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Changes have been made, that is causing problems NHS has today.
OTOH other changes have not been made which also is causing NHS problems.
Unlike say USA where healthcare umbrella covers both in hospital and rehab the two are distinct in UK under NHS.
Like USA and other countries successive governments both Labor and Conservative in UK have reduced number of inpatient hospital beds. This in keeping with near universal working theory that much care can and should be provided at home or in a care (rehab) facility.
Thing is in UK NHS only covers hospitalization. Local councils deal with care outside of hospitals (care homes, rehab, district nursing, etc...). As one might imagine not all councils have equal resources for out patient care/rehab and or aren't interested in spending more tax money in aid of.
When patients cannot be safely discharged to rehab/care or home care they must remain in hospital. That is issue plaguing much of NHS at the moment. Worse since there are fewer inpatient beds overall it is causing huge stresses upon system. Patients from emergency rooms cannot be admitted if there aren't beds for them and so forth.
In terms of care homes, they are mainly private and not run by councils, and many people in them are self funding, unless they have a significant health problem.
In terms of rehab and out patient care, that is usually the remit of either local Doctor's surgeries that are private and contracted to the NHS or in relation to NHS hospitals, whilst the NHS operates Community Hospitals, in relation to such services.
Similarly dentists are private, although dentistry for certain groups such as Under 18's, those on state benefits including disability etc are NHS funded, whilst there are also NHS Dental Hospitals and other units for those with serious dental related issues.
Opticians are similarly private, and are on most high streets, and they include large well known chains such as Vision Express, Spec Savers, Boots Opticians etc etc, whilst serious eye conditions are referred to NHS eye hospitals or departments.
Hospices are usually funded by the voluntary sector (charities), as are Air Ambulances and some other facilities, whilst large teaching hospitals involve partnerships with Universities, as does most research which is often a mix of state funding, charitable foundations, academia, pharma and biotech and other partners. Whilst NHS hospitals often contract out specific services to the private sector, and this often involves support services from catering to cleaning through to security and maintenance.
It also should be noted that many people now choose to die at home if terminally ill, and they are often supported by a mix of the NHS staff, as well as voluntary service organisation such as Macmillan nurses or Marie Curie Nurses, who are specialist cancer nurses with experience and qualifications in cancer care, whilst Local District and Community Nurses along with other local General Practitioner services support people in their homes.
So in terms of the NHS, it already has a lot of private sector input, and the mix of state, private sector, voluntary sector, academia and other collaborations is consistently examined, whilst in terms of in-patient services, minor surgeries are now often conducted on the same day, and people often go home as soon as possible, as surgery itself has changed.
It also should be noted that Mental Health Services also receive a lot of private input, and there is a mix of public, private and voluntary input, with a number of private companies running units that provide contracted out services for the NHS commissioning groups, and these include elective services which are chosen (elected) by the patient or physician that is advantageous to the patient but is not urgent, as well as certain mental heath services.
It also should be noted that we have four NHS's and not one, in relation to NHS England, NHS Scotland, NHS Wales and the HSC in Northern Ireland, and that most NHS funds and spending is decided locally by what are currently known as Clinical Commissioning Groups (CCGs), and are clinically-led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area including the mix of healthcare partners.
Like most countries, the UK has pressure on it's NHS systems due to an ageing population, however there are countries in Europe and throughout the world with a much greater problems, and in terms of increased funding of the NHS, this is already been the subject of political debate including a new NHS Tax to replace National Insurance, something which the current Chancellor and longest serving Secretary of State for Health Jeremy Hunt has extensively written about, whilst a Transformation Fund is also being advocated by the Kings Fund (a health care think tank).
As for any changes to the NHS, the most likely changes would be to examine other systems who have universal systems that regularly perform well such as the French and some other European systems, however universal healthcare has cross party support in Britain and is extremely popular, and is not going anywhere.
It also should be noted that there are many positives in terms of the NHS, and it is not broken, with the main future emphasis being on future funding initiatives, as well as the mix of state, private, voluntary sector, academia and other partnerships, and it should be noted that the NHS already has a significant mixture of private and voluntary sector input, as well as University and Academic partnerships etc.
As for fixing any health care system, never mind the NHS, the last people I would listen to are Americans and the American MSM. I suggest Americans concentrate on their own massive health and social problems rather than try and lecture to others, and if Britain is looking for solutions to some heath issues than the health systems of our European neighbours which are often ranked highly in international studies offer much greater solutions than than that offered across the Atlantic.
Last edited by Brave New World; 07-17-2023 at 02:54 AM..
My Mrs has Muscular Dystrophy and in 2020 was diagnosed with cancer, she also had blood clots on her lungs, sepsis and problems with her gall bladder (not a good couple of years), she has had two major operations completed a course of chemotherapy, stayed in the hospital 4 times, I called an ambulance 5 times, she has regular physio, regular heart and lung checks, CT scans, she has been given a hospital bed, a stairlift and her bathroom adapted, her care has been stupendous. I don't know what any of that would have cost us in the US? What would calling the ambulance five times cost alone?
