As is often the case, I agree with your sentiments! As an OT for over 40 years—now retired from the NHS—I have sadly watched its demise over many years, to the point I could no longer work within it! I cannot change the philosophy or organisation of the NHS, but I can no longer work in an institution I do not believe in.
In my opinion, one way to secure healthcare staff for the future would be to pay for training for the professional degree courses, in exchange for an agreement of 5 years' service (obviously paid).
Additionally, some countries, such as Austria, for example, provide healthcare/pension with a green card. It is expensive, at around 400 euros per month, but not all expenses are included with this card. If you require a hospital stay, your meals are required to be paid as an 'accommodation fee ' at around 15 Euros per day—an estimation of what you would spend per day at home on meals.
You can walk into a GP surgery and be seen that day. For example, when visiting a hospital, residents either present their Green Card or credit card before being seen. Prompt payment for a service they will receive!
Efficiencies could be made in many ways, but I agree that a substantial organisational change is required.
As a dual Australian/British citizen who has lived in both countries as an adult, I was saying this about 35+ years ago when I was first living in the UK, I could see what was happening even then, but was shouted down by my friends who were absolutely wedded to the idea of the NHS. Since then the decline of the NHS has accelerated, especially over the past 10-15 years.
I reflect that when I was first suspected of having MS, it took me 2 weeks to see a neuro, and then less than a week for the MRI, yes I had to pay about 30-40% of the cost for the appointment and MRI, but there is also a safety net for people who can't afford it. After diagnosis, I then got to choose any of the medications I wanted which cost me $AU35 per prescription (private price $26000).
I compare this to some of the waiting times my now elderly relatives are having to wait before they even get in to see a specialist for the first visit in the UK of 6 months or more.
The NHS was an amazing idea at the time, but health care has moved on so much and is so much more expensive, and many more people are living for much longer, it really can't cope, Nye Bevan would be turning in his grave.
I certainly think that a national debate on the future of healthcare is way overdue. Similarly I think that all politicians should start being more honest and open about the stark and pressing choices facing the UK and that all this nonsense about reducing the numbers of managers to free up money is just that ‘pure nonsense’ designed to distract from the real and pressing problems: we are all living longer but not necessarily living longer healthy lives I.e old age brings increasing amounts and years of healthcare; modern medicine can do wonders but it costs and someone has to pay; individual and population expectations of good healthcare are increasing yet the idea of paying more tax to support the NHS seems to horrify a good percentage of the population and I think that basically politicians are too ‘chicken’ about saying anything that might in any way imply higher taxes or damage to the sacred cow I.e the NHS. Politicians have a choice : grab hold of the blindingly obvious problems and set an agenda for the future or sit on their hands until the whole thing becomes a crisis. Part of this national debate needs to be about individual’s responsibility for their health - a tricky and sensitive issue but basically there is a limit to the abilities of a healthcare system to keep people healthy, healthcare has to be a partnership between the healthcare system and the individual
We need our politicians to be honest and pragmatic. Rather than being an albatross around the Government's neck healthcare expenditure should become one of the drivers of the economy.
There is a wider context here. It is not just the NHS in dire need. I volunteer in my grandsons primary school as a gardener/mentor and am saddened by the lack of resources, the huge classes, low levels of staffing and the evident lack of investment in 'extras' like working gutters. There is plenty of vital learning not being done - how to use social media for one, health for another (Please stand aside Henry VIII!).
So too with the criminal justice system, probation, social work and just about every other part of the public sector. At the same time there is a cost of living crisis leaving many without savings after all the bills of modern life; including mobile phones, internet expenses, the high cost of transport, energy, water and housing. For many families, health is somewhere down the list and healthy living not on it at all.
Farming too is in a state of crisis with our need to import £68bn of food annually. Then the costs of climate change are beginning to be felt and will rise exponentially as well as the rise of fascism in America on the backs of the disaffected, the dangers of AI, increased expenditure on weapons and the increasing divide between unarguable excess wealth and poverty.
