The NHS for sale?

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Richard
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The NHS for sale?

Postby Richard » Sun Mar 14, 2021 7:50 pm

NHS and Private Healthcare:

We have two systems in place, the 'not for profit' NHS and the 'for profit' private one(s).
I believe that there are fundamental issues in allowing companies to profit from the NHS.
You can look to the situation in the U.S. where private companies involved in healthcare commit fraud on a huge scale each year, in spite of the well-resourced legal and regulatory systems that are in place to combat it.

False charging occurs inside the NHS too, some deliberate some accidental.
The costs in the U.K. of catching fraud or inadvertent charging are too great to manage.
As a consequence small fines are accepted instead of proper and full reimbursement.

Private healthcare companies often employ NHS consultants and doctors, which means they are not available to the NHS who complain about poor staffing levels.

Would it not be better to fund the NHS more fully, rather than allow 'for profit' companies to manage the current shortfalls?
After all private companies pay dividends and hope to push up their share prices on the back of tax-payers money.
This does not seem right to my mind at all.

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seahermit
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Re: The NHS for sale?

Postby seahermit » Mon Mar 15, 2021 12:51 am

This is a very old argument .. as old as the NHS itself. I am not sure that anyone living in a small town can claim to be an expert, able to pontificate on the complexity and pros and cons of our healthcare systems .. but so far as I know there are dual public/private systems in many countries and the private sector fulfills a need at times, in maintaining a pool of expertise and giving a more personal quality of care and often in areas where the NHS does not excel.

There will always be things which can be changed/improved and the way in which private healthcare has come to dominate the care-home sector, heavily guided by monetary motives, is deplorable.

But it is a myth that "private" doctors and consultants only work in the private sector. Many do no doubt, but many others work for both sectors and indeed are keen to spend some of their time "at the front line" in order to keep abreast of what is happening and to widen their practical experience.

Despite all the blunders, confusion and false steps over last year (inevitable during an entirely new, unprecedented situation), I think the NHS has in the end performed well and resoundingly proved its value. Compare that to the situation in Europe - bureaucratic, unwieldy and inefficient, so that the vaccination figures lag far behind those in the UK and the mortality figures are in some countries far ahead.

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number9
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Re: The NHS for sale?

Postby number9 » Mon Mar 15, 2021 1:26 pm

seahermit wrote:Compare that to the situation in Europe - bureaucratic, unwieldy and inefficient, so that the vaccination figures lag far behind those in the UK and the mortality figures are in some countries far ahead.


It's the European Union that appears to be "bureaucratic, unwieldy and inefficient" but some of the countries individually have excellent heath systems perhaps a lot better than ours :)

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Richard
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Re: The NHS for sale?

Postby Richard » Mon Mar 15, 2021 10:18 pm

seahermit, we are here to learn, not to claim expertise!
Private companies do not pay tax on many items and yet the NHS does.
Many NHS staff work privately as well, you won't see senior medics (consultants) at NHS hospitals over the weekends, except in emergency situations.
They are working privately for better pay.

The NHS works wonders and yet few people know how many former NHS services are now provided by private healthcare providers.
Outpatient care clinics, NHS 111, Agency nurses.
Services contracted out and work won by private tenders on contracts.
Most GP practices are privately run.

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seahermit
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Re: The NHS for sale?

Postby seahermit » Mon Mar 15, 2021 11:16 pm

I am not that interested in all the intracacies of the relationship between the NHS and the private sector, all that has been long argued about by people better qualified than myself.

Many GP practices have control over their own budgets, planning etc. but that is not the same as independent, private doctors working wholly for themselves for fee-paying clients. Their practices still work with, and to some extent within, the whole health system and they are subject to many controls and sanctions. I don't see anything necessarily wrong with that as long as it works, but of course there are abuses - it is difficult to change, the NHS is an unwieldy and cumbersome organisation and there are likely to be many things happening which we don't even know about.

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Richard
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Re: The NHS for sale?

