How should the NHS be reformed?
How would you reform the NHS? The NHS confederation says unless big changes are made, the health service in England will be £15 billion short of the cash it needs in just two years and with public services stretched everywhere, it's a problem facing the NHS across the whole of the UK.
So how would you reform the NHS? Would you charge to see a GP or to go to A+E? Scotland has free presciptions and eye tests - should these be kept or scrapped? What is your plan?
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5LNPI: Have BA staff ruined your Christmas?
10:30 Tue, 15 Dec 09
Are British Airways cabin crew ruining your Christmas? Or are BA bosses in the wrong as they try to cut staff? Cabin crew voted nine to one in favour of strikes from the 22nd December over job cuts and staffing levels. Up to one million passengers face the prospect of having journeys cancelled during 12 days of industrial action. So- Should the crew keep working through the festive season? Or are they right to strike?
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My local hospital, Kings College, is a fantastic place.
Not wishing to say cut this or cut that, without any statistical evidence that what I would suggest would save any money at all, I would say that I have one or two impressions of what would save a few pounds.
IVF on anyone over 35; preventive treatment of obesity amongst the younger age groups to try to improve health issues for them when they reach their twenties; upping the tax on cigarettes to increase tax revenue for sole dedication to NHS work; stopping some of the ridiculous screening clinics run by GPs which pay the GPs for the service but are actually lip service.
Haven't time for anything else, have to start walking now as we have a tube strike............at least the NHS doesn't have too many stoppages.
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Make drunks pay for their treatment if they are involved in fights. Charge them for the ambulance as well.
It'd be a start.
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If you think privatising is a good idea you should watch the documentary "sicko" by michael moore. We have a health system that is the envy of the world and I would be very suspicious of anybody arguing passionately for privatisation.
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I couldn't get health insurance - what woud I be left with?
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How can I contact the gentleman who rang into Nicky Campbell this morning stating that he had been to USA or Amsterdam for prostate cancer treatment because the had equipment far in advance of that used by the NHS. Id be happy for my e-mail address to be passed to him so that I could make contact.
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Cut the number of managers (no I do not work in the NHS but have knowledge of the structures etc.)
Ask them this:
How many volunteers work in the NHS ... How much money is spent on mental health patients compared to other kinds of patient. Indeed ask them how many mental health patients compared to others and then compare spend...
If he is that GOOD, get Alan Sugar to run it!
In the NHS, there is a culture of apathy, jobs for the boys and girls where faces fit, people employed from agencies when there are enough hospital staff to do the job.. the list goes on and on...
Why is it when you ask for people to be like a business, everyone goes hysterical. From my experience you can think efficiency and not be mercenary...
Time for a re-conditioning of their minds. Bit like MPs and civil servants actually, and yes the BBC as well. To be fair the BBC has an independent board; or so we are led to believe.
As for paying more, it is always brought out... look at paying more for dentists; has it got better.... No.... we are just paying more... so don't be silly... we already pay too much...
Governments do not like to accept evidence to say that the whole lot is run poorly.
Investigate how the money is being spent.. Do not employ past NHS staff to inspect them.. employ investigators as well as real assertive outspoken service users...
Consultations are a waste of time and public money...
Remember the NHS staff overeat (see the size of nurse) they smoke... drink alcohol.. it goes on and on... if we adopt some tactics voiced on the phone-in we would not have anyone to treat us!
THERE ARE TOO MANY MANAGERS !!!
THOSE THAT STAY NEED RETRAINING OF THE HIGHEST ORDER... OUTSIDE TRAINERS PLEASE..IT NEEDS CHANGING
We have had this debate before...it is time to act now; get on with it!
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This year the NHS will cost us £118 billion, the total for all income tax paid this year will be £141 billion. Of course there is a problem, we can not afford an NHS that has seen its budget rise from £34bn in 1997 to £118bn today, a 300% rise in 12 years!
Total government income will be £494bn according to this years budget, therefore the NHS represents 24% of all government income. It's time to get real, ignore the facts if you like, but we can not and will not be able to spend at this level in the future, costs must be reduced.
Firstly ending free treatment to those not born in the UK would save a significant sum. In 2007/08 733,000 people entered the UK and were given a national insurance number on entry, giving them access to free NHS treatment. NHS hospital closures could with this policy be targeted at areas with large immigrant communities.
Staffing levels have risen from 1m in 1997 to 1.25m today. These staff are able to claim a golden pension, a person retiring from the NHS on a salary of £30,000 after 30 years service will recieve an inflation proof pension of £11,250 and a cash free lump sum of £33,750. The basic state pension is £4,953 and NHS workers get this too. Ending NHS pensions would save at least £4bn. Public sector pensions have a liability of £915bn, there is no money set aside to pay for them, it comes out of our taxes every year.
Cutting wages for non front line staff in the NHS by 20% would save at least £4bn.
According to a study by the Guardian and the Institute of Fiscal Studies in 2007/08 only £1.7bn of the then £105bn health budget was spent on accident and emergency, staff costs were £30bn. A&E is poor because so little is spent on it. If anyone still believes NHS staff are underpaid visit www.jobs.nhs.uk to see, the average UK wage is £24,809.
