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How do we fix the failing NHS


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I am aware that this is a very complicated issue to resolve. But the service on which we all rely is in a massive decline.

I constantly read about endless waiting times, needless deaths and suffering.

It appears to be on the verge of collapse so should we demand as a nation immediate improvements from the NHS and the Government .   

The NHS  is gradually being privatised so eventually will they introduce a medical insurance system like the USA where only the wealthy can afford to use it.    

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18 minutes ago, FANG said:

I am aware that this is a very complicated issue to resolve. But the service on which we all rely is in a massive decline.

I constantly read about endless waiting times, needless deaths and suffering.

It appears to be on the verge of collapse so should we demand as a nation immediate improvements from the NHS and the Government .   

The NHS  is gradually being privatised so eventually will they introduce a medical insurance system like the USA where only the wealthy can afford to use it.    

I would challenge "massive decline" and "verge of collapse" quite strongly - you have probably been reading too much newspaper hyperbole.

Do you know what "collapse" would actually mean?  It would mean you call 999 and they just say "we don't do ambulances any more, sorry".  It would mean you try to book a doctor's appointment and they say "there are no NHS doctors any more, sorry".  We are nowhere near that.

The two choices as I see it are:

- Decide we want the NHS to provide fewer services, and cease providing lots of the things it currently does

- Decide we want the NHS to provide all of its current services better, and dramatically increase taxes

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20 minutes ago, FANG said:

I am aware that this is a very complicated issue to resolve. But the service on which we all rely is in a massive decline.

I constantly read about endless waiting times, needless deaths and suffering.

It appears to be on the verge of collapse so should we demand as a nation immediate improvements from the NHS and the Government .   

The NHS  is gradually being privatised so eventually will they introduce a medical insurance system like the USA where only the wealthy can afford to use it.    

Are you Laurence Fox in disguise?  NHS isn't perfect but every time I had to use it I didn't have any issues. Sure, I had to wait a bit to get seen but nothing that in my view was excessive.  I think it's a brilliant organisation.

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I would see this as a first sign of the outworkings of "de-growth" or contraction of the real economy.

If we think that the underlying "real" economy of energy and resources has plateaued and is starting to contract after a couple of centuries of growth: Cheap (i.e. easy to extract / get) energy and resources fuel ever more "complexity" in society and the economy - I suppose the way "degrowth" or contraction manifests itself is though simplification of society and the economy.

Anyway I would see the NHS as a hugely complex system. I would think there are different aspects that need to be tackled in different directions.

One is vested interests - as you say, there are powerful groups who want to dismantle the NHS or run it down so that they can personally benefit or profit from its decline and failure. This needs to be carefully analysed to find out who these individuals or groups are and what their influence and motivation is.

Another is setting clear targets, not in an "outcome" kind of way but in a "system" kind of way. What kind of system would be the most simple, resilient, effective?

Another is a kind of resource allocation analysis. How much of the UK's productivity do we want to put into the NHS? Set a percentage on this. We can't just let that percentage incrementally grow otherwise after a certain number of years the entire economy services the NHS and nothing else can get done.

Then acknowledge that if the real economy of energy, resources, labour, is shrinking, then the NHS budgets will also naturally have to shrink along with it. Trouble is everyone wants their personal budget to stay fixed or grow, and so they work to try and get someone else to shrink faster.

Finally - put some funds into serious lifestyle research. I know a lot of people on here follow "alternative" nutrition, health and fitness advice that their GP would panic about (lift weights, eat steak and eggs and salad leaves for breakfast) - it is a huge drag on the NHS that official advice is to do aerobic exercise and eat a low-fat diet with lots of whole grains. Swapping this advice around would massively increase health and wellbeing and massively cut costs. But it needs root and branch reform of "nutritional science" to get started. Perhaps that is as naive as hoping for root and branch reform of "economics"...

 

 

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21 minutes ago, FANG said:

I am aware that this is a very complicated issue to resolve. But the service on which we all rely is in a massive decline.

I constantly read about endless waiting times, needless deaths and suffering.

It appears to be on the verge of collapse so should we demand as a nation immediate improvements from the NHS and the Government .   

The NHS  is gradually being privatised so eventually will they introduce a medical insurance system like the USA where only the wealthy can afford to use it.    

Its already the case. I know someone in agony who needs a hip replacement, but can't get anywhere on the NHS. It will happen eventually in several years. If she could find £10k she could have it done straight away (from what I have read it will even be the same pool of doctors?)

Isn't the real problem its not funded properly? Not enough public money to pay for everyones treatment, but most of us don't have insurance and so can't pay directly. Why not do what the European countries do and have insurance + public system and include the guarantee of treatment for all (unlike the American system). Don't know what they have in Asia, but have heard e.g S. Korea is very good.

