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Should the NHS have its blank cheque written?

Should the NHS have a blank cheque?  

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  1. 1. Should the NHS have a blank cheque?



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As many of you will have noticed previously, i feel that the NHS is too bloated and would like a much leaner NHS which did not provide things like hymen replacements and transgender operations among other things. Because no RL party wishes to really restrict what the NHS offers or fundamentally change the structure (perhaps private outpatient insurance) the NHS budget continues to balloon.

 

My question is whether you want cost cutting alternatives or whether you think the NHS should have the money it wants thrown at it (it's asked for both £30bn and £8bn so i'm not sure it knows what it wants itself).

 

 

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I'm assuming you believe the NHS should remain free at point of use (i.e. taxation) for the majority of care and treatment? Or by your later comment "perhaps private outpatient insurance" that non emergency treatment should be covered by private insuranceI feel that the NHS should get whatever funding it requires to operate on my previous premise of free at point of use. Its by no means perfect (and of course, on the rare occasion, some of what the NHS has funded is questionable), however it often tops the international rankings. Don't we spend less of our GDP on health than many of our European counterparts, and even the US?

 

Pit makes some good points. A blank cheque and as you where, no; however reform and whatever funding to deliver a high quality NHS care, yes (so both option don't really apply, for me) 

Edited by Mark Bayley

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Well cutting the funding will mean less nurses and Doctors. What we need is a reduction of managers less red tape and politicians to stop messing around making changing polices all the time. Somebody came up with an interesting suggestion to stop time wasters at AE. Charge them and only refund if they have something actually wrong. Interesting idea.

Giving a blank cheque would only encourage more wastage.

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There is far too much spent on fat cat administrative bods and not enough on front line nursing and doctor staff - the red tape needs to be cut. Far too much money is wasted through outsourcing staff - cleaners would do a far thorough job if under direct control and subject to internal discipline procedure.

The medical staff should contract, say for a period of 5 years after training, rather than going on the 'bank' to be employed at vastly inflated rates with pay scales to compensate for this and encourage staff to stay. Obviously things like pregnancy would be a get out clause and staff could transfer internally within the NHS.

As far as drugs are concerned especially for cancer patients which can be very expensive due to the research costs involved but surely the NHS is in a position to negotiate costs on an economy of scale basis - after all those who are seriously ill need the best care science can provide.

And perhaps a further point is that the police could stop using the A & E as drunk cells for people who are otherwise healthy. The NHS should be for people who are genuinely ill or injured needing treatment, people wanting operations and treatment purely on cosmetic grounds should pay, otherwise free at the point of entry for all UK subjects whilst the costs of treatment can be recovered from their own countries in the case of other EU citizens.

Edited by mike Meehan

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Yes NHS spends far too much on agency staff. Cleaning staff back to central control.

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I'm assuming you believe the NHS should remain free at point of use (i.e. taxation) for the majority of care and treatment? Or by your later comment "perhaps private outpatient insurance" that non emergency treatment should be covered by private insuranceI feel that the NHS should get whatever funding it requires to operate on my previous premise of free at point of use. Its by no means perfect (and of course, on the rare occasion, some of what the NHS has funded is questionable), however it often tops the international rankings. Don't we spend less of our GDP on health than many of our European counterparts, and even the US?

 

Yes. It's my firm belief that for big things like cancer ect.. these should remain as part of the regular NHS. Ideally though i'd have working people take out outpatient insurance to free up resources in the NHS that could be diverted into the things they want rather than having central government chuck more money at it. A leaner NHS that's still entirely free at the point of use for children and pensioners and free for the important things for working people (could possibly get a pension like scheme whereby the employer pays half as well since it's only a few hundred a year for outpatient insurance).

 

Which NHS? There are 4 in the UK.  :wink:

 

Ironically for all the lefty rhetoric the Scottish NHS has had less spent and the roof is still on.

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Ironically for all the lefty rhetoric the Scottish NHS has had less spent and the roof is still on.

 

It's a case of the government actually wanting it to work, rather than saying they want to keep it but actually wanting to privatise it.

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Yes. It's my firm belief that for big things like cancer ect.. these should remain as part of the regular NHS. Ideally though i'd have working people take out outpatient insurance to free up resources in the NHS that could be diverted into the things they want rather than having central government chuck more money at it. A leaner NHS that's still entirely free at the point of use for children and pensioners and free for the important things for working people (could possibly get a pension like scheme whereby the employer pays half as well since it's only a few hundred a year for outpatient insurance).

 

Fair enough, can't say i'd agree with the later. I wouldn't like the thought of, if i say, broke my arm i'd have to have some sort of private insurance to cover costs of treatment. I wonder if a politician would ever consider such arrangement, i imagine it would be political suicide? I do agree with you, however, on that the NHS, needs change. Change as illustrated by Mike and The Pit 

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I'm not sure why you think transgender ops shouldn't be on the NHS?

 

I would agree that non necessary, non life changing/wouldn't leave permanent damage if not performed operations should be looked at. Perhaps if there is money left after, then they could be considered. but it's a sliding scale, where do you stop, who chooses what is important and what isn't.

 

What the NHS needs in my professional opinion is not unlimited money thrown at it or cuts (it can barely survive with the current cuts), but a complete no tolerance on money wastage. Some of the things that waste money off the top of my head are;

 

Non attendance at appointments.

Using private contractors to buy things like toilet paper etc.

Attending A&E unnecessarily.

