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'Safe in our hands'

Nick Robinson | 19:55 UK time, Monday, 27 July 2009

Whatever else might have to be cut, you can rest assured that the NHS is "safe in our hands". That's the message coming from both the Tories and Labour - although no-one is daft enough to recycle the words Margaret Thatcher used when she tried and failed to reassure people about her approach to the health service.

Yet the message coming from others is much less sanguine. Niall Dickson, the Chief Executive of the King's Fund - an independent health think think - says:

"The scale of what is about to hit the health care system is unprecedented... [it] will be the first time in [its] history that it has had to go for such a long period with rising demand and little or no new money."

Economists from the King's Fund and the Insititute for Fiscal Studies have looked at the best- and worst-case scenarios for NHS funding over the next few years. They calculate a shortfall between £6.4bn and £32.4bn by 2016/17 at today's prices - that's between 6% and 31% of the entire NHS budget.

I'm moonlighting this week as a presenter on Newsnight. Tonight, in a special programme, we'll be asking how the NHS will cope without the huge spending increases it's grown used to.

An ageing population combined with improvements in technology and greater public demands at a time of a public spending squeeze: the challenge is not, of course, new. They all existed in Margaret Thatcher's day. She never escaped the charge that she had cut the NHS. It's worth remembering that in her time in office, health spending increased on average by 3% in real terms.


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  • Comment number 1.

    So which of the 4 NHS systems in the UK are you talking about Nick? Forgotten to read your guidelines on devolved issues again?

  • Comment number 2.

    The debate leading up to the election will be who is going to cut the most?

    The main parties will of course be spreading alarm and despondancy about the other party's planned cuts with each trying to undercut each other.

    Forget about DC's pledge to be open and transparent, the cynical vote grabbing politician will take control. GB will still be in cloud cuckoo land saying that there will be no cuts, only investment, despite what Darling and Mandelson say.

    There is a need to reduce spending in all areas and the NHS will not be immune. Neither will all the other 'frontline services' e.g. education, defence etc.

    We are all in for a hard time!

  • Comment number 3.

    the NHS has been systematicly ruined by recent governments, underfunding reduced staffing etc etc.
    i feel its been a government plan to kill off the NHS creating an american system that will do nothing but harm to older and less able sectors of the community.
    its bad enough this government wants to introduce £20 pound fee's to see the doctor, that is not keeping the NHS healthy its alienates those less well off.
    this or the next government should re-introduce national service but aim it at hospitals,fire service, police service etc along with military services.

  • Comment number 4.

    I think we have an excellent health service. I'm sure it could be better, but nothing is perfect. Almost everyone I know is happy with the service they have received, but we still want a higher standard. It will be very difficult to make cuts - but we are just getting to the position that other countries like France have had to accept, namely that we have the choice of increased taxes or better treatment. The sums are simple. If someone is given a drug treatment costing £50000 it takes all the taxes from at least 5 people to pay for it. I'm not sure of the accurate figures, but the principle is pretty clear.

    Most of government spending is in wages, so while 'efficienct savings' are desirable and possible they are not as desirable or pain free as the image of cutting government waste might create. Do you pay for the drug or do you provide employment for a couple of families ensuring that their children do not grow up in poverty with the attendant risk to their health and stability of their families?

    These are tough questions. I would prefer politicians to talk about the principles they would use to decide such problems rather than simply talking about figures. I don't think we will like what any party will do, and I don't think that the problem is completely the fault of the credit crunch. I think that the problem was going to appear anyway. So to all the Brown bashers and Cameron cursers, perhaps we can talk about principles rather than playing the same broken record. Once we have got clear principles, followed by a judgement of keeping to them and competance then we can make an informed choice. At the moment we are missing the first stage of the process.

  • Comment number 5.

    The answer to the NHS problem is simple.

    If you are a UK citizen, born and bred, then the NHS is free.
    If you are a holiday maker, asylum seeker or economic migrant then you have to pay.

    Let non UK nationals take out health insurance.
    Let non UK nationals pay face value for their medicines.
    Let non uk nationals pay for their consultaions and operations.

    Why should the UK tax payer provide a health service for the rest of the world?

    We have the NATIONAL health service not the INTERNATIONAL health service.

    If visitors.migrants and asylum seekers are not willing to pay, then let them eat cake.

    While we are on the subject of the NHS, why should we pay for people to be treated who have self inflicted injuries through smoking, drinking and drug abuse?

  • Comment number 6.

    What about all the administrators and managers in the NHS.
    Bureaucracy is the single biggest drain on public finances in all areas of spending.
    NOOB Labour have increased bureacracy to an almost unimaginable level.

    We need fewer MPs, fewer 'crats and fewer civil servants.
    The UK needs to be run like a business; a lean, mean wealth creation machine.

  • Comment number 7.

    While we are at it, lets stop giving multi million pound hand outs to other countries.

    Charity begins at home.

    Invest the money in English health and education instead.

    The Scottish model for health and education should be the new yard stick.

  • Comment number 8.

    My Wife, my son and myself went for an NHS dental check up recently, £62 it cost, now I know that NHS dentists are even rarer than Hen's teeth, and people might say I shouldn't complain, but £62 at the point of delivery simply for a check up makes a mockery of anything Nu Labour say of about the NHS and it being free at the point of delivery. Although anyone know how much a private dentist charges for a 5 minute check up?

  • Comment number 9.

    Invader-Zim (#5) has a valid argument, although whether NHS expenditure on the categories he outlines is all that great would require a great deal of trawling through the accounts to establish; doubtless the figures are "not separately recorded" or "only available at disproportionate cost".

    I'm not sure about discriminating against smokers and drinkers; at least their vices (oops; on reflection, mine as well) both make considerable contributions to the Treasury coffers. OTOH, charging people who because of their alcoholic excesses require reassembly on Friday and Saturday nights seems eminently sensible. Bit of a problem if they don't have any money though, which they won't.

    But I think "health tourism" *is* a problem, although again how much of the total it is responsible for is something I simply don't know.

    As I didn't suggest on one of Nick Robinson's postings (the topic was different but the underlying principle is the same), I object to my taxes (paid on modest occupational pensions) going to patch up drunken youths and other "undeserving" cases. It might seem harsh but I would also consider NHS IVF treatment as suitable for cut - backs.

    Now that's *bound* to get me into trouble; any room on your planet until the dust settles?

  • Comment number 10.

    To paraphrase George Orwell: -

    Politics - a snout snuffling in a swill bucket.

    Politicians are only interested in their own financial future.
    If they do some good on the way to making their fortune, it is more luck than judgement.
    A happy accident on the road to wealth and power.

    Talking about work is much easier than actually doing work.
    Just ask the Benn dynasty.

    We live in a world where energy and resources are in short supply by design.
    Profit is king, economic slavery and poverty are the court jesters.

    These blog topics are a distraction, just like football and soap operas.
    Bankers and faceless Business Barons rule the world.
    The general public are their ignorant willing slaves.

    If politicians have a choice between wealth and Health, then the NHS is a patient on the political terminal ward.

  • Comment number 11.

    Like most large organisations, NHS is likely to have its share of job squatters at all levels. They soak up valuable resources and impede those who are able and willing to give it their best.

  • Comment number 12.

    8. At 9:31pm on 27 Jul 2009, TheEnglishman
    My Private Dentist charges 12 pounds for a check up.
    More importantly, she is a babe.
    I love going to the dentist :0)

  • Comment number 13.

    9. At 9:43pm on 27 Jul 2009, Radiowonk wrote

    Yes, there is plenty of room on my home world.
    Most of our population is out and about visiting other low level civilisations, very much like your own.
    We may even have a special dinner, where you can be the guest of honour.