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I personally think the NHS does need changing to secure its long term future. However it's politically impossible to say that, so I doubt it will ever happen.

I have no idea how it needs changing but it's clearly not sustainable as a fix every disease / illness / mental health one stop shop as it is. 

You could double the NHS budget and it wouldn't be enough

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3 minutes ago, scottbeard said:

I would challenge "massive decline" and "verge of collapse" quite strongly - you have probably been reading too much newspaper hyperbole.

Do you know what "collapse" would actually mean?  It would mean you call 999 and they just say "we don't do ambulances any more, sorry".  It would mean you try to book a doctor's appointment and they say "there are no NHS doctors any more, sorry".  We are nowhere near that.

The two choices as I see it are:

- Decide we want the NHS to provide fewer services, and cease providing lots of the things it currently does

- Decide we want the NHS to provide all of its current services better, and dramatically increase taxes

Or make it a basic minimum service with optional additional cover at additional cost?

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3 minutes ago, erat_forte said:

I would see this as a first sign of the outworkings of "de-growth" or contraction of the real economy.

If we think that the underlying "real" economy of energy and resources has plateaued and is starting to contract after a couple of centuries of growth: Cheap (i.e. easy to extract / get) energy and resources fuel ever more "complexity" in society and the economy - I suppose the way "degrowth" or contraction manifests itself is though simplification of society and the economy.

Anyway I would see the NHS as a hugely complex system. I would think there are different aspects that need to be tackled in different directions.

One is vested interests - as you say, there are powerful groups who want to dismantle the NHS or run it down so that they can personally benefit or profit from its decline and failure. This needs to be carefully analysed to find out who these individuals or groups are and what their influence and motivation is.

Another is setting clear targets, not in an "outcome" kind of way but in a "system" kind of way. What kind of system would be the most simple, resilient, effective?

Another is a kind of resource allocation analysis. How much of the UK's productivity do we want to put into the NHS? Set a percentage on this. We can't just let that percentage incrementally grow otherwise after a certain number of years the entire economy services the NHS and nothing else can get done.

Then acknowledge that if the real economy of energy, resources, labour, is shrinking, then the NHS budgets will also naturally have to shrink along with it. Trouble is everyone wants their personal budget to stay fixed or grow, and so they work to try and get someone else to shrink faster.

Finally - put some funds into serious lifestyle research. I know a lot of people on here follow "alternative" nutrition, health and fitness advice that their GP would panic about (lift weights, eat steak and eggs and salad leaves for breakfast) - it is a huge drag on the NHS that official advice is to do aerobic exercise and eat a low-fat diet with lots of whole grains. Swapping this advice around would massively increase health and wellbeing and massively cut costs. But it needs root and branch reform of "nutritional science" to get started. Perhaps that is as naive as hoping for root and branch reform of "economics"...

 

 

Theres really no 'powerful groups' trying to dismantle the NHS.

There are powerful groups within the NHS, clinging onto its current lousy organisation.

No-ones copying the NHS. The 'bets in the world' spouted all the time just isnt true.

Just pick one of the better performing health care systems- despite the claims, there are more health care setups other than the US and the UK - and copy it.

 

 

 

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9 minutes ago, MancTom said:

Its already the case. I know someone in agony who needs a hip replacement, but can't get anywhere on the NHS. It will happen eventually in several years. If she could find £10k she could have it done straight away (from what I have read it will even be the same pool of doctors?)

Isn't the real problem its not funded properly? Not enough public money to pay for everyones treatment, but most of us don't have insurance and so can't pay directly. Why not do what the European countries do and have insurance + public system and include the guarantee of treatment for all (unlike the American system). Don't know what they have in Asia, but have heard e.g S. Korea is very good.

In terms of cost/capita the NHS is one of the most expensive healthcare systems going.

 

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We already have an insurance policy to pay for the NHS it's called National Insurance however should we need extra cash then I suggest the billions spent on nuclear weapons or the billions spent on HS2 or the billions spaffed up against a Serco track and trace system that other countries provide for a fraction of the cost, or the 1 Billion given to the DUP to bribe them to vote with the Govt. Maybe we could just start taxing twats like Branson instead of paying him when his Virgin Healthcare doesn't win contracts. The people who benefit from a run down NHS are the private health care providers that people resort to out of desperation. 

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Just now, spyguy said:

Theres really no 'powerful groups' trying to dismantle the NHS.

There are powerful groups within the NHS, clinging onto its current lousy organisation.