We must see where healthcare fits into all this. One thing I know for sure; if we don't educate our kids better and do something about their rapidly declining prospects, we will have less taxpayers and more patients.
I have family and friends in both Norway and Sweden. They are not thrilled with their medical system, they say the waiting lists are too long for everything. But then again, for something serious, you get appointment within a week.
I agree with the majority of this letter, but there is a surplus of cooks (managers). We need more cleaners/porters/doctors/nurses/OTs/physios. We can do without the managers, who think every problem can be solved by employing another manager. Yes, cut the managers, but make sure that there is more meat after trimming the fat.
How about a national commission to look at the future of healthcare in the next decades: taking into account the increasing longevity of individuals; national and individual expectations of healthcare; the increasing sophistication of medicine etc and associated massively increasing costs; the costs of training ; emigration of staff to other high wage countries with better resources and less pressure on staff; the role and responsibility of citizens in maintaining their own health etc etc. It’s a massive issue but we can’t keep on trying to patch up a failing system. The world has changed massively since the NHS was created, healthcare/ medical care has changed massively with new medicines etc that were unheard of when the NHS was created; potentially it should soon be possible for each of us to get complete genetic assessments at birth to identify health risks , susceptibilities etc ( including MS?) who is going to pay for that and e.g if an individual ignores advice on protecting against various individual health risks then who pays if that individual goes on to develop/ suffer from that condition. Should the tax payer pick up the bill for that individual’s negligence?
Personally I am very much of the view that the future is healthcare has to be based on some sort of contract between State and Individual, one in which both parties have duties and responsibilities.
The contract between state and individual was tried and failed. It was called the NHS charter. As medicine becomes more complicated, government are dumbing down the players. PAs are supposed to have a limited role. Unfortunately, there are cases of these PAs being used to fill hospitals’ unfilled doctor posts. The simple question to ask yourself is, do I want to be cared for by somebody who has spent 5 years at university and another 5+ years being supervised in practice, or somebody with just 3 years in higher education? Yes, there are some amazing PAs (or so I’ve heard), but on balance, I’d prefer somebody with more education.
Kind of depends on what the disease/ condition is. Many things that used to be he domain of Drs are now treated by senior nurses. My wife used to be a Sister treating eye conditions and over her career took on many of the duties and medical responsibilities that used to be done by Drs and Consultants
Historically nurses did more, then less and now more again. Physician Assistants (PAs) aren’t the same as Consultant Nurses. The former are potentially school leavers who failed to get the A levels for medicine, did a VTS and landed in the role of a junior doctor, whereas the latter are generally highly experienced professionals who have honed their skills in the NHS crucible and floated to the peak of their chosen specialty.
"...potentially it should soon be possible for each of us to get complete genetic assessments at birth to identify health risks , susceptibilities etc ( including MS?) who is going to pay for that and e.g if an individual ignores advice on protecting against various individual health risks then who pays if that individual goes on to develop/ suffer from that condition. Should the tax payer pick up the bill for that individual’s negligence?"
You have just described exactly why to NOT get a genetic assessment. You are seeing it as a cudgel. And there are plenty of people who will be thrilled to use it as such, and not just for conditions that supposedly can be totally "controlled". I can't begin to tell you how delighted I am that I never gave into the siren song of 23 and Me, now that their genetic data is up for grabs.
Not quite sure what you mean by ‘you are seeing it as a cudgel’ but personally I would welcome genetic testing to spot any susceptibility to e.g developing a particular type of cancer , or any other condition and thus I would be able to get regular checks and catch it at an early stage. It’s is already happening with some cancers.
I completely agree. Perhaps a Citizens Assembly can be convened to explore public attitudes along the lines you suggest.
I also second the point of view below about the need for honesty about the choices we face, with the pros and cons of each approach clearly outlined. I wish governments would treat us as grown-ups.