    (heh heh heh...drool.)

  • Comment number 14.

    I have no idea why people are surprised that the NHS budget will drop a bit. It was flagged by Brown a while ago. Visible in government projected spending plans. What's newsworthy about that? It was always intended by Brown. Nothing to do with the financial disaster we struggle against today. Brown planned it. Darling gets the "credit". McCavity Brown slips out onto the patio to wail for a while on the garden fence....

    I'm posting this again here.
    Apparently there was some profanity included in my attempt to post on Nick's last (few days ago) blog.

    I couldn't work it out. Maybe some others could? I may get rude from time to time, but I can't work out what was profane in this stuff.

    #349, sagamix wrote:
    "FOM @ 345

    Inequality happens

    yes, we agree on that - that's what I said, didn't I? - but it's a bad thing, and we should therefore be working towards reducing it - that's all - and when I then read through your post ... epic btw! ... I find you agree with me on that too - so, yes, great ideas on the banks -


    I didn't choose my parents. Nor did you. Some people get born in total poverty, which has nothing to do with the "relative poverty" stuff we are supposed to believe in the UK.

    Some people can't find enough drinking water. Or enough sustenence to make it through the night. We have people in the UK who are "relatively poor", with a house, a plasma TV, trainers to die for, (NO books, of course) but "poor"?.

    I have no problem with banks. If they take deposits, manage money carefully and help people. Gambling is not the same as banking. I always knew that banks did overnight trading (after considering the risk). But it's quite different to deal with general deposits, rather than "risk-taking money".

    Why did our financial surveillance bodies not get involved when bog-standard banks (like HBOS or RBS) become gamblers? Nobody seemed inrerested - certainly not at governmental level - because there was a tax-take to pour into stupid projects. It came from corporate and personal tax-takes (from those huge bonuses - unless they were well protected).

    Did it make sense? Don't think so. I could never work out why there was no intervention to stop finance players allowing folk to borrow against massive "loan-to-value" or "loan-to-income" deals.

    Guess who could have stopped it? Gordon Brown, as Chancellor, by leaning on the BoE (or some part of the triumvirate he created). Did he? Nah. Too much dosh flowing about. Too much ready cash from the tax-take to hire people to do nothing jobs - useless waste of tax money - in the public sector, as well as paying people doing necessary jobs in both private and public sectors.

    (Just how many IT schemes actually deliver what government say they want, versus what they get? Government wastes a huge amount of tax because they have no idea about how to define requirements, how to monitor progress and how to achieve and measure delivery.)

    I get teed off, because my kids got caught up in the appalling mess that Brown allowed to happen - because he funded it.

    Just how many kids who got a good GCSE result would have managed an International GCE? But we (Labour social engineers) keep saying that education is getting better? How? Take any 100 kids who got good results at GCSE and ask them to sit an old fashion "International GCE" and I'd bet that the simple folk in India, Jamaica, Pakistan, etc, would perform better.

    It's always been the case that you challenge things. But if you don't understand the platform from which a challenge makes sense, rather than being a relatively knowledgeable person, there isn't much hope left.

    Thank goodness there is a real talent-base in the UK. Don't care what background, creed, colour, origin it emerges from. I'd prefer that more recognition was given to the "think it, work it out, make it" school than to the idealistic idiots who end up in government.

    There are loads of very clever people in parliament. Actually, practically measureable folk? Not too many. So we get laws that don't make sense. Rushed through with insufficient scrutiny? Well, surprise...

    Even the judiciary says there are too many laws from local or EU orgins they can't keep up with.

    I've said before and will say again, I'd like every MP to sign an affidavite that he or she had studied every single law or regulation that they nodded through. If there were any honesty in parliament, I'd guess that maybe 1 - or fewer - MPs understands and could explain the wave of garbage that has allowed 3,000 new offences to appear on the statute book over the last decade or so.

    Come on. I challenge anyone - MP or other - to define all the new laws and regs that we risk breaking every day. BUT MPs have a huge summer break. So pop down to your local MP with a bit of obscure law or regulation (wherever it originated) and ask what it actually means. And whether he/she was aware of it, or if he/she actually knew it was now a part of the legal framework for all of us...

    That's my holiday project.

    It should be fun!

  • Comment number 15.

    #5 Invader

    Are you writing the BNPs' health policy by any chance?

    I have some additional groups you could pick on to reduce the bill further:
    - sporting injuries
    - DIY accidents
    - car accident victims (get the insurers to pay)
    - fat people
    - pregnant women

    There are severe flaws in your ideas, not least what should British citizens not born here do for health care?
    Should we refund the NI and Income tax of all non British nationals working here legally as we are not going to provide the service it nominally pays for?

    You might be shocked but the groups you mention actually should pay or we are reimbursed IF the paperwork gets done and right questions asked. If you go abroad this is what the EU insurance card is for.

  • Comment number 16.

    Do I understand your prediction Nick? The Kings Fund and another Quango state that NHS costs will rise by 6% to 31% by 2016/17. David Cameron will be Prime Minister by then; the Conservatives will not increase NHS payments and therefore the NHS will lose out. Labour on the other hand will keep payments on the increase.

    Where do you get this 'STUFF' from? Day in and day out you come up with these hypothesis, if it were not so serious it would almost be a comedy show. I assume you will supply this type of thing for the next 10-11 months, am I right?

  • Comment number 17.

    I may have mentioned this before, but what the hell if I am repeating myself.

    I submitted a proposal to the treasury regarding quantitative easing and investment in renewable energy technologies.

    The proposal required a great deal of NON PROFIT cooperation between the G20.

    Ian Pearson - Treasury Minister sent me a very polite reply and proptly disregarded the proposal.

    The reason for disregarding the proposal, there was no Profit.
    Everyone was a winner.
    There was no personal financial gain for the Political elite and their cronies.

    What hope do we have for the Health of the nation when our Governement is only interested in personal profit.

  • Comment number 18.

    15. At 9:58pm on 27 Jul 2009, Whistling_Neil wrote:

    I like it when a Noob Labour do-gooder responds.

    When a post appears that doesn't fit within their looney left doctine they throw in the BNP card.

    The NHS is expensive.
    The NHS should be exclusively for the British People who pay for it.
    Stating this fact is neither racist nor pandering to the BNP.

    Spend less time whistling and more time paying attention.

  • Comment number 19.

    15. At 9:58pm on 27 Jul 2009, Whistling_Neil wrote:

    Incidentally, how many people in the medical professions have you spoken to regarding the impact of migrants on the service they can provide?

    I would wager that you have not spoken to any.

    I have had this same conversation with several Doctors and Nurses.
    Obviously the discussions are in hushed tones to avoid reprisal.

  • Comment number 20.

    Ref 5. Invader-Zim

    "The answer to the NHS problem is simple. If you are a UK citizen, born and bred, then the NHS is free."

    But then you go on to ask, "...why should we pay for people to be treated who have self inflicted injuries through smoking, drinking and drug abuse?"

    Didn't you just say the NHS is free for UK citizens, born and bred?

    How about 'boy-racers' who drive their cars so fast they smash themselves up? That's self-inflicted.
    What about cancers caused by incorrect diet?
    Heart disease through lack of exercise?
    Rugby players often end up in casualty. No one forced them to endanger their health, and run-up NHS costs.
    Back problems caused by trying to shift paving slabs in the garden, instead of getting help? Shouldn't they follow 'Safe Handling?
    Then there's people caught in house fires, yet they hadn't fitted smoke-detectors?
    Sun bathers who get skin cancer? Self-inflicted?