My Mrs has Muscular Dystrophy and in 2020 was diagnosed with cancer, she also had blood clots on her lungs, sepsis and problems with her gall bladder (not a good couple of years), she has had two major operations completed a course of chemotherapy, stayed in the hospital 4 times, I called an ambulance 5 times, she has regular physio, regular heart and lung checks, CT scans, she has been given a hospital bed, a stairlift and her bathroom adapted, her care has been stupendous. I don't know what any of that would have cost us in the US? What would calling the ambulance five times cost alone?
Oh my… many good thoughts for Mrs. Easthome.
I had to call the EMS service last November for my wife who was having an “unresponsive spell”.
Frightening to say the least, thinking she may have been suffering a stroke, so made the call.
First the nearby fire department fire truck arrived within 5 minutes and their trained med techs began checking her out, then a couple minutes later the ambulance arrived to take over.
After an examination and a quick blood test, they determined her glucose level had plummeted, rendering her into a stupor. After administering some liquid glucose orally, she began to come around as her blood sugar quickly rose.
(She is not diabetic and has no history of such).
They began to question her as she recovered, and after a little while asked if she would like to be transported to the hospital. She felt well enough to refuse the transport offer, so they packed up and departed after about a half hour or so in our home.
If she had gone to the hospital, our Medicare coverage would paid for about everything. But since she didn’t we received a bill from the County medical services for $470 a month later.
My last stay in hospital after a mild heart attack & another stent implant in 2018, my Medicare coverage paid all but $250 of the $30,000 charges.
12 years ago when one of my sons had emergency life-saving surgery after he sliced his femoral artery on a work job, he was billed close to $70,000.
Since he was poor he had no health insurance. The public hospital business office worked out a payment plan where he would pay what he could each month. So he sent them a check for $20 each month for several years, then the hospital stopped sending him the monthly bill.
He does carry an insurance plan now.
The Romans were a force of occupation, and I don't think they are comparable with US forces in Europe, and I don't think US forces have built any Colosseum's or engaged in any Crucifixion that I know of. I think US forces may however enjoy Wine and Italian food.
In terms of US forces most have left since the end of the cold war, and the remaining bases in Britain tend to be intelligence orientated, although there are a couple of US air bases.
As for Europe, it is cooperating in terms of defence, and is aware that Trump and other US politicians are not supporters of NATO, indeed Trump allegedly wanted to leave NATO and in recent week US politician Marjorie Taylor Greene (the AOC of the right) has both harshly criticised NATO allies and introduced several US amendments in Congress calling for the US to withdraw from NATO.
In terms of US forces in Europe they amount to around 5% of the US Defence budget, so are not going to achieve massive savings in terms of the overall US budget, however that's an issue for the US to decide.
As for Medicare and Social Security in the US, I am sure reports of their demise are over estimated, as they are no doubt popular with the electorate, just as universal heath care systems such as the NHS are popular with electorates outside the US.
I would not place too much stock in what the NYT has to say about the NHS. The American system has plenty of big problems of it's own. The system works well for many people but it does not work well for many people. At least everyone in Britain is covered under the NHS and all at an equal level.
America health is plagued by staggeringly high drug prices. Biden has managed to bring down the price of insulin which previously cost the patient around 100 dollars a month, now fixed at 35 dollars a month but other drugs prices still remain out of sight and Medicare does not cover all of them. Some people die because they cant afford the prices but in Britain under the NHS this would not happen. Paramedic and ambulance services are very good here but if I needed a two mile ride to the nearest hospital it would cost me 200 dollars under my plan.
Nursing homes here are run on a privately owned basis and no funding from the State or Government
America politics are in turmoil. There is a sizeable voting bloc of incredibly stupid people who would be quite happy to see Trump back in the White House. A recent poll showed that over 50 percent of registered Democrats and over 50 percent of registered Republicans would like to see a third political party come into being and 70 percent of independent voters wishing for the same.
We seem to be caught between far left liberalism/ nanny state regulations and rampant Woke-ism on one side and near Fascism on the other side.
As far as mutual defence Biden has at least forged the NATO alliance into a much stronger entity than before. Trump and his idiot minions would destroy it very quickly.
I would not place too much stock in what the NYT has to say about the NHS. The American system has plenty of big problems of it's own. The system works well for many people but it does not work well for many people. At least everyone in Britain is covered under the NHS and all at an equal level.
That is the issue though. If you have people willing and able to pay for a higher standard let them. This is the number one problem with a single payer system. No one would chose to emulate the US system, but the UK is almost unique among wealth countries in having a single payer system with a single government provider.
That is the issue though. If you have people willing and able to pay for a higher standard let them. This is the number one problem with a single payer system. No one would chose to emulate the US system, but the UK is almost unique among wealth countries in having a single payer system with a single government provider.