Just reply to your point about being treated as grown ups. I always find myself thinking that when a politician starts saying that things are complicated etc it basically means they don’t understand and don’t have the capacity to explain things . It worries me that too many politicians are out of their depth on important issues. Many moons ago there was something like a royal commission/ national inquiry into the future of higher education. It collects lots of views , evidence and produced a range of reports on different aspects of higher education (known as the Dearing Report) . From what I remember there wasn’t a politician on any of the various committees and it was very much an independent commission/inquiry
If NHS hospitals have a private floor or wing, consultants can make themselves more available. If they’re working in a private hospital 5 miles down the road, they can’t dash in to deal with emergencies in a timely manner. Bring in the full private services and the hospital becomes more efficient. I’ve seen it work in a state hospital which devoted its top 2 floors to private patients. The benefit of this is private medical facilities in trusts subsidise the NHS.
The private sector already runs the NHS, including real estate, linen, IT services, transport, supplies, pharmaceuticals, etc. It does not run the front-line services, but that is all. I suggest that the government doesn't fund it, but individuals fund it themselves or via their employers through insurance premiums. The model will allow healthcare expenditure to increase, but not as part of general taxation.
That’s all well and good but I believe the private sector companies are only interested in their bottom line and expect it to increase each year. This would surely impact the service they provide.
On the other note I have no employment and am disabled so expecting someone like myself to fund it is very worrying
Hard disagree. The existence of private healthcare drains resources from the public and discriminates against those with existing conditions, leading to worse health outcomes for the chronically ill (e.g. pwMS). Why is it so fantastically implausible to imagine a properly funded public healthcare system in the sixth biggest economy in the world? Why must we compromise with the obscenely wealthy who tell us they couldn't possibly pay a bit more tax back into the system which they have drained dry?
I'm not sure if you know that the UK's wealthy pay a larger proportion of tax than rich people in other countries. I suggest the government spread the tax burden across the population rather than focusing on the wealthy. The wealthy are voting with their feet, so increasing taxes on the rich becomes self-defeating. This is economics 101, which is why political parties have not implemented wealth taxes in the past.
Economics 101 dictates that low taxes lead to the wealthy investing in property, thereby pushing up the house prices. It's a no brainer to raise taxes on the top earners. It's how the NHS was created in 1948 (90% top rate). If the wealthy really are as patriotic as they say they are, they'll stay. In fact, a number of millionaires are calling for higher taxes (see Dale Vince for example). The government won't raise taxes on the wealthy because they're scared they'll turn their media organs against them, which is hardly very democratic, but hey.
The Government is going to have to put up taxes anyway. However, a different funding model will have to be adopted to fund the NHS and healthcare from now on.
You haven't replied to any of ky points. I live in a country where the funding decline to public health has resulted in it being gutted and resources moved to private healthcare, which I am unable to access as a pwMS (I go through torturous, invasive questionnaires, only for them to tell me the algorithm has rejected me for reasons unknown). My experience in the UK was that private health was used as a means of queue-jumping (ie you'd pay to see the same consultant, only quicker). There are massive ethical issues with private healthcare and its de facto social Darwinism. I repeat my thesis: why is it so difficult to conceive of a properly funded public system? If you're writing to the PM, demand that instead of compromising with private health vultures
Because it is too expensive, and a lot of what people want covered by the NHS is lifestyle-related and will not be covered, e.g. weight-loss treatments, eye surgery to correct vision, .... Therefore, we need a new funding model. Healthcare will still be socialised, only funded by tax and private insurance contributions. This model works very well in many European countries. At the moment, the Government is trying to control supply and demand, and this has resulted in the NHS becoming 'broken'. The NHS needs to be fixed, and more tax and money are not going to work.
In which countries does this model work? I can accept that simply throwing money at the problem is not the entire solution, but privatisation under the table isn't a solution either. I think you're spot on when you talk about a holistic approach to healthcare: these kinds of lifestyle changes will save the NHS a huge amount.