  • Comment number 21.

    I just dont understand why we are fiddling, while Rome burns

    We do not have a funding crisis in the NHS

    We have a funding crisis in

    The military
    Law and order
    Social reform
    And the NHS

    We cant tinker with one or the other, nor ring fence one or the other without effecting them all. We have to decide what type of society we want over the next thirty-forty years and plan for it.

    With resources, employment and pensions disappearing in this country by the minute to cause a revenue crisis, set against enough cheap highly skilled labour in China and India to provide everything the world is lily to want for the next ten to fifteen years the concept of racking up the revenues funds even by taxing the wealthy is pretty slim and without the work for the rest then what is a small contribution in full employment times becomes a large loss in terms of exchequer funds.

    What surprise me is that the red tape and the bureaucracy of government is set to make the problem worse it is to much hassle if not financially swinging for companies to exist at the margins and easier for them to close giving less revenue again

    We can not sort the NHS on its own we have to have a new cohesive policy backed by the citizens who pay for it. We have to decide what our socio economic model is going to be what type of society we want and how it is to funded from schools to hospitals and everything inbetween.

    Creating stockades will see too many perish both outside and in.

  • Comment number 22.

    Whistling Neil the NuLab voter,
    Meets his PC, BNP Quota,
    Opposing views start him ranting,
    With Looney leftist labour chanting,
    He doesnt care for the NHS,
    He overlooks the Labour mess,
    Soon for the Tories, an election won,
    And NuLabs misdeeds will be undone.

  • Comment number 23.

    20. At 10:17pm on 27 Jul 2009, Richard_SM

    I am happy to restrict the list to Alcoholics, Chain Smokers and Drug abusers.

    On relection, I agree that "Boy Racers" should be an edition to the list and is most welcome.

  • Comment number 24.

    That, Nick, is downright bad.

    It doesn't take a political editor more than a couple of mnutes to work out that the PRESENT government plans to reduce the real-terms spend on the NHS.

    So why do you wrap it up as a FUTURE government (potentially Tory) spending plan?

    Brown can't afford to keep pumping money he never had, but wished for, into an (understandably) expensive NHS. He could have chopped out Billions, but preferred to hire lots of people to do "non-productive" jobs - often accessible only via the Guardian, the in-house blurb - but that would have cut the objective of increasing public spending (regardless of actual tax take).

    The reduction of NHS spend was planned years back. It was in Treasury statistics and forecasts.

    NOTHING to do with any future government.

    Sorry, Nick. That was a bad post.

    Brown planned a decrease in spending that Darling will have to carry through. It was predicted before the credit crunch, because the rate of increased spend was unsustainable.

    (Driven by stupid adminsitrative costs, rather than "front-line" spending. Take out the targeted objectives, with all that cost to set the targets, have multiple people check them, compile reports while people hover on trolleys - or are forced to wait in ambulances because admission times aren't "quite right" - and let doctors and nurses do what they should do and in a decade or so, we'll have a good health service.)

    As you said, Thatcher managed some increase. (But I'd accept not enough.) Get real, folks.

    Medecine is about helping people. It's not about government targets. This mob have so little understanding of real life that they BELIEVE management consultants. GET REAL.

    DELIVER something worthwhile and maybe people will vote for this shambolic mass of flotsam.

    Unravel the rediculous form-based "entitlements" nonsense, that even the folk administering don't understand, and then maybe - just maybe - someone would agree that life could be a bit more straightforward.

    10p tax band? Problem resolved? There should be a "Strictly come Honesty" game show for politicians.

    Wonder who'd turn up???

  • Comment number 25.

    I am very pleased that oldnat @ 1 pointed out that there are actually four distinct NHS systems in the so-called UK.

    Time and time again, if you bother to listen carefully to the news, you will hear this sort of refrain ' ... it was announced that in England and/or Wales ...' or similar.

    Why anybody outside of Westminster believes this is still a 'United Kingdom', in the political sense, simply defies comprehension.

    Usually it is my fellow English people, who seem blissfully unaware of the political undercurrents in Scotland and Wales.

    They are going to find out soon enough.

  • Comment number 26.

    21. At 10:30pm on 27 Jul 2009, hack-round

    As you will see from my comment at #6, I totally agree.

  • Comment number 27.

    24. At 10:37pm on 27 Jul 2009, fairlyopenmind

    Yes that's it.
    The men behind the curtain.
    The "Managment Consultants" and the "Financial hit men".

    Politicians are the puppets of Big Business and Banking.
    A world designed to reinforce the wealth of the rich through profit, poverty and politics.

    This is the fundamental problem that we need to address.
    Until then we are all slaves to the false economy.

  • Comment number 28.

    richard @ 20

    yes and that's not the half of it - what about a non British born guy? ... a New Zealander, say ... who's over visiting his fiance's family in St Albans, and he goes for a round of golf at The Club with the prspective Father In Law - but he doesn't wear his hearing aid (the New Zealander, I mean, who suffers from early onset deafness at just 32 years old) on account of he's slightly, you know, embarassed about it - and because he's been lax about not wearing what he needs to ensure his ears work, he doesn't hear the shouts of "Fore!" when he's standing on the third tee - the shouts coming from the guy on the second who's just carved his ball about 100 yards off line! ... hurtling down towards the third tee! - oh no! - a one in a million, but tragedy ensues ... our friendly Kiwi takes it full bore on the bonce and needs a million quid's worth of brain salad surgery to put him back on his feet ... are we really saying No Room At The Inn when stuff like that happens? - what, even if he's White and it's a pukka golf injury?

  • Comment number 29.

    I believe that intrinsically there are no funding issues at all in our health (or education) services.

    There is plenty of taxpayers money being poured into these services.

    But ... much of it is absorbed by the bureaucracy in 'overheads', so much so that health (and education) outcomes are generally poor by international standards.

    That is the political bullet that politicians refuse to bite for, I suppose, a variety of reasons depending on where the politician sits on the political spectrum.

    Essentially I suspect that genuine reform of these services would result in politicans more-or-less exiting these areas (which they usually know nothing about in the professional sense), that is, giving away power, in these cases, to health (and education) professionals in the public and private sectors, which would be something that politicians are always reluctant to do.

    Therefore I conclude that we put up with mediocrity and stupendous waste because politicians will not admit that they are controlling services that they usually know very little about.

  • Comment number 30.

    28. At 10:51pm on 27 Jul 2009, sagamix

    Even more tragic.

    Imagine the ball actually hit him in the groin and his golfing partner had a heart attack while rolling on the floor laughing.

  • Comment number 31.

    I'm sure that there are efficiencies that can be made in the health service. For a start in my opinion there are far too many administrators and too few clinicians.

    Like ZIM I have said this before on other threads, but what the hell, I don't mind repeating myself. Taxation should be more transparent with the tax on fags and booze being seen to part fund the NHS. Also a way found to tax unhealthy food with the proceeds ring-fenced for the NHS. I am a small state person but fully support the principle of a world class focused health care for our population.

    Like ZIM I think that only those who have contributed to the UK economy should be in receipt of a free service. Like he says we just cannot afford to care for the world on our own. Having said that I would be prepared to donate to charity which helps to pay for care for the less well off from other countries.

    A root and branch review is required to decide what will be provided free at point of use on the NHS. It has to be questionable for sex change ops and a lot of non reconstructive cosmetic surgery to be justified. I'm sure that there are many other examples. Also related, reverse this Government's stupid decision to extend bar and pub opening times. It seems to me that if we can cut the amount of booze drunk by our youth we can cut the demands on our hospitals at a stroke.

