The future of the NHS

[Clint Planet]

Having the sound on the tellies in the A&E waiting rooms

And the racing.

 

[The Cowboy]

I believe that National Insurance was originally to cover NHS, state pension etc.
Problem is that has never been ring-fenced so is really used for general spending.
One solution would be to raise the basic rate of both Income and Corporation tax and get rid of this confusing pseudo-tax. But no politician would have the nads to do it.
While they're at it, get rid of all 0% and reduced rate VAT, but put the rate down to say 12% and scrap the registration threshold. All of a sudden, you've simplified the tax system and reduced the possibilities for avoidance, by implication raising more revenue.
But am I serious?

Yeah, I don't see the point of having income tax and NI. Just bundle them into one tax. Or rebrand it as NHS tax.

 

[DownOnTheUpside]

I haven't interacted with the NHS for many years (Thank God and touch wood) apart from the odd minor illness requiring a visit to the GP. Recently my Mum was diagnosed with a terminal illness and it has been a nightmare. I don't mean treatment wise, that's been fine but trying to communicate with anybody about how and why certain decisions were being made, trying to get care packages in place for when she came home. A complete lack of communication with nobody taking responsibility for anything. It seems to me that there is far too much admin and beaurocracy (sp?) that is clogging up the whole system.

They used to have long term geriatric wards in hospitals. Great idea - better than unscrupulous care homes run entirely for profit.

Nobody talks to anyone in the nhs in my experience working in it
You have to spend half your time chasing people to find out where anything is or whats going on and its pretty ridiculous

The admin is actually underfunded and very very nescessary otherwise people dont get paid or stuff isnt ordered or people don't get correct treatments or whatever

For every treatment you need someone booking in patients, someone ordering stock to make sure its available, someone making sure the trust gets paid the right amount for that patients treatment, someone updating details of any test results etc etc

And theyre all nescessary functions but theres no real public will to fund these departments compared to primary care staff

 

[Huyton Layne]

I hope it goes the way of the Americans so you too can enjoy holding off on viral infections for weeks rather than have to spend the money on an appointment.

Oh and I'm not sure if people realise that American health insurance only covers a percentage, so visit the A&E and you're coughing up a fair wedge yourself.

 

[Alex123]

Just wondering what your thoughts are on the NHS. I'm talking practical ideas...

It's "chronically underfunded."

The government should be running a fiscal stimulus program. And since healthcare spending is particularly stimulative, much of the stimulus program money should be pumped into the NHS.

 

[The Cowboy]

Nobody talks to anyone in the nhs in my experience working in it
You have to spend half your time chasing people to find out where anything is or whats going on and its pretty ridiculous

The admin is actually underfunded and very very nescessary otherwise people dont get paid or stuff isnt ordered or people don't get correct treatments or whatever

For every treatment you need someone booking in patients, someone ordering stock to make sure its available, someone making sure the trust gets paid the right amount for that patients treatment, someone updating details of any test results etc etc

And theyre all nescessary functions but theres no real public will to fund these departments compared to primary care staff

Yeah, I had the snip last year, and I had to work my way around my GP, my surgery, the consultant, the surgery where the consultant did the procedures, the surgery where the consultant is actually based out of, and the pathology lab at the hospital. 6 different parties, all of whom appeared to have no idea what the others were doing.

 

[The Cowboy]

It's "chronically underfunded."

The government should be running a fiscal stimulus program. And since healthcare spending is particularly stimulative, much of the stimulus program money should be pumped into the NHS.

Not interested. The point of this thread was to discuss practical measures that could improve the service.

 

[Alex123]

discuss practical measures

Increase funding.

 

[tadao]

Increase funding.

Reduce spending.

 

[Mr. White]

Take back crutches!!!

I have 4 sets in my garage because the NHS don't want them back...

 

[tadao]

Reduce spending.

Didn't mean that in a facetious way but, more relating to the amount it costs for the drugs etc.
Understandably, every time someone gets treated, it's new gloves for hygiene etc but, is there actual competition for the contracts or, is it a closed shop where between them the companies decide on the pricing band?

 

[DownOnTheUpside]

Yeah, I had the snip last year, and I had to work my way around my GP, my surgery, the consultant, the surgery where the consultant did the procedures, the surgery where the consultant is actually based out of, and the pathology lab at the hospital. 6 different parties, all of whom appeared to have no idea what the others were doing.

Yerh try having patients kicking off on you cause theyre held up from a file someone has left somewhere and then gone home

 

[DownOnTheUpside]

Didn't mean that in a facetious way but, more relating to the amount it costs for the drugs etc.
Understandably, every time someone gets treated, it's new gloves for hygiene etc but, is there actual competition for the contracts or, is it a closed shop where between them the companies decide on the pricing band?

Its competition like, buuut in practise there's few companies that make each item to the stringent criteria and in sufficient numbers and whatnot
I've friends in purchasing and supplies and a big part of their job is trying to save money negotiating

 

[tadao]

Its competition like, buuut in practise there's few companies that make each item to the stringent criteria and in sufficient numbers and whatnot
I've friends in purchasing and supplies and a big part of their job is trying to save money negotiating

So, do your friends think it's more expensive because of the standards set for the product or, is it target price for sales or, have I misread that?
Also, shouldn't the gov't be able to put pressure on pharmaceuticals re pricing structures?

Edit: Yes, I know gov't wants profits and employment but, surely this is an area, like education, where other priorities take precedence?

 

[DownOnTheUpside]

So, do your friends think it's more expensive because of the standards set for the product or, is it target price for sales or, have I misread that?
Also, shouldn't the gov't be able to put pressure on pharmaceuticals re pricing structures?

Yerh it's mostly because theyre confined to an approved list of products essentially and people like infection control are an utter nightmare to convince them to add something to that approved list
Thats not the exact situation but it's the best I can do without going into crazy detail

A big form of waste is again a communications issue: departments like to air on the safe side by ordering more stuff than they need and sending stuff back once it gets anywhere near expiry dates (im talking 2 months before on a lot of things) it's in the clinic's interest to air on the safe side while purchasing has to try and save money

The final layer of issues is around budgets - if you have budget left at the rollover date then the excess is taken out of your next budget
So say if your department budget is £200, and you only spend £180; then your next budget allowance is dropped to 180
So departments around april start buying a load of stuff they don't need - i've seen computers still in boxes being used as doorstops
But if you don't play this inane game then you can have your budget cut and you dont know how much next year will cost