I can’t see how the current NHS model can survive with standards so shockingly low. I disagree on cutting the managers - they are a big part of how standards got this bad. It’s hard to think of another organisation so badly run; values and ethics left the building long ago with cover up rampant at the cost of patient safety. Even if the level of management rises again in the future best to cut the rot and build up again. And it’s through private sector openness and competition that the opportunity of AI will become less constrained. Overall, I agree that the blended model is where things are likely to go. All citizens must have equal access to the services they need and a bit of footwork is needed on innovative private care financing models to ensure that.
Pressed send by mistake - an All Party Political Group should help ensure the problems in the NHS are acknowledged by all political parties and prevent the NHS being used as a political football. The reason the NHS problems haven’t really been tackled before is because of the political fallout of doing so properly.
Then the cross party group can decide to hold a national consultation etc. I agree politicians are not the experts, but they are needed for the reason stated above. It may take a few years for the report to be written. It also, I agree, needs to look at foreign healthcare models.
We lived in Switzerland for many years. There, healthcare insurance is mandatory. Premiums were low (although I think they have gone up considerably since we left). You chose your level of cover. Many employers helped. Costs were transparent - very important as most UK citizens have no idea of the cost of a blood test, an MRI or a birth etc. You got billed and could reclaim all of your expenditure except on prescriptions I think where you could only reclaim 90%. People were much more conscious of their personal healthcare choices because they had to pay something towards it. There children always saw a paediatrician, taking the burden off the British GP system and the receptionist was a trained nurse who triaged appointments and gave medical advice on the phone eg at what point to worry and ring again etc. Women went to a woman’s GP, so although you were sent to consultants there was less of a gatekeeping GP system. I felt much better cared for there.
Hard to see how this will help anyone except for the private healthcare companies and banks.
I'll not get medical insurance - no company in it's right mind will charge me an acceptable premium to fund my DMT treatment and MRIs.
I worked my entire life and paid tax, and retired (against my wishes) with a modest medical pension and a small lump sum, which is my only security for the future. I suspect this will be swallowed up funding my own healthcare privately, and then I'll be dumped into the 'safety net' - which will face the same funding squeeze as the current system (or worse).
To me this is a recipe for a 2 or 3 tier healthcare system (to match our education, and every other system in this country). No point in a 'consultation' or 'national discussion' - the political classes already know what they are going to do. And every current political party is in essence singing from the same songsheet.
Instead of squeezing the, already broke, poor and middle classes, why do none of them tackle the taboo idea of making big businesses pay some tax on their profits? These days everything must be sacrificed for the already super-rich to add a few zeros to the end of their bank balance.
But how do explain the success of the dual funding model in other countries? This is about funding a part of health care by the private sector and decompressing the NHS. The NHS will still be there to look after people with health problems.
I have been in Benendan for years and it was through them I eventually received my MRI scans which confirmed a neurological condition as go said arthritis (at least twice in 8 years despite neurological symptoms showing) .Benendan do not treat neurological conditions but at least I got my scans ordered by a orthopedic specialist as I have bi lateral foot drop and pes cavus feet and had other neurological symptoms .My first neurologist appointment was paid for by Benendan .Since then though I had to pay privately twice for a neurologist to try Fampridine .This drug is available free on the NHS everywhere but England.As I have Ppms no other drugs available to me for walking problems..The neurologist I paid for is in the same team as my neurologist at the Walton centre.The drug didn't work for me However lots couldn't even pay to try it or if it does work cannot afford it .Yet the NHS pay for weight loss drugs?? Annoying for me as I know with determination and healthy eating and appropriate exercise everyone can lose weight if healthy and can move about have access to healthy foods .But the NHS already pays for a lot of private hospitals to do treatment anyway.I pay for my family for a limited amount of private care but not sure at all what is for the best.Look at America.Treatments need to be authorised and are restricted on a personal basis .Not good either.
Dear Gavin,
As is often the case, I agree with your sentiments! As an OT for over 40 years—now retired from the NHS—I have sadly watched its demise over many years, to the point I could no longer work within it! I cannot change the philosophy or organisation of the NHS, but I can no longer work in an institution I do not believe in.