    Why not have a modest insurance scheme imposed upon employers of a certain size to help fund the service.

    I believe that is is possible to achieve cuts in the NHS budget whilst still improving the delivery of the service in fewer core areas. At the moment the NHS is trying to provide everything for everyone and we cannot afford for this to go on unchecked

  • Comment number 32.



  • Comment number 33.

    over the period in question it should be possible to fund the reductions through internal efficiencies and savings without compromising the NHS ethos of treating all people with a health need. This is said with the experience of working at a senior level in the NHS for over six years unlike I suspect the majority of your correspondents particularly those who are not content with making a couple of contributions.

  • Comment number 34.


    "why should we pay for people to be treated who have self inflicted injuries through smoking, drinking and drug abuse?"

    You'd like it narrowed down to just "Alcoholics, Chain Smokers and Drug abusers"

    1) So how would you define an alcoholic and a chain smoker?

    2) What would happen if a drunk gets run over by a car and knocked unconscious?

  • Comment number 35.

    Ref 31. oldreactionary

    "Why not have a modest insurance scheme imposed upon employers of a certain size to help fund the service."

    Do you mean like National Insurance?

  • Comment number 36.

    35 Richard_SM

    Good point well made.

    Although I did say modest! Also where is the transparency that this tax take is ring fenced for the NHS.

    34 Richard_SM

    The tax on fags and booze does mean that the abuser pays in both of your scenarios. It hurts me to say so as a modest drinker, but i think that the tax particularly on strong alcohol has to be raised and duty levied on the stuff that comes in from the continent. If the EU is not happy stick up two fingers to them

  • Comment number 37.

    31. At 11:01pm on 27 Jul 2009, oldreactionary

    It is a sad fact that our current drunken youth (by Labour design), will drown the NHS with liver and kidney complaints.

    This is a sad fact and indictment of Labour policy.

    A drunken, poorly educated electorate is a Labour electorate.

    Encourage the public to wallow in ignorance and poverty and they will always see red.

  • Comment number 38.

    oldreactionary @ 31 wrote:
    "Why not have a modest insurance scheme imposed upon employers of a certain size to help fund the service".

    Employers already pay a very sizable chunk in National Insurance contributions..and it's calculated on the total gross pay of every employee!

  • Comment number 39.

    34. At 11:12pm on 27 Jul 2009, Richard_SM

    1. A typical smoker. ( All smokers increase their risk of cardio vascular diseases and stroke).

    2. Follow up by reverse gear, just to make sure.

  • Comment number 40.

    Nick on Newsnight?
    Much better than Ms Wark!
    I actually understood every word

  • Comment number 41.

    Ref 39. Invader-Zim

    You ran out of answers very quickly. I knew a few questions would blow you out the water.

  • Comment number 42.

    Fairly Big Nose @ 14

    I didn't choose my parents. Nor did you

    don't know why you keep making out we don't see eye to eye when we do - better run NHS, for example, yes please! - and inequality, we agree on that except even more so - in particular:

    - it's natural to some extent
    - but gross inequality is a bad thing
    - and so it's an important part of any govts job to mitigate against it


  • Comment number 43.

    41. At 00:06am on 28 Jul 2009, Richard_SM

    Not wanting to disappoint: -

    If you smoke, you do so at your own risk.
    If you drink to excess, you are a danger to yourself and others.
    If you are a druggy the same applies.

    Why on earth, or any other planet for that matter, should the civilised majority endure these social misfits.
    Why should we pay for them to abuse themselves (but not in a good recreational way) and the NHS?

    Let them suffer and be damned.

    Why should we pay for their mistakes?

    Incidentally, I am yet to receive a broadside of sufficent magnitude that sends me to Davy Jones.
    You need to be firing much heavier rounds than grape shot.

    In truth, I get a little bored when there are so few posts.

  • Comment number 44.


    You wrote: "The answer to the NHS problem is simple."

    But you haven't been able to answer a few questions - in fact in #43 you're now reduced to asking questions. It took just a couple of grape shot, nothing more.

  • Comment number 45.

    Nick, very scary to see you fronting a mainstream news programme. Best you're left to editorial comment and we can take a view as to how neutral you are....

    As for the topic (got there eventually) it's a hard choice but we need strong government to make these choices.

    Insist on full insurance for all non british citizens (I hope we do already). If you don't have insurance you don't get in.

    Make sure every penny of NI goes to the NHS (I doubt it does)...

    Every penny of state funded research on health issues that is sold abroad goes back to the NHS... Oh how much would that return???

    Stop sex-changes, gender ops, fertility treatments, obesity operations. If these guys/girls think they are more worthy than those in real need then they should get psychiatric help when the recession is over (or not please)...

    Spend money where it is essential and stop messing around, we're in a crisis and needs must..

    *** I'd rather see the 6 year old with leukemia getting help than the bloke down the road that wants tits....

  • Comment number 46.

    44. At 01:20am on 28 Jul 2009, Richard_SM

    Yet another Ant attempting to eat an Aardvark.

    Oh dear.

    I suggest you light up, drink up and calm down.
    But don't bother your local GP or spend my tax curing your ailments.

    what a jolly good weeze!

  • Comment number 47.

    Are there anymore Chain-smoking, Beer swilling, Drug addicts that would like to take a pop at the resident illegal Alien?

    I sincerely hope so.

    I'll continue spewing forth Invader propoganda until Gordon Brown changes his underwear.

    I think I will be here a long long time.

  • Comment number 48.

    43. At 00:28am on 28 Jul 2009, Invader-Zim wrote:

    "Why on earth, or any other planet for that matter, should the civilised majority endure these social misfits.
    Why should we pay for them to abuse themselves (but not in a good recreational way) and the NHS?
    Let them suffer and be damned.
    Why should we pay for their mistakes?"

    Agree on the lack of posts..... Perhaps we're all waiting to die....

    Because there are always extremes. If it's not drink or drugs, if they didn't exist we'd be shouting at the guy who eats too much red meat, or the woman who ran 20 miles a day risking heart attacks and knee joint problems.

    Society is measured by excess, good or bad, we need excess to lay boundaries. Those seemingly excessive boundaries are actually tolerable and could be a lot worse. Imagine massive heroine abuse, 30% glue sniffing, a nation of alcoholics. It's the large minority that measure the allowable excess. If it wasn't for them, and what society deems acceptable, all hell could break loose...

    Written by SomethingWonderful
    2 O Levels In English and Lit
    1 O Level in Maths
    1 A/O in Advanced Maths

  • Comment number 49.

    48. At 01:37am on 28 Jul 2009, SomethingWonderful

    My faith in humanity restored, I shall retire for the evening.


  • Comment number 50.

    49. At 01:58am on 28 Jul 2009, Invader-Zim wrote

    "My faith in humanity restored, I shall retire for the evening.


    The only decent thing I've managed in my life!

    I'm going to celebrate with muchos tobacco and booze!


  • Comment number 51.

    sagamix @28

    There is a simple answer to this - it is called travel insurance. When ever I visit another country (either within the EU or not) I always take out travel insurance. Simples....

  • Comment number 52.

    #42, sagamix wrote:
    "Fairly Big Nose @ 14
    I didn't choose my parents. Nor did you

    ...don't know why you keep making out we don't see eye to eye when we do - better run NHS, for example, yes please! - and inequality, we agree on that except even more so - in particular:
    - it's natural to some extent

    Saga: It's absolutely natural that inequality starts at birth (well before, really. The gene pool produces differences. It's chance that determines whether you were born in the UK or in Somalia. Good people exist all over. And bad!). Some people run, jump and kick, better than others. Some think, read and write better than others. Problem is that the "clever" types think they are "better" than most others and often try to impose their view of "equality" on the rest. (See the social-engineering folk in this government, who imagine they can "legislate" us into equality. The Soviets said they were trying that. Didn't work there! Far from it... "All animals are equal. But some are more equal than other.")

