousands of people each year - It's time for reform, we can't continue to chuck money at it in the hope it will improve, history tells us it will not.

Factually incorrect piffle.

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The NHS is a failure.

It's crap. Scrap it, copy the French, or German, or Australian, or Irish, or any other bloody system.

So you'd prefer Zambian or Somalian "health care", then?

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A complex issue indeed.

Very....there is much room for improvement, sharing of resources, departments that talk and work together, more economic use of generic drugs not expensive ones that do the same job, cutting out wasteful administration and pen pushers, giving patients more choice, to name a few.

...look what happened when they privatised hospital cleaning, complete disaster, dirty wards, cleaners that didn't care or clean properly, paid very poorly without any accountability, germs and infections abound.....one hospital I visited the toilets were discussing, there was pigeon shit on the window ledges, the windows were filthy....yuck. :angry:

Edited by winkie

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A big problem has been the attempts to establish 'internal markets' and various other reforms, more than actual private sector involvement. Essentially, it's a case of 'Let's bring in the least efficient bit of marketised systems without any of the benefits'.
That's what I was implying.

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Most people are capable of making an informed choice about food.. although the existence of mass obesity calls this into question. Still, you have to generally assume that people are responsible for their actions.

However, the amount of information required to make an informed choice about medical treatment is much higher, and it is not always obvious that the right choice has been made. This makes an effective healthcare market an extremely hard thing to arrive at. As an example, homeopathy still exists in the market despite being repeatedly shown to be completely ineffective. A bit like a TV still selling that only showed static..

Obviously I expect that a dogmatic free-marketeer will refuse to understand the concept of a market not working.

Yes yes, people are stupid, people are irresponsible. What we really need is a nanny state controlled by Guardian readers forcing everybody to do exactly what they are told.

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And yet the system delivers as good outcomes for a lot less money than the private systems used elsewhere.

A lot fewer genuinely private systems then you think, most are regulated for producer interests. The American is socialism posing as free market for example.

So please provide examples of it being better than a free market system. (which you won't be able to)

A point you seem to ignore.

Because its totally vacuous.

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Yes yes, people are stupid, people are irresponsible. What we really need is a nanny state controlled by Guardian readers forcing everybody to do exactly what they are told.

CRB check for you if you carry on like that. ;)

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A lot fewer genuinely private systems then you think, most are regulated for producer interests. The American is socialism posing as free market for example.

So please provide examples of it being better than a free market system. (which you won't be able to)

Because its totally vacuous.

Oh sorry I didn't realise the NHS was having to compete with a theoretical system that doesn't, and never could, exist.

In that case you win - your imaginary system would be better than my real life, backed with evidence, system.

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