In my opinion, one way to secure healthcare staff for the future would be to pay for training for the professional degree courses, in exchange for an agreement of 5 years' service (obviously paid).
Additionally, some countries, such as Austria, for example, provide healthcare/pension with a green card. It is expensive, at around 400 euros per month, but not all expenses are included with this card. If you require a hospital stay, your meals are required to be paid as an 'accommodation fee ' at around 15 Euros per day—an estimation of what you would spend per day at home on meals.
You can walk into a GP surgery and be seen that day. For example, when visiting a hospital, residents either present their Green Card or credit card before being seen. Prompt payment for a service they will receive!
Efficiencies could be made in many ways, but I agree that a substantial organisational change is required.
As a dual Australian/British citizen who has lived in both countries as an adult, I was saying this about 35+ years ago when I was first living in the UK, I could see what was happening even then, but was shouted down by my friends who were absolutely wedded to the idea of the NHS. Since then the decline of the NHS has accelerated, especially over the past 10-15 years.
I reflect that when I was first suspected of having MS, it took me 2 weeks to see a neuro, and then less than a week for the MRI, yes I had to pay about 30-40% of the cost for the appointment and MRI, but there is also a safety net for people who can't afford it. After diagnosis, I then got to choose any of the medications I wanted which cost me $AU35 per prescription (private price $26000).
I compare this to some of the waiting times my now elderly relatives are having to wait before they even get in to see a specialist for the first visit in the UK of 6 months or more.
The NHS was an amazing idea at the time, but health care has moved on so much and is so much more expensive, and many more people are living for much longer, it really can't cope, Nye Bevan would be turning in his grave.
I certainly think that a national debate on the future of healthcare is way overdue. Similarly I think that all politicians should start being more honest and open about the stark and pressing choices facing the UK and that all this nonsense about reducing the numbers of managers to free up money is just that ‘pure nonsense’ designed to distract from the real and pressing problems: we are all living longer but not necessarily living longer healthy lives I.e old age brings increasing amounts and years of healthcare; modern medicine can do wonders but it costs and someone has to pay; individual and population expectations of good healthcare are increasing yet the idea of paying more tax to support the NHS seems to horrify a good percentage of the population and I think that basically politicians are too ‘chicken’ about saying anything that might in any way imply higher taxes or damage to the sacred cow I.e the NHS. Politicians have a choice : grab hold of the blindingly obvious problems and set an agenda for the future or sit on their hands until the whole thing becomes a crisis. Part of this national debate needs to be about individual’s responsibility for their health - a tricky and sensitive issue but basically there is a limit to the abilities of a healthcare system to keep people healthy, healthcare has to be a partnership between the healthcare system and the individual
We need our politicians to be honest and pragmatic. Rather than being an albatross around the Government's neck healthcare expenditure should become one of the drivers of the economy.
There is a wider context here. It is not just the NHS in dire need. I volunteer in my grandsons primary school as a gardener/mentor and am saddened by the lack of resources, the huge classes, low levels of staffing and the evident lack of investment in 'extras' like working gutters. There is plenty of vital learning not being done - how to use social media for one, health for another (Please stand aside Henry VIII!).
So too with the criminal justice system, probation, social work and just about every other part of the public sector. At the same time there is a cost of living crisis leaving many without savings after all the bills of modern life; including mobile phones, internet expenses, the high cost of transport, energy, water and housing. For many families, health is somewhere down the list and healthy living not on it at all.
Farming too is in a state of crisis with our need to import £68bn of food annually. Then the costs of climate change are beginning to be felt and will rise exponentially as well as the rise of fascism in America on the backs of the disaffected, the dangers of AI, increased expenditure on weapons and the increasing divide between unarguable excess wealth and poverty.
We must see where healthcare fits into all this. One thing I know for sure; if we don't educate our kids better and do something about their rapidly declining prospects, we will have less taxpayers and more patients.
First and foremost we need the government to set up a cross (political) party working group - an APPG
Just wondering what do you think, which European country has the best health care system? It’s not Bosnia for sure 😂
If you have MS the Australian system is also very good.