    - but gross inequality is a bad thing

    Define it, Saga. Inequality in what form? Looks? Height? Diet? Common sense? Intellect? "Riches"? Social environment? Climatic conditions? I've never worked out whether the Inuit have a better or worse time of it than the Kalahari Bushpeople. "Equality" presumably means both sets of people should be supplied with fridges, patio heaters (even for non MPs), warm clothing and bikinis. Sounds a bit daft, doesn't it? That's the sort of nonsense that seems to colour government thinking in our "Human Rights" era.

    - and so it's an important part of any govts job to mitigate against it

    Saga, I guess that within a relatively small group of people, some degree of "equality" could be achieved, because there could be agreement about what it means. But "forced equality", e.g. a small clique of fairly well off people (like MPs) imposing their view on everybody else doesn't seem very "equal" to me.

    I've got a big nose. Is it my "right" to have a smaller one - at everybody else's expense, so I'm more "equal"? If so, what size and shape? If you're brighter than your neighbours (which it sounds like), should they be allowed to apply for you to have a teensy bit of brain surgery to make you "equal" to them? If you bought more books, rather than bottles, should you share them around at a government-targeted rate?

    Getting some form of "level playing field" is an enormous challenge. But this government seems to want equality of outcome. Hence our dumbed down education system. And the casual assumption that allowing kids to "achieve" results with no genuine emphasis on the stretch required to learn stuff is rediculous.

    I don't like "bankers" who make millions by gambling on something that isn't "real". Playing around and making fortunes in a virtual world, as though futures, derivatives, even shares are equal to making stuff or delivering real services.


  • Comment number 53.


    "A string of colleges face serious financial difficulties because of a mismanaged national rebuilding scheme, an MPs' report says.

    The Learning and Skills Council, which oversaw the scheme, allocated £2.7bn more than it could afford to rebuild England's further education colleges."

    Learning and Skills. Couldn't work out that they overcommitted by GBP 2,700,000,000.

    Just how many of the idiots who approved this have been fired?

    Of course, as it's a QANGO, so not directly part of any government department, no minister would contemplate resigning. But it was all due to the fact that the LSC is being reorganised into 3 different QANGOs, so they "took their eye off the ball"... 2,700,000,000 times!!!!

    Of course, instead of 1 head of a QANGO, we'll now have to pay for 3 heads and associated management teams. Lucky us.

    Oh well, I suppose that given our current financial mess, the odd 2 or 3 Billion doesn't make much difference. Tell that to the folk who are still disadvantaged because the Great Leader scrapped the 10p tax band.

  • Comment number 54.

    5# Invader-Zim wrote:

    "While we are on the subject of the NHS, why should we pay for people to be treated who have self inflicted injuries through smoking, drinking and drug abuse?"

    For the same reason we pay for a health service for people who have sporting injuries or are involved in car crashes or preganant women.

    Why do you particularly focus on smoking drinking and drug use? There are inumerable ways in which people need NHS treatment for self inflicted purposes.

    I would suggest you have a misguided pompous sense of superiority
    which has no foundation, i would be willing to bet there are a number of things you would use the NHS for i could argue were self inflicted.

  • Comment number 55.

    The usual sacred cow debate.
    No party will be able to carry out an effective review of the NHS because as soon as there is a sniff of one the opposition (whichever flavour) and there media supporters will scream aloud about cuts in nurses etc.
    There needs to be a complete review of the whole NHS programme. To include who is entitled to totally free at point of use service, what treatments are valid for a free service, and what level of Management is required to ensure these services are delivered expediently.
    I have friends who have worked on a hospital expansion project over the last few years and the waste is incredible. As a brief example, all contractors involved were summoned to a meeting (some from Europe), however the NHS Manager had confirmed the meeting but then took holiday without canceling the meeting. So all the contractors turned up and the managers deputy had to stand in. On the Managers return all contractors were told the meeting would be rearranged and all their costs for the first meeting would be paid.
    The is massive waste in the NHS and some of the spending borders on misappropriation. This New Labour sham of a Government has demonstrated that it is incompetent in spending taxpayers money effectively (not just in the NHS, Aircraft carrier overspend 1Billion, 8 Chinnocks unusable, etc)the problem is that no future Government will be allowed to carry out proper reform.

  • Comment number 56.

    Dear Invader,
    I have sympathy with part of your thesis, the part which excludes visitors to these shores from free NHS Treatment.
    As for the " self inflicted" problems , most any disease/condition falls into that category.
    Part of the human condition of stupidity!

  • Comment number 57.

    What we must keep in our minds is that when politicians say that the NHS is safe in their hands they mean that it is not safe in their hands. They are a thieving bunch of unprincipled liars.

  • Comment number 58.

    If the middle managers in every area of the public services were to be cut out then the efficiency of the system would improve greatly. How many times, following a mistake/problem/court case, have you heard a politician saying that they are taking the problem seriously, and are forming a committee/creating a new post to look into the problem." It would be interesting to see what spending per patient is compared between the NHS and a private hospital for people in a similar situation, eg a broken leg without complications etc. The same could be done for education. Then we could see how much of our money is wasted.

  • Comment number 59.

    "[Thatcher] never escaped the charge that she had cut the NHS. It's worth remembering that in her time in office, health spending increased on average by 3% in real terms."

    It is not how much you spend, it is what you spend it on.

    There are many, many gravy trains in the NHS whereby hard earned taxpayer money is flowing cheaply into private contracts be it on ineffectual contracts or agency fees. Politicians, civil servants, and the primary care bureaucrats hand wring while the core problem of structure, design and complement remains. Politicians tinker at the edges with polyclinics and the like, buying time ("they need time to bed in") whilst the hideous monster at the centre remains. The NHS was a "from the bottom up" design and that means the top layer was incorporated last. That is the layer that is primarily messed up most - the Department of Health. In other words the bureaucracy must be sorted and fast.

  • Comment number 60.

    I tuned into Newsnight last evening in the hope of seeing some meaty fare given the usual Newsnight twist. However, what I saw Nick was you trying to rewrite the entire prevailing political agenda. I am sorry it just got boring towards the end and I knew I wasn't enjoying it as I failed to fall asleep throughout.

    The current political agenda is about Labour denying that there will be `cuts' and just about everyone else saying there are going to have to be some cuts whatever happens. So why are we now being jollied along to expect cuts in the NHS? Is there some agenda we don't know about? Is this an early attempt at the sort of shroud-waving from the medical professions we used to see when the Tories were last in office?

    To my mind the easiest way to protect the NHS is to charge the worried- well ten pounds for every time they turn up in their GP's surgery. I avoid the doctor as I consider them patronising, opinionated and ignorant for in my experience they never question their own diagnosis even when the patient is not getting any better: they just keep upping the doseage until the medicine makes the patient sicker than the original condition. They have no concept of customer service, satisfaction or even participation.

    Yet millions rush to their doctor at the drop of a hat expecting pills and potions for conditions which do not even fall into the category of sickness. But what do you expect from a system which is free at the point of delivery? It is not going to be treated with any respect at all.

    We must charge for accessing the NHS. This will discourage the worried-well from filling up the surgeries. This will require the doctors to focus on people who actually are sick and needing teatment, thus improving service quality. This will also slaughter the drugs bill. I expect it will also reduce illegal immigration. To me this is a no-brainer. It did not require some 45 minutes of quality evening air-time.