Like it or not the NHS as it is today, serving everyone free on demand can not continue.
Another website www.vocalize.org.uk has more on this subject and some solutions, that although unpalatable to some would allow the NHS to continue to serve the British people.
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I have lived, worked and experienced health-care in 5 countries. When I hear that the UK NHS is best in the world and that other countries are looking at it as an example, I say rubbish.
Other countries are looking at it, yes, but to find out what to avoid. My experience of the NHS is appalling although the private health care in this country is as good as anywhere in the world I and my husband have had surgeries in private hospitals and medical and nursing care was excellent. As a start, private hospitals are clean!
In the NHS, the doctors on the whole, especially consultants are tops, but the organisation and the nursing care let the system down terribly. I have experienced it!
The US medical care is excellent and despite what British people say, there is some security for the poorest. I am not advocating their totally insurance-based system but the medical and nursing care are absolutely excellent and hospitals are very clean. The French system perhaps has the best of both worlds: subsidised but you have to pay something at the point of use depending on your means. You also have a choice of physician and people think before going to the doctor for a sniffle. People take more responsibility as a result of being made aware of the cost and of paying something.
The Canadian system is closer to the UK than most others in that it is free at the point of use BUT every person has to have a social security type card to access it so that people cannot travel to Canada to be treated freely at the cost to taxpayers. And that has been operational for over 25 years. If a Canadian citizen does not live in Canada for 3 years, he loses his right to free health-care, obviously getting it back if he/she returned to live in the country. The hospitals in the UK seem full of medical tourists, we even pay for interpreters. I hate to say this, but as in the Canadian system, an ID card would help here.
The Swiss system is insurance based and closer to the US, with all the freedom that it entails. There again, the hospitals are clean, easily and quickly accessible, and the care excellent.
My main problem with the NHS is that no-one thinks of or wants to control costs: why pay for care for people travelling here but not entitled to health care? Why pay for people being treated after car or mountain climbing accidents? This should be covered in your car/sport insurance. Why pay for people to have skin grafts to remove tattoos? Surely, they paid to have it put in; they pay to have it removed. There are so many examples of these costs that the taxpayer should not have to cover. The reasoning of it costs more to administer is false: other countries do it. Why pay for people to have babies even after more than one IVF??? Because medical research enables a treatment, does not mean it should be made available to all. There are other priorities specially as the population gets older and more chronic diseases require longer and costlier therapy, and the alternative of not treating is death.
The UK systems is bursting at the seams because waste is enormous, demands show no bounds, but it appears that the good public is more concerned with the status quo and with keeping a system invented after the war, than having an system appropriate to our times, with some limitations, where people contribute, have choice, is consumer-driven not government-dictated, but still where the poorest are protected. Why do we easily spend £20 for an evening at the pub but think it is too expensive to pay the same amount for a prescription or an eye test???
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I work for an NHS Doctors as a Pharmacy Technician. Without workers like myself you wouldnt be able to get your prescriptions made.
I have not had a payrise or a cost of living pay increase for 2 years. I am not over paid and or a massive salary. I stuggle like everyone else in these times of financial worry. I would make more money each month if I were to work at a well known supermarket chain on the check outs!
I am also one of thousands of women in the UK who suffer with a fertility problem. I was born with it and will probably need medical help to have a child. I was sickened to here so many callers saying IVF was a major cause of over spending in the NHS. We need that treatment just like everyone else with a chronic health problem needs their treatment.
I do beleive that the NHS has problems that they have created themselves (over prescribing, new computer system, electronic prescribing) But please dont call for treatments such as IVF to be stopped, its unfair to discriminate against those who really need the treatments.
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Apologies if anyone has mentioned this before - just got home from work (I work in the NHS) but wanted to add to this.
IVF - most places offer only 1 cycle of NHS funded IVF/Assisted Conception. Most tend to be in agreement that there is a maximum age for treatment, but the severity of the policy regarding access will vary. The challenge we have - as a service - at the moment is that people want 3 cycles funded and believe it is their absolute right to have this. At an average cost of £3500 per cycle and numbers growing for this service the NHS cannot sustain the cost of universal access to IVF. Before anyone says I'm heartless and unsympathetic I have secondary infertility and am devastated at the thought of not having a child but I count my self very lucky to be healthy and have a loving family and friends (and more recently husband). It is not the right of the NHS to give me a child at the expense of someone who has, for example, cancer.
Cosmetic surgery - most hospitals and PCTs have criteria over access. For example cosmetic breast surgery is not done routinely unless, for example, it is post mastecomy. Where people seek funding for cosmetic surgery it is very rarely funded unless there are very strong clinical and/or individual circumstances.
A&E - sorry I'll be controversial and say if you turn up at A&E because you could not be bothered to see your GP or you got drunk and fell over then you should be charged. I've only ever been to A&E 3 times in my life (one for head injury, one for broken foot and one for major burn to arm) and for the 2 times I've been as an adult the number of people turning up because they can't be bothered to wait for their GP or (in one case) they were going on holiday and wanted A&E to do their travel jabs.