No-ones copying the NHS. The 'bets in the world' spouted all the time just isnt true.

Just pick one of the better performing health care systems- despite the claims, there are more health care setups other than the US and the UK - and copy it.

 

 

 

Which, why haven't you named them? Then tell us how much is spent on the good perfoming health services in comparison to the NHS.

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1 minute ago, Lucky Larry said:

We already have an insurance policy to pay for the NHS it's called National Insurance however should we need extra cash then I suggest the billions spent on nuclear weapons or the billions spent on HS2 or the billions spaffed up against a Serco track and trace system that other countries provide for a fraction of the cost, or the 1 Billion given to the DUP to bribe them to vote with the Govt. Maybe we could just start taxing twats like Branson instead of paying him when his Virgin Healthcare doesn't win contracts. The people who benefit from a run down NHS are the private health care providers that people resort to out of desperation. 

National Insurance is not insurance. Its just a tax that goes into the same pot as income tax for general use on whatever the government wants.

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4 minutes ago, spyguy said:

In terms of cost/capita the NHS is one of the most expensive healthcare systems going.

 

Is this yet another of your 'the UK has one of the oldest populations in Europe bllsht again?

 

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29#how-much-does-the-uk-spend-on-healthcare-compared-with-its-international-peers

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3 minutes ago, MancTom said:

National Insurance is not insurance. Its just a tax that goes into the same pot as income tax for general use on whatever the government wants.

Yes, they're very adept at renaming taxes , duty , charge,  etc etc 

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19 minutes ago, miguel said:

Which, why haven't you named them? Then tell us how much is spent on the good perfoming health services in comparison to the NHS.

BMA for one, which restricts training places to protect existing workers from coemption.

https://worldpopulationreview.com/country-rankings/best-healthcare-in-the-world

Theres a whole load of stats collected on healthcare systems.

Singapore's prob the best, in terms of outcomes and cost.

 

 

 

 

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20 minutes ago, MancTom said:

National Insurance is not insurance. Its just a tax that goes into the same pot as income tax for general use on whatever the government wants.

No it doesnt.

There is a sperate pot/account for NI.

 

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18 minutes ago, miguel said:

Youll note that Italy spends less but out performs the UK.

 

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2 hours ago, FANG said:

I am aware that this is a very complicated issue to resolve. But the service on which we all rely is in a massive decline.

Well you don't fix it by privatising it which is exactly what the government's latest health care bill does, which has now received its second reading in parliament. Private healthcare is less efficient, achieving lower coverage at higher financial cost. Shareholder profits have to come from somewhere, namely reduced patient service. Set the system back to what it was circa 1975 ought to fix it. No internal market, funded from general taxation. As I believe Corbyn would have done. Not a peep from Starmer it seems on this ...

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I used the NHS last weekend so I think I might be qualified to post my thoughts here. I damaged my hand playing cricket with the palm split and blood pouring. After a quick first aid bandage, ended up in A and E. Was checked in quickly. When I did go to the trauma unit there were probably about 10 people waiting. This is where I was disappointed a bit. It was first come first serve irrespective of the injury. Although I was bleeding hard  others with a sprained ankle or other minor injuries were looked at first. My turn came after an hour and half. The nurse who tended to me was very friendly, chatty, polite, and professional. Did everything quickly and dressed the wound and got me an appointment with a surgeon in another hospital. She seemed very over worked , poor thing.

At the main hospital,  things were more organised since they were expecting me. A covid test first and a wait for results. After it was negative things moved quickly. Two surgeons assessed the wound and decided what the course of action would be. Wheeled into a operating room, local anaesthetic administered and wound stitched and wheeled out. All paperwork sorted and done professionally and sent home.

I think things are actually quite good at the NHS in my opinion, especially if it's an urgent matter. The doctors are really good Nd so are the nurses. I am grateful really to have received the care considering the reputation of NHS. 

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13 minutes ago, spyguy said:

Youll note that Italy spends less but out performs the UK.

 

Is that all you have?  A little different to 'In terms of cost/capita the NHS is one of the most expensive healthcare systems going'. Which would suggest that it's one of the worst performing health care systems in the entire world. 

 

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If you rely on it or think you'll need the NHS soon, and you can't afford private healthcare (most of you?) then vote for whichever party will fund and run the service best.

It's not hard. I also don't remember the NHS being discussed as being "in decline" until after the financial crisis.

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12 minutes ago, miguel said:

Is that all you have?  A little different to 'In terms of cost/capita the NHS is one of the most expensive healthcare systems going'. Which would suggest that it's one of the worst performing health care systems in the entire world. 

 

Best to just ignore him. I really don't think they're very well!

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