    What we need in the UK is social medicine of a modern European standard not the nationalised, paternalistic medical service of the post-war period.

  • Comment number 61.

    #55 newthink wrote:
    The usual sacred cow debate.
    No party will be able to carry out an effective review of the NHS because as soon as there is a sniff of one the opposition (whichever flavour) and there media supporters will scream aloud about cuts in nurses etc.


    This is the core of the problem we have in dealing with an issue that is enormous and growing day by day.

    We need an all party solution to NHS funding and general welfare. As long as the parties are looking only five years ahead maximum they will not make the difficult decisions required, people are going to lose out big time whether it is losing "free at the point of access" or treatments not provided at all.

    We are living longer and the population is ageing as a whole. Forget the argument about smokers and alcoholics, they die ealier and probably save us money in the long run (pay more tax + shorter lives).

    I believe this is a national emrgency that is not recognised as such because of the slow but constant way that it is growing (similar to global warming). Until the fear of voter reaction through media hype is put to one side we will never make the decisions required.

    The sad thing is that without making the hard decisions now the NHS will eventually crumble.

  • Comment number 62.

    59. At 09:15am on 28 Jul 2009, fillandfrowpist

    I totally agree with this. The outflow of money into dirty private hands is rife and aided by petty bureaucrats and civil servants.

    But what can be done? Brown is politically dead and mandelson is building some other private political powerhouse right behind him. There'll be a change of leader of mandelson's design meanwhile the country sinks into the abyss.

  • Comment number 63.

    A year or two ago I forgot to make a appointment within 6 months and was struck of The NHS list. My dentist HAS TOLD ME THAT THE PRIVATE CHARGES ARE NOT THAT MUCH MORE AND THAT THEY USE SUPERIOR INGREDIENTS FOR FILLINGS. THE nhs ONES HE SAYS ARE SUB PAR, LESS SAFE AND OFTEN NEED TO BE REPLACED MUCH SOONER. MAKES YOU THINK DOESN'T IT? Sorry about the caps but hit the caps lock half way through and can't be ar _ _ _ to go back and correct it!

  • Comment number 64.

    To me it is pretty clear that the NHS in its current form is unsustainable. As the population gets older, and we learn to treat more and more ailments, the cost of keeping people alive increases. Cold logic, but there it is.

    The only person I have heard actually come out and say this is Anne Widecombe, she is in her political twighlight years and can afford to challenge on controversial issues. For anyone else, it would be political suicide to threaten the NHS. But there is simply not enough money to pay for the medical treatment of a country in which more than half is out of work due to age (young or old), disability, or shear bone idleness, and another significant proportion has its wages paid by the government.

  • Comment number 65.

    It astonishes me that the BBC retains its licence and NR his job when an article like this is posted.

    Can you not see the rich irony of the title 'safe in our hands' and the suggestion that this is a toss up between who can make the best case for the difficult times ahead?

    'Safe in our hands' - is that what newlabour will be arguing at the next election?

    About the the NHS - because they spent three times as mucvh money.
    About education - because grade degradation ensured standards rose.
    About the war on terror - after the 7/7 bombings
    ABout our gold - that they flagged to the market would be sold and achieved world record low prices for.
    About the private pensions system - that they decimated
    About the destruction of civil liberties
    About the enormous levles of government debt?

    I am surprised, amused and incredulous that you think anyone in this country thinks anything is 'safe' in the hands of the newlabour wreckers.

    Breath taking denial from the BBC as ever.

    Call an election.

  • Comment number 66.

    Well, if the England National Health Service is to face massive cuts then there some key National Budgetary adjustments an English Parliament could be making (were one to exist):

    Does England need more motorways and dual-carriageways given the eco-condition of the planet? No, so stop the lot even if they are half-built.

    Do English Tax-payers need to subsidise Scotland-Wales-Northern Ireland Capital Expenditure when all 3 have their own devolved Governments and could/should be left to their own Taxation/Public Spending plans? No, so give back all monies accrued in UK Taxation from the 3 and tell them to get on with it - - near full Exchequer devolution-independence at a stroke - - the 3 can decide if they want to participate in UK Armed Forces and if they don't fancy paying their share then so be it.

    Does England need to hand over billions to the European Union? No, stop it at once and invite the EU to chuck England out asap - - freedom from EUrocratic tyranny at a stroke - - this would of course lead to
    abandonment of numerous EU regulations-authorisations-systems-processes and thus cut-back even further the cost to English Tax-payers.

    Does England have to provide Social Benefits at the pint of entry to every immigrant whether legal or or illegal and whether asylum or economic migrant? No, stop all benefits except for those under-18 for the initial 2 years from their arrival - - is it unfair? is it inhumane? - - well, if the 49,000,000 children, women and men of all races and creeds already living in England cannot receive the best of Health and Welfare Care from their NHS partially from pressure on costs for treatment of new non-tax-paying arrivals then that is certainly unfair and inhumane to the indigenous population.

    Does England require in the next 5 years any Banker, Business Executive, Superstar etc. earning over 250,000 p.a. in salary/bonus to pay no less than 50% Tax? Yes, and make it 60% from 1,250,000 and 70% on anyone earning 2,500,000+ p.a.

    Somewhere in that lot the English NHS should receive enough funding to function properly whilst the English finally sort out the free-loaders and hangers-on on the borders and from abroad!

  • Comment number 67.

    "5. At 9:17pm on 27 Jul 2009, Invader-Zim wrote:
    The answer to the NHS problem is simple.

    If you are a UK citizen, born and bred, then the NHS is free."

    Not quite true... If you are involved in an acident the NHS, Fire Service and Police are supposed to try to recover their costs in helping / rebuilding you from your or the 3rd parties insurance.

  • Comment number 68.

    61 Dotsanddashes
    Totally agree. If the nettle is not grasped now then the NHS will implode. A cross party agreement with a long term plan is the only route forward without increasing tax to levels that will pay for the future costs of care.
    Incidently I believe it is the cost of caring for long term terminally ill that will give a route to assisted suicides becoming acceptable to politicians, not a change in moral judgement.

  • Comment number 69.

    You are all afraid to say it, the mantras of David Cameron and Michael Howard before him are / were:

    Immigration Immigration Immigration

    My general hospital, which is huge, has 90% foreign patients and 90% foreign staff.

    What the hell is THAT costing us?

  • Comment number 70.

    34. At 11:12pm on 27 Jul 2009, Richard_SM wrote:


    "why should we pay for people to be treated who have self inflicted injuries through smoking, drinking and drug abuse?"

    I dont do any of the above (execpt drink 1/2 bottle of wine a week....

    BUT what about sports releated ingeries which are just as self inflicted?

    Or Dietry inflicted healt issues?

    Why just pick on smoking, drinking and drugs (2 of which pay massive of taxes anyway)?

  • Comment number 71.

    Your catoesque calls for an election are admirable. Who do you think would be capable of 'righting' all the 'wrongs'? Which vote isn't a wasted one?

  • Comment number 72.


    Why are you playing the game?

    You *must not* let politicians tell bare faced lies.

    If you cannot nail these people down, then give your job to someone who can. Or are your eyes too firmly fixed on your long term career plans to want to make any journalistic waves?

  • Comment number 73.

    #62 doctorbreezy
    "Brown is politically dead and mandelson is building some other private political powerhouse right behind him. ... "

    You may well be right, but Mandelson will be destroyed (again) by his own hubris. For years he has tried to create the myth, bought alas even by some BBC correspondents, that New Labour's electoral victories were down to him.