Sweden
Then Switzerland and Norway. But they are not part of the the EU.
I have family and friends in both Norway and Sweden. They are not thrilled with their medical system, they say the waiting lists are too long for everything. But then again, for something serious, you get appointment within a week.
I agree with the majority of this letter, but there is a surplus of cooks (managers). We need more cleaners/porters/doctors/nurses/OTs/physios. We can do without the managers, who think every problem can be solved by employing another manager. Yes, cut the managers, but make sure that there is more meat after trimming the fat.
How about a national commission to look at the future of healthcare in the next decades: taking into account the increasing longevity of individuals; national and individual expectations of healthcare; the increasing sophistication of medicine etc and associated massively increasing costs; the costs of training ; emigration of staff to other high wage countries with better resources and less pressure on staff; the role and responsibility of citizens in maintaining their own health etc etc. It’s a massive issue but we can’t keep on trying to patch up a failing system. The world has changed massively since the NHS was created, healthcare/ medical care has changed massively with new medicines etc that were unheard of when the NHS was created; potentially it should soon be possible for each of us to get complete genetic assessments at birth to identify health risks , susceptibilities etc ( including MS?) who is going to pay for that and e.g if an individual ignores advice on protecting against various individual health risks then who pays if that individual goes on to develop/ suffer from that condition. Should the tax payer pick up the bill for that individual’s negligence?
Personally I am very much of the view that the future is healthcare has to be based on some sort of contract between State and Individual, one in which both parties have duties and responsibilities.
The contract between state and individual was tried and failed. It was called the NHS charter. As medicine becomes more complicated, government are dumbing down the players. PAs are supposed to have a limited role. Unfortunately, there are cases of these PAs being used to fill hospitals’ unfilled doctor posts. The simple question to ask yourself is, do I want to be cared for by somebody who has spent 5 years at university and another 5+ years being supervised in practice, or somebody with just 3 years in higher education? Yes, there are some amazing PAs (or so I’ve heard), but on balance, I’d prefer somebody with more education.
Kind of depends on what the disease/ condition is. Many things that used to be he domain of Drs are now treated by senior nurses. My wife used to be a Sister treating eye conditions and over her career took on many of the duties and medical responsibilities that used to be done by Drs and Consultants
Historically nurses did more, then less and now more again. Physician Assistants (PAs) aren’t the same as Consultant Nurses. The former are potentially school leavers who failed to get the A levels for medicine, did a VTS and landed in the role of a junior doctor, whereas the latter are generally highly experienced professionals who have honed their skills in the NHS crucible and floated to the peak of their chosen specialty.
"...potentially it should soon be possible for each of us to get complete genetic assessments at birth to identify health risks , susceptibilities etc ( including MS?) who is going to pay for that and e.g if an individual ignores advice on protecting against various individual health risks then who pays if that individual goes on to develop/ suffer from that condition. Should the tax payer pick up the bill for that individual’s negligence?"
You have just described exactly why to NOT get a genetic assessment. You are seeing it as a cudgel. And there are plenty of people who will be thrilled to use it as such, and not just for conditions that supposedly can be totally "controlled". I can't begin to tell you how delighted I am that I never gave into the siren song of 23 and Me, now that their genetic data is up for grabs.
Not quite sure what you mean by ‘you are seeing it as a cudgel’ but personally I would welcome genetic testing to spot any susceptibility to e.g developing a particular type of cancer , or any other condition and thus I would be able to get regular checks and catch it at an early stage. It’s is already happening with some cancers.
I completely agree. Perhaps a Citizens Assembly can be convened to explore public attitudes along the lines you suggest.
I also second the point of view below about the need for honesty about the choices we face, with the pros and cons of each approach clearly outlined. I wish governments would treat us as grown-ups.