Personal Responsibility - as harsh as it sounds people have got to start using the services properly and responsibly. That includes taking care of your health. Loose weight, exercise and drop the drink and smokes. Please. I may not be the healthiest person on the planet but I'm taking my own steps to do the above. I only see my GP when I am very ill (e.g. chest infection) and not on a whim/minor issue that perhaps a walk in centre or pharmacist could have helped with. People also need to stop being abusive to staff.
Final comment - to the man complaining about equipment this morning. Ever thought it is not just about getting equipment but also the staff to operate the equipment? No staff around, equipment gets wasted. Please try to take that into consideration before making sweeping statements about the NHS.
As one of the message boards says we still have a service that is free at the point of access. How many countries can claim that?
That's all folks.
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I am a Doctor in the NHS.
I would like to eloborate on Working Hours. As a Trainee we are allowed to work Not more than 40Hr/ Week in the forth coming years because of the Working times Directive.Fine.... Someone is there to look after us.
On the Contrary, Are there any limits for Minimal working hours for a PERMANENT EMPLOYEE? Certainly Not.
Let us take an example of a Consultant. Most of the Consultants are working Part Time or Maximum Part Time.This means they work for approximatly 5 sessions a week and the remaining 5 sessions they are in Private including the admin/ Teaching/ Audit session they have been offered in the NHS.
As they offer only 5 sessions the remaining 5 sessions, there is no one to cover the Job!So, Naturally the Job Suffers.Hence the Hospital Management decides- Well we are Understaffed- So we need to Recruit Another consultant. The Implications of recruting another Consultant is -You need to Recruit another Registrar, Another SHO, Another Secretary, and Whole load of Another provisions...............
If a Rule comes that , If you arec a consultant-YOPU Solely need to OFFER your services to the NHS for all 10 Sessions.You can do your Private work after you work your 10 sessions in the NHS. You can work in the Morning , Evening or over the weekend! I know a few departments where quite a few consultants Just work 1 or Max 2 sessions- But they have the whole array of Support.
If the Current working Consultants are made to work on a Compulsory basis for 40 Hours a week, Then The NHS can make more be 150% efficient with 50% of the Manpower available.You will barely need 50% of the Consultants who are working currently.
Imagine the Cost Implication.........
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Peet park unfortunately is only a trainee and seems to have no clue about how consultants work in the NHS. he will have to read the consultant contract and talk to consultants rather than pass comments which reek of "frustration" perhaps based on poor experiences with a consultant that he may have worked with in the past.
people are used to the free life. i could rave and rant forever, but i would instead merely support what Brummieladywolf has stated above.
if you can pay at your pub for your alcohol, you can definitely afford to pay for your gastritis as well. Proving the association though may be difficult often and this is what will blur the issue. we cant raid obese peoples fridges to establish that they eat more, nor can we access their tesco shopping list of baddies,then how can we say we wont pay you cos you are causing your own problem? So punishing is just not on, paying because you were a bad boy is also just not on, as it is difficult to police....
so what is possibile?
£1 for every A&E visit for everyone
60 million people in the country
A&E attendance in the year 2008April to 2009 March= 20 million (ACCCESS DATA HERE: http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/AccidentandEmergency/DH_077485
Bingo, £20 million instantly available at the end of the year.
add to this:
£1 to be paid by every patient who gets admitted to the ward from a&E (token, nothing more!!) (3 million per year- access data here: http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/AccidentandEmergency/DH_079092)
£1 token if you are admitted to the ITU
£1 token for having an ambulance drive them back 10 miles- fair?
£1 if the patient has to be followed up in clinic
So for £5 you are getting free healthcare in hospital- or shoudl i say for a macdonalds meal you have had perhaps a five day or maybe 2 month stay in hospital with free bed, food, heating, nursing care, doctors time, medications, investigations including ct mri, whatists and all...
AND what has it given to the NHS? 23 million or maybe 35 million- Paltry savings you would say compared to the 100 billion NHS budget, but add to this GP referrals, with Medical and surgical unit visits +/- admissions, and you are talking much bigger savings for the NHS!!!!!
now now, i can hear you say, i have paid my taxes, why shoudl i pay £5 more? well honeybunch, i also paid my taxes like the altruistic gentleman that most people are, so that people like you who require it in the hour of need can get it for £5 charge- and still retain your noclaims bonus when it comes to the next tax year!! that is if you are working....
bUT NO! the politically incorrect sounding theme wont wash with you people, you will need it to be dictated to you, and END UP HAVING TO PAY TO THE PRIVATE COMPANY HUNDREDS OF POUNDS AS PRIVATE INSURANCE, AS THE NHS WILL GO BUST IN A FEW YEARS BECAUSE YOU WERE UNWILLING TO PAY £5 FOR A HOSPITAL VISIT...serves you right!!!!
A passionate advocate for the free NHS!
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