    I believe the truth to be rather different. Madndelson's organisational skills may have been useful in 1997, but they certainly weren't decisive. Mandelson personally has never been an electoral asset to Labour. Since 1997, his influence upon the party leaders has made them less rather than more popular. He is like a grotesque cross between Mephistopheles and Malvolio, destroying those he purports to help, yet simultaneously puffing up his own ridiculous and insufferable vanity.

    I expect Labour to suffer its worst electoral defeat since 1931 - possible worse in terms of the popular vote. When it does, Mandelson will be consigned to the oubliette of history, which is where he richly deserves to be.,_1931

  • Comment number 74.

    "if you are UK born and bred" is, on the face of it, a good idea.

    However, doesn't everybody know that millions of pregnant women arrive here from abroad to give birth just to give their child a British passport - a passport to all the free handouts available AND our poor overstretched NHS.

    Plus: they grow old here too - another burden in old age!

    Why is so blindingly obvious that nobody can see or admit to it - the BBC and the government are afraid to see it.

  • Comment number 75.

    See points 3 and 4 of this official website for some of the answers:

  • Comment number 76.

    #18,19 and 22 Invader-Zim
    you wrote in #5:
    The answer to the NHS problem is simple.

    If you are a UK citizen, born and bred, then the NHS is free.


    Invader, your choice of language raised the thought to my mind that you may well be BNP health secretary. You could have stopped at UK citizens and I would have ignored your rambling rantings as usual, why try to qualify it with simplistic rubbish.

    If the point is that we need to stop abuse of the system by those not entitled to use it then you will get no arguments from me but my problem is with the bigoted language not the underlying principle.

    There is a problem of health tourism in specific areas, however if it went away tomorrow it is not going to suddenly release all the funds required to give everyone what they want out of the NHS for free or close this putative gap that the Kings fund is forecasting as you imply.

    The system is there to charge if the person is not entitled to free care, always has been, it is just abused and not properly used. We just don't tend to ask the patient in A&E for their credit card details or insurance documents before treating them, probably we should but then we would get ravings about stasi state if someone asked us to produce any document to prove our right to be treated for free.

    There are many non-british citizens who are legally living and working here and paying their NI and taxes just like you and I who are just as entitled to the care of the NHS which the are paying towards. They would be more justified in getting care than say someone who has spent their life on benefits and actually paid nothing towards even had they been born and bred.

    You are also sadly mistaken in your assumption of my political leanings but I enjoyed the poem anyway, most amusing.

    The problems of the NHS are complex not simple - such simplistic jingoistic nonsense as you started with was unnecessary. Simple solutions to complex problems usually mean you didn't understand the problem in the first place.

  • Comment number 77.

    If you really needed to reduce costs, the NHS could set up its own not-for-profit generics business, because a huge number of medicines are now off-patent. If they were all sold-on at-cost, it might be interesting to add up the numbers.........

    Probably best to limit that to ongoing scenarios where demand is stable and predictable.

  • Comment number 78.

    I saw you the other night is this the cut backs that the BBC were talking about you and others moon lighting. Those in power want a NHS like the Americans which is run for the rich and the pill companies and were there is many layers of treatment according to pay. We would soon have the disease back on this small island that we had be for. the NHS should be free for those who are born here and others pay it is not and never has been free this is why we paid NI something that is forgotten, get ride of the quangos and the bounces for the doctors and pen pushers like trusties which should be free and not paid for because they come from the white upper middle classes.

    Stop paying for and running huge hospitals like the Liverpool Royal it never worked and is to hard to run. When people had their own local hospitals it was better, now they are show pieces with attitude most people do not like hospitals and rightly so but now they are run like a meat factory. If it was not for those from over seas these places would grind to a holt it has always been the same. But they are to big many of these knew hanger hospitals to keep clean and safe, do we want to see police walking the halls with guns, no but we have them because other size of the place. We are fleeced when in hospital and any visitor with car parking and television and phone charges then the food its a hit and miss affair the same as the cleaning which is contracted out to the cheapest firm usually not the best.

    But go into the private hospitals and you can see the difference and we train the nurses and doctors in the NHS I feel that they should have to work five years in the NHS after they pass to pay it back and also like PMs it gives them insight in to the real world and makes them better people. But this will not happen like Thatcher who sold of company that were public owned so the big one is the NHS, she would have had it sold by now and we would have had more than swine flu to cope with greed is blind and people have forgotten why the NHS was formed and for who it was made so there has to be a vote from all off us it is a public company.

  • Comment number 79.

    Whistling Nell you speak like a liberal leftie who lives in an unaffected area.

    Rest assured, if this government gets re-elected the problem will be coming to an area near you soon.

    No doubt you will be overjoyed.

  • Comment number 80.

    #73 sashaclarkson

    The next election is not a foregone conclusion so i believe a prediction along the lines of 1931 are not possible at this stage.

    Labour is certainly in trouble and their supporters have not turned out at the last few voting tests however the Conservatives have not mopped up the votes yet either.

    Both parties (apologies to Lib Dems etc) can win or lose voters in the next 11 months and so they will tread extremely carefully around contentious issues such as the NHS, to the point where key policy decisions are not made for fear of alienating the electorate.

    The result will be grand statements from both sides about the safety of NHS funding and waffle about structural reform to correct the underlying problems.

    It will be thus until the NHS actually breaks and the crisis can safely warrant extreme action.

    Imagine the government paying billions to the banks before the crisis hit, the uproar would have shaken parliament into the Thames. But, when the population was scared witless at the thought of the economy imploding all sorts of decisions were made in quick time and justified by the crisis (regardless of the debt incured).

    If the NHS has weeks to survive (nurses not being paid, waiting lists in years etc) the government will be able to impose emergency measures and pose as the saviour.

    Not the best way to plan and run a key part of our society

  • Comment number 81.

    #76 Whistling Neil
    "There are many non-british citizens who are legally living and working here and paying their NI and taxes just like you and I who are just as entitled to the care of the NHS which the are paying towards"

    Could this be a reason for ID cards then?
    I hope not

  • Comment number 82.

    Oh, just been informed the BBC HAVE mentioned some of the problem is this article:

  • Comment number 83.


    It is over simplistic to believe that charges will somehow change the face of the NHS, be it at the GP, the operating theatre, the dentist, the chiropodist, or the paediatrician. Sickness does, because history tells us it does, target the poorest in our society, whilst the wealthiest generally have higher standards of health. Despite exceptions this is fact and was, when all the analysis was done, the reason why we have an NHS.

    Excluding the poorest via a charge (however small) may appear to improve prospects financially but does it? There are huge hidden costs to ignoring public health or introducing barriers to managing it. These costs greatly exceed those that we can expect in the NHS by whatever means we manage it. An ageing population is not an issue if people are healthy and occupied. But, crucially, economists never target the elderly because there is little disposable income available except for the minority and that is another problem needing political attention.

    Target lead economics have failed. We really need to get back to treating all people as equally important, not in words and laws, but in practice. The elderly must be seen as a huge, untapped resource - not a blemish or a problem that we can do without but cannot avoid dealing with.

    There is plenty of waste in the NHS and it is not always in expected areas (number of patients for example) but in areas like management of resources, private contractors, patient-service interfaces etc. We have been far too prone to over-hyping minor problems to the exclusion of the much bigger issues that must be dealt with. GP practises generally do a great job at the front line of our delivery of health - it is a pity that their professionalism is not matched in the bureaucracy.

  • Comment number 84.

    Everyone complaining about paying for other people... Its simple

    Scrap the NHS - its a disaster and a disgrace. Leave the money in our pockets and let us make our own arrangements.