Just reply to your point about being treated as grown ups. I always find myself thinking that when a politician starts saying that things are complicated etc it basically means they don’t understand and don’t have the capacity to explain things . It worries me that too many politicians are out of their depth on important issues. Many moons ago there was something like a royal commission/ national inquiry into the future of higher education. It collects lots of views , evidence and produced a range of reports on different aspects of higher education (known as the Dearing Report) . From what I remember there wasn’t a politician on any of the various committees and it was very much an independent commission/inquiry
Allowing the Private sector to be part of the NHS is a recipe to disaster. Any extra money the government puts in will be swallowed up by them
If NHS hospitals have a private floor or wing, consultants can make themselves more available. If they’re working in a private hospital 5 miles down the road, they can’t dash in to deal with emergencies in a timely manner. Bring in the full private services and the hospital becomes more efficient. I’ve seen it work in a state hospital which devoted its top 2 floors to private patients. The benefit of this is private medical facilities in trusts subsidise the NHS.
The private sector already runs the NHS, including real estate, linen, IT services, transport, supplies, pharmaceuticals, etc. It does not run the front-line services, but that is all. I suggest that the government doesn't fund it, but individuals fund it themselves or via their employers through insurance premiums. The model will allow healthcare expenditure to increase, but not as part of general taxation.
That’s all well and good but I believe the private sector companies are only interested in their bottom line and expect it to increase each year. This would surely impact the service they provide.
On the other note I have no employment and am disabled so expecting someone like myself to fund it is very worrying
Hard disagree. The existence of private healthcare drains resources from the public and discriminates against those with existing conditions, leading to worse health outcomes for the chronically ill (e.g. pwMS). Why is it so fantastically implausible to imagine a properly funded public healthcare system in the sixth biggest economy in the world? Why must we compromise with the obscenely wealthy who tell us they couldn't possibly pay a bit more tax back into the system which they have drained dry?
I'm not sure if you know that the UK's wealthy pay a larger proportion of tax than rich people in other countries. I suggest the government spread the tax burden across the population rather than focusing on the wealthy. The wealthy are voting with their feet, so increasing taxes on the rich becomes self-defeating. This is economics 101, which is why political parties have not implemented wealth taxes in the past.
Economics 101 dictates that low taxes lead to the wealthy investing in property, thereby pushing up the house prices. It's a no brainer to raise taxes on the top earners. It's how the NHS was created in 1948 (90% top rate). If the wealthy really are as patriotic as they say they are, they'll stay. In fact, a number of millionaires are calling for higher taxes (see Dale Vince for example). The government won't raise taxes on the wealthy because they're scared they'll turn their media organs against them, which is hardly very democratic, but hey.
The Government is going to have to put up taxes anyway. However, a different funding model will have to be adopted to fund the NHS and healthcare from now on.
You haven't replied to any of ky points. I live in a country where the funding decline to public health has resulted in it being gutted and resources moved to private healthcare, which I am unable to access as a pwMS (I go through torturous, invasive questionnaires, only for them to tell me the algorithm has rejected me for reasons unknown). My experience in the UK was that private health was used as a means of queue-jumping (ie you'd pay to see the same consultant, only quicker). There are massive ethical issues with private healthcare and its de facto social Darwinism. I repeat my thesis: why is it so difficult to conceive of a properly funded public system? If you're writing to the PM, demand that instead of compromising with private health vultures
Because it is too expensive, and a lot of what people want covered by the NHS is lifestyle-related and will not be covered, e.g. weight-loss treatments, eye surgery to correct vision, .... Therefore, we need a new funding model. Healthcare will still be socialised, only funded by tax and private insurance contributions. This model works very well in many European countries. At the moment, the Government is trying to control supply and demand, and this has resulted in the NHS becoming 'broken'. The NHS needs to be fixed, and more tax and money are not going to work.
In which countries does this model work? I can accept that simply throwing money at the problem is not the entire solution, but privatisation under the table isn't a solution either. I think you're spot on when you talk about a holistic approach to healthcare: these kinds of lifestyle changes will save the NHS a huge amount.