Postby Richard » Tue Mar 16, 2021 8:33 pm

seahermit,

You did say 'I think the NHS has in the end performed well and resoundingly proved its value'.

I think that has to be qualified, the NHS is not performing well everywhere, just as education ranges from poor, moderate and good, depending on the the school and its governance, so the NHS service varies accordingly, with some hospitals performing variably across a whole spectrum of issues.
You may go to a particular hospital, presenting with a certain ailment, and be told that there is nothing that can be done and you should just accept the matter, consigned to the scrapheap.
Or you may go to a different hospital and be told to attend for surgery immediately and have a serious issue tackled. This is all rather concerning.
Unless you have the ability/agility to cope with variable responses by shopping around, and not all older people have that ability, then you may be treated very poorly, or much better, just by chance.

You may not realise that you will be assigned to a hospital locally that may be good or bad unless you know to ask for 'choose booking'.
If you do then your GP must offer you choices between different NHS hospitals and show success rates and grades according to various metrics.
Plus you are allowed to choose a private hospital, such as Bupa, for treatment.
But not everyone is made aware of such choices or success rates.

Okay so not strictly about NHS versus private but it bears considering.

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number9
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Re: The NHS for sale?

Postby number9 » Tue Mar 16, 2021 9:28 pm

Well I think all Drs & specialists earning over £90,000 should be made to pay a higher tax rate
At the moment I believe the high rate is 40%. I say if they want these outrageous salaries then
make them pay 75% taxes. If they also work at least 30 hours including 1 weekend in 3 for the NHS then their tax bill goes down to 55%.
Of course an argument against will be their time at university & training... Oh you poor things !

And don't let me get started on the The typical Department of Health UK Nhs Chief Executive salary of over £240,000. Nhs Chief Executive salaries at Department of Health UK can range from £230,000 upwards.

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seahermit
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Re: The NHS for sale?

Postby seahermit » Wed Mar 17, 2021 12:45 am

That is true and one of the drawbacks of a huge and cumbersome system - treatment standards vary hugely, even in quite basic care, hence the scandals of the Staffordshire hospital, the Maidstone one and numerous others .. Even the Conquest had several inspections which led to damning reports, seems to have improved a little in recent years.

I think my records probably list me as a stroppy patient - I ask questions, some doctors don't mind and are really helpful, but others seem to resent it, answer curtly and take the view that it isn't any of my business! But I have learned that you have to stand up for yourself and challenge things sometimes. The system nowadays is much more flexible and patients have a lot of rights regarding choices, second opinions, shopping around etc. - although, as you say, the NHS doesn't like you to be too aware of all that!

I was given hearing aids in 2017 - they were totally useless, the crackling and interference drowned all other sounds. It took me a year of arguing and repeated visits (and they were re-programmed three times) before Audio finally got it right. I was told "you will get used to them" - by a young Asian man who had never experienced hearing problems himself.

I am definitely listed as "stroppy"!

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number9
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Re: The NHS for sale?

Postby number9 » Wed Mar 17, 2021 9:26 am

seahermit wrote:I am definitely listed as "stroppy"!


seahermit listed as "stroppy" :shock: :lol: :lol: :lol: :lol:

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Richard
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Re: The NHS for sale?

Postby Richard » Wed Mar 17, 2021 7:45 pm

All companies, across a range of industries, seem to have to spend their budget to show the need for funds the next year as otherwise they have their income cut if it appears they don't seem to need such funding.
All doctors I have spoken with claim that the NHS is okay but the management is poor or struggling to cope.
On a similar vein:
If hospitals have surplus covid vaccine slots available and patients booked ahead cannot attend at short notice, they will then offer staff to invite their relatives to attend instead, so that the supplies are used up.
In other words the NHS are under pressure to demonstrate a need for the clinics to be open or they will be reduced in number, just because of a 'blip' in attendance rates.
We are just told that failed appointments cost the NHS x,y or z pounds/year.


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