    The NHS only exists so MPs have something to bang on about.

    With out nationalised industries MPs would be shown up as actually having very little to do or say.

    Nationalise an industry (like banks) and all of a sudden MPs are experts on it and want to get their oars in...

    Get these ignorant fools out of the equation wherever possible - leave peoples earnings in their own pockets so they can set their own priorities - rather than having gordon browns priorities stuck down their throats, whether they like it or not.

  • Comment number 85.

    As with all other public services (large class sizes, not enough housing, overstretched police) the problem could be resolved largely by curbing immigration. Who do we have to blame for allowing that to spiral out of control?

  • Comment number 86.

    Got to hand it to them, the Border Agency for the government do a wonderful job of advertising and enticing foreigners here and tell them how to get their free NHS care:

  • Comment number 87.

    #74 Flamepatricia.

    Sorry but you are wrong on that,

    You should have remembered Maggie changed the law in the early 1980s to stop this practice which was a common sense change.

    It was true before but it is not now.

  • Comment number 88.

    Whistling Nell. I am sorry but YOU are wrong. I live in Brent the area worst affected in the whole country.

    Look it up. You may be amazed.

    I live here so I should know - thank you.

  • Comment number 89.

    @#15 whistling_neil, you've added some good ideas to invaders list: well done sir, let's hope they all happen!
    thank you!

  • Comment number 90.

    Re the various posters claiming that the NHS is free.

    I can assure them all that for UK taxpayers it is far from free! I don't know about you but a pretty decent share of my income tax, national insurance & VAT amongst others pays for it. I'm sure the same applies to the rest of you (non dom millionaires and newspaper proprietors obviously excluded) as well.

    Rant over I'm off to have my lunch (not out to lunch as some joker will no doubt try to point out).

  • Comment number 91.

    Flamepatricia, I like you! i like you a lot, thank you for the links you provide.
    We need more folk like you, i think i'll start a fan club!

  • Comment number 92.

    A funding priority needs to be common sense funding. All else will follow.

  • Comment number 93.

    How can anyone compare smoking related illnesses to sports injuries?

    Smoking is harmful to your health. Fact.

    Most sports are beneficial to your health, some carry a RISK of injury.

    Does anyone have the p.a. costs of 1) smoking related diseases to the NHS and the costs of 2) sports injuries to the NHS available?
    Throw in the cost of treatments for quitting smoking to 1).

    I'd guess 1) is costing more. Far more.

    Even some alcohol (e.g. red wine) can be beneficial in moderation. But smoking??

  • Comment number 94.

    #79 Flamepatricia:

    The current government is dead and buried come the election, this is not in doubt and good riddance to them.

    Where we differ is that I do not see Cameron as the second coming and solution to all our ills. He is certainly the most credible leader you have voted for in the last 12 years, but then law of averages said you had to get it right once, you had enough goes at it. Lets face it, he didn't really start to shine until Blair left the building. Brown is just such an easy target it is hard to miss and he does very well at it.

    I for sure have a more liberal view of life, affirming my place in the world does not require denigration of others to make it valid for me or picking on one group or another as the source of all ills.

    A parting thought , you are referring to Northwick Park in your grossly inaccurate 90% foreign comment aren't you? I know it well, majority of the staff, yes (but nowhere near 90%), patients, they reflect the community you live in and just because they are not white does not mean they are not British. Harrow has become a very multicultural area as people have legally settled and the nature of the place has changed beyond recognition, it is however still a really nice place to live and I can see the attraction these people you seem to dislike see in it.

  • Comment number 95.

    Remember if we get rid of the influence of all those annoying foreign types on the NHS...we wouldn't have many people left to staff it. Health tourism may be a problem but it cannot match the real problem.

    The real NHS problem is like everything else government related. Management.
    Paper shufflers, meeting monkeys and other waste of oxygen types. Where has all the money poured in to the NHS gone? Management.

    You want someone to beat up on? They are your targets.

  • Comment number 96.

    #73. sashaclarkson wrote:

    "When it does, Mandelson will be consigned to the oubliette of history, which is where he richly deserves to be."

    I have only ever seen one genuine oubliette and this is at the Château of Meung sur Loire apparently the hole in the ground where the poet François Villon languished for a while. Is it really worth digging a hole fro any politician - just ignore them as the pass in the street - that would be a far greater torture!

    I would add that we have a generation of morality and ethically free politicians - no(non criminal) convictions - in a sense that is our fault! We wanted two conservative parties and that is what we got. Mandelson and other members of the Labour party suffer from our expectation that they actually stood for something and that was to do with improving the lot of the dispossess, disenfranchised and the poor. They forgot why we elected them and they must be punished.

    PS Dave Cameron should remember that many in his party have expropriated the left field and they will be similarly punished when they fail to deliver a 'safe in our hands' health service etc...

  • Comment number 97.

    94. Whistling Nell. Don't just ask me ask the others affected. If it is great then why are all the indigenous population moving out then?

    Why is it when I telephoned the nurse in charge of my husband to ask how he was she could only say to me "he ok" which she repeated seven times?

    How on earth can a nurse like that be responsible with medication and her other duties which rely on the English language?

  • Comment number 98.


    I think you are missing a point on smoking (I am not a smoker by the way).

    1) Smokers pay one hell of a lot more tax than most people.
    2) Smokers as a general rule live for less time. Therefore although they may cost more for the few years they are ill, they cost over less time.
    3) If people do not suffer from smoking related illness, they will everntually suffer from something else instead, no reason why the something else will not be equally costly. As a general rule, as age goes up, so does the cost of keeping someone in health (sorry if this seems cold).

    I do not subscribe to the view that smokers cost more. The amount they cost is concentrated over a smaller amount of time perhaps, but that is all.

  • Comment number 99.

    Message 83 fillanfrowpist

    My objective in charging a fee of ten pounds when someone starts a course of treatment through their GP surgery is to thin out the time and resource wasting worried-well who infest the NHS for the simple reason it is free. Go into any GP waiting room and pick out the ones who are really ill: there are not that many.

    This has nothing to do with penalising the poor as ten quid these days is not that much. It is enough to make you think before you go to the doctor but not too much to discourage the sick from attending a doctor. One commentator on Nick's programme last night suggested twenty quid but I thought that a bit over the top.

    I have heard a doctor suggest that it need only take ten minutes for a person to state their symptoms and for the doctor to diagnose. This is nonsense. A sick person is usually unable to articulate their symptoms properly and doctors need the time to explore the issues raised by the patient. This is just not allowed for in the NHS as precedence has to be given to the worried-well.

    My brother had to see his GP three times before the bumptious oaf decided he had better send him off for tests as the swelling on his leg might be cancerous - my brother lost his leg but not his life. My cousin was diagnosed with IBS four times when she was actually suffering from stomach cancer: she died young. This just isn't good enough. Yet an acquantaince who was suffering from a cold obtained antibiotics from her doctor at the drop of a hat. When I challenged her she justified it as she had paid the prescription charge.

    I can go on if you want but this is starting to get tedious. The reality is that in France, Germany and other countries in the EU there are absolutely first class social medical services. Why don't we have one? The difference is that there they expect the patient to commit to being ill and stump up some money first. There are charities to help the very poor. Over here we just indulge the worried-well, clutter up the service with healthy people having their egos massaged and leave the real sick to suffer and die due to neglect.

  • Comment number 100.

    Flame Pat
    "However, doesn't everybody know that millions of pregnant women arrive here from abroad to give birth"

    Just how many millions are we talking here? 5, 10?


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