Many of the more affluent NHS patients have actually switched to private insurance. This has happened in Canada also. It has it's advantages, less waiting time for surgery, private rooms in hospitals etc.
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Last edited by elnina; 07-17-2023 at 06:57 PM..
Reason: Off topic, US politics rant. Post on PoC.
That is the issue though. If you have people willing and able to pay for a higher standard let them. This is the number one problem with a single payer system. No one would chose to emulate the US system, but the UK is almost unique among wealth countries in having a single payer system with a single government provider.
The UK doesn't have a wholly single public system (single-payer) there are private heath care alternatives and private hospitals, as well as large parts of the system being largely private such as local GP surgeries, dentistry, opticians, care homes and nursing homes etc, whilst the voluntary sector also has a large input. Even renowned specialist NHS hospitals, often have private wards and wings, and are used by those seeking medical care from across the globe.
The UK has a mix of systems just like most European systems, and is only unique in relation to the mix of state, private, voluntary, academic and other partnerships etc.
France also has a mix of state, private and voluntary, with about "62 percent of French hospital capacity is met by publicly owned and managed hospitals. The remaining capacity is split evenly (18% each) between non-profit sector hospitals (which are linked to the public sector and which tend to be owned by foundations, religious organisations or mutual-insurance associations) and by for-profit institutions."
The UK has National Insurance which all working people are forced to pay, and this is similar in some respects to mandatory contributions in relation to public insurance funds and government national health insurance in other European countries such as France. There have been suggestions that National Insurance could be replaced by a more European type system, in relation to an NHS fund, and the mix of public, private, voluntary etc is something that is open to some change within most universal healthcare systems.
The Italian system is sometimes compared to the NHS, whilst it should be noted that the NHS is nothing like the Canadian system which in many respects is more of a so called single public system or what Americans seem to refer to as a 'Single Payer System' or a so called 'Socialist' system.
In reality, the system in all parts of the UK is not some rigid single payer system, and has a significant amount of both private input and choices, as well as support from the voluntary sector and from the academic, charitable foundations and other such sectors, and any debate in the UK is more around these mix of providers and areas such as European type funding rather than Universal healthcare itself, which is not under any threat and is universally popular and has significant political consensus.
Last edited by Brave New World; 07-18-2023 at 03:09 AM..
I had to call the EMS service last November for my wife who was having an “unresponsive spell”.
Frightening to say the least, thinking she may have been suffering a stroke, so made the call.
First the nearby fire department fire truck arrived within 5 minutes and their trained med techs began checking her out, then a couple minutes later the ambulance arrived to take over.
After an examination and a quick blood test, they determined her glucose level had plummeted, rendering her into a stupor. After administering some liquid glucose orally, she began to come around as her blood sugar quickly rose.
(She is not diabetic and has no history of such).
They began to question her as she recovered, and after a little while asked if she would like to be transported to the hospital. She felt well enough to refuse the transport offer, so they packed up and departed after about a half hour or so in our home.
If she had gone to the hospital, our Medicare coverage would paid for about everything. But since she didn’t we received a bill from the County medical services for $470 a month later.
My last stay in hospital after a mild heart attack & another stent implant in 2018, my Medicare coverage paid all but $250 of the $30,000 charges.
12 years ago when one of my sons had emergency life-saving surgery after he sliced his femoral artery on a work job, he was billed close to $70,000.
Since he was poor he had no health insurance. The public hospital business office worked out a payment plan where he would pay what he could each month. So he sent them a check for $20 each month for several years, then the hospital stopped sending him the monthly bill.
He does carry an insurance plan now.
Thank you so much, that is very kind of you. Of course I am sending the same good wishes back the other way! My Mrs is now (touch wood) so much better, I can't thank the guys that work in the medical profession - doctors, nurses, ambulance drivers even the guys behind the registration desks enough, because of the care they have given my admiration for them all is huge - and I just know that the guys that do the same jobs that side of the pond (and everywhere else really) are exactly the same. I think you have to be a 'caring' kind of person to do these jobs.
Thankfully my Mrs has come through the cancer, the blood clots, the sepsis and the issues with her gall bladder, the Muscular Dystrophy however is incurable, she continues to receive wonderful support for this. Of course nothing is perfect but after cancer diagnosis she was operated on almost immediately and of course the clots and gall bladder issues were also dealt with immediately. There was one time after being picked up by the ambulance she was in A&E for 24 hours before they could move her to the AMU ward, it was the weekend and the hospital was damn busy, lots of drunks with broken limbs! Another time she was sharing a ward with a woman who was driving her mad but a sudden positive Covid test meant she was put into a private room (never was anybody so pleased to have Covd) but she has had a LOT of hospital care both as an outpatient and as a 'stayer' and I couldn't praise the people that have cared for her enough.
NHS has been having problems with strikes as I highlighted in my thread about COL in Britain.
I guess everyone is seeing how much money is going to UKR, and they are thinking, "the heck, where is my money?", "this is totally unfair, you have all that money for UKR, but cant give me a raise?"
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