Paying for agency staff when full time staff would be cheaper.

Giving out prescriptions for OTC medication free when the patient can afford to pay for it e.g paracetamol.

Spending money on stupid things like a piece of art for a waiting room.

 

The list goes on. All I know is the answer is definitely not more cuts.

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It's a case of the government actually wanting it to work, rather than saying they want to keep it but actually wanting to privatise it.

 

Under fund it, create crisis, promise more funding, doesn't work, privatising the answer (seen as the Tories love privatisation), or is that too cynical SS?

Edited by Mark Bayley
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Yes. It's my firm belief that for big things like cancer ect.. these should remain as part of the regular NHS. Ideally though i'd have working people take out outpatient insurance to free up resources in the NHS that could be diverted into the things they want rather than having central government chuck more money at it. A leaner NHS that's still entirely free at the point of use for children and pensioners and free for the important things for working people (could possibly get a pension like scheme whereby the employer pays half as well since it's only a few hundred a year for outpatient insurance).

 

 

Ironically for all the lefty rhetoric the Scottish NHS has had less spent and the roof is still on.

Ummm problem with pension like schemes money gets drawn away elsewhere or simply lost as markets crash. As we've already seen privatizing public services doesn't work as it leads to a poorer service and eventually the most needy can't afford it.

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I think also there are a lot of overpaid admin. Granted, admin play an important role, but most admin in my team are on Band 4 or 5, which is more than some of the Community mental Health Nurses earn or Mental Health Workers who are on the front line and have the responsibility.

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There is far too much spent on fat cat administrative bods and not enough on front line nursing and doctor staff - the red tape needs to be cut. Far too much money is wasted through outsourcing staff - cleaners would do a far thorough job if under direct control and subject to internal discipline procedure.

The medical staff should contract, say for a period of 5 years after training, rather than going on the 'bank' to be employed at vastly inflated rates with pay scales to compensate for this and encourage staff to stay. Obviously things like pregnancy would be a get out clause and staff could transfer internally within the NHS.

As far as drugs are concerned especially for cancer patients which can be very expensive due to the research costs involved but surely the NHS is in a position to negotiate costs on an economy of scale basis - after all those who are seriously ill need the best care science can provide.

And perhaps a further point is that the police could stop using the A & E as drunk cells for people who are otherwise healthy. The NHS should be for people who are genuinely ill or injured needing treatment, people wanting operations and treatment purely on cosmetic grounds should pay, otherwise free at the point of entry for all UK subjects whilst the costs of treatment can be recovered from their own countries in the case of other EU citizens.

I agree with all that Mike has said in his post, especially the second paragraph. The problem with nurses etc is they can earn far more by working via an agency, than on permanent contract. If the Government thinks they are being clever preventing nurses having pay rises then it is backfiring without doubt. Nurses are leaving the NHS and joining Agencies en masse and so it is costing the NHS far more than giving the nurses reasonable recompense instead of thinking they have an easy target because of the commitment of the nurses to their patients. Some nurses have a halfway house situation whereby they are employed by the NHS during the week and take on the role of "Bank" nurses at weekends.

Another reason that the NHS is struggling is because of bed blockers as patients once they are on the mend have nowhere to go longer term, due to cuts in Local Government. This also impacts on the Ambulance service which is also NHS funded through overtime payments necessitated by vehicles queuing  up at hospital entrances waiting to discharge patients into A & E but cannot do so as those in A & E requiring to stay in for further treatment cannot move onto wards until a" bed blocker" is transferred elsewhere.

 

As I have stated on numerous occasions on this message board it always sounds good when the Government states that savings have been made, but it is inevitably at a cost both in quality of service or actually financially as the burden transfers elsewhere e.g from local government to Hospital Trusts.

 

Kind Regards

 

Dave

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No serious problems thank goodness but I'll be 68 this year - on the grounds that, what with my pension, bus pass and all I should just quietly go away somewhere and die in a corner before Im a real burden.

 

Oh, sorry, under UK Law I am not allowed the dignity of dying at a time and place of my choosing so you'll just have to put up with me.

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If your going to offer a blank cheque then surely every taxpayer and long term contributer to the system should be entitled to the best treatment and no medication should be withheld on grounds of cost (like the announcement today that a number of cancer drugs are to witheld on the NHS).

 

Better to get their house in order, cut the red tape, remove the middle mangelment and  get services back under the same roof?

Edited by Jax

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We should be spending millions more preventing people needing to go into hospital in the first place.  A stitch in time saves nine.

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We should be spending millions more preventing people needing to go into hospital in the first place.  A stitch in time saves nine.

Quite. Unfortunately in my experience management are more bothered about quick fix solutions rather than long term ones.

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Quite. Unfortunately in my experience management are more bothered about quick fix solutions rather than long term ones.

I think the problem here Lauren is yearly budgets - they have so much money a year to spend but it is an unrealistic view - let's compare it with say a householder - he knows that if there is a leak in his roof it will cause further damage so if he is sensible he will get this damage repaired at the earliest moment saving him money in the long term, Likewise if the NHS were to spend more money in training and retaining their long term staff, give them security and reasonable pay to encourage them to stay, it would work out cheaper in the long run.

 

Another point is, how many older hospitals do you know that are double glazed, have adequate insulation and LED lighting etc? - what would be the costs in power alone to keep it going? yet to install these would save significant amounts of money - further if you consider the amount of roof space usually available and the amount of grounds they usually have a sizable amount of the energy