But then the economy will contract; it is the inverted U-curve. Tax is a balancing act; you get it wrong, and it has unintended consequences.
https://www.investopedia.com/articles/08/laffer-curve.asp
I can’t see how the current NHS model can survive with standards so shockingly low. I disagree on cutting the managers - they are a big part of how standards got this bad. It’s hard to think of another organisation so badly run; values and ethics left the building long ago with cover up rampant at the cost of patient safety. Even if the level of management rises again in the future best to cut the rot and build up again. And it’s through private sector openness and competition that the opportunity of AI will become less constrained. Overall, I agree that the blended model is where things are likely to go. All citizens must have equal access to the services they need and a bit of footwork is needed on innovative private care financing models to ensure that.
Pressed send by mistake - an All Party Political Group should help ensure the problems in the NHS are acknowledged by all political parties and prevent the NHS being used as a political football. The reason the NHS problems haven’t really been tackled before is because of the political fallout of doing so properly.
Then the cross party group can decide to hold a national consultation etc. I agree politicians are not the experts, but they are needed for the reason stated above. It may take a few years for the report to be written. It also, I agree, needs to look at foreign healthcare models.
We lived in Switzerland for many years. There, healthcare insurance is mandatory. Premiums were low (although I think they have gone up considerably since we left). You chose your level of cover. Many employers helped. Costs were transparent - very important as most UK citizens have no idea of the cost of a blood test, an MRI or a birth etc. You got billed and could reclaim all of your expenditure except on prescriptions I think where you could only reclaim 90%. People were much more conscious of their personal healthcare choices because they had to pay something towards it. There children always saw a paediatrician, taking the burden off the British GP system and the receptionist was a trained nurse who triaged appointments and gave medical advice on the phone eg at what point to worry and ring again etc. Women went to a woman’s GP, so although you were sent to consultants there was less of a gatekeeping GP system. I felt much better cared for there.
Hard to see how this will help anyone except for the private healthcare companies and banks.
I'll not get medical insurance - no company in it's right mind will charge me an acceptable premium to fund my DMT treatment and MRIs.
I worked my entire life and paid tax, and retired (against my wishes) with a modest medical pension and a small lump sum, which is my only security for the future. I suspect this will be swallowed up funding my own healthcare privately, and then I'll be dumped into the 'safety net' - which will face the same funding squeeze as the current system (or worse).
To me this is a recipe for a 2 or 3 tier healthcare system (to match our education, and every other system in this country). No point in a 'consultation' or 'national discussion' - the political classes already know what they are going to do. And every current political party is in essence singing from the same songsheet.
Instead of squeezing the, already broke, poor and middle classes, why do none of them tackle the taboo idea of making big businesses pay some tax on their profits? These days everything must be sacrificed for the already super-rich to add a few zeros to the end of their bank balance.
But how do explain the success of the dual funding model in other countries? This is about funding a part of health care by the private sector and decompressing the NHS. The NHS will still be there to look after people with health problems.
I have been in Benendan for years and it was through them I eventually received my MRI scans which confirmed a neurological condition as go said arthritis (at least twice in 8 years despite neurological symptoms showing) .Benendan do not treat neurological conditions but at least I got my scans ordered by a orthopedic specialist as I have bi lateral foot drop and pes cavus feet and had other neurological symptoms .My first neurologist appointment was paid for by Benendan .Since then though I had to pay privately twice for a neurologist to try Fampridine .This drug is available free on the NHS everywhere but England.As I have Ppms no other drugs available to me for walking problems..The neurologist I paid for is in the same team as my neurologist at the Walton centre.The drug didn't work for me However lots couldn't even pay to try it or if it does work cannot afford it .Yet the NHS pay for weight loss drugs?? Annoying for me as I know with determination and healthy eating and appropriate exercise everyone can lose weight if healthy and can move about have access to healthy foods .But the NHS already pays for a lot of private hospitals to do treatment anyway.I pay for my family for a limited amount of private care but not sure at all what is for the best.Look at America.Treatments need to be authorised and are restricted on a personal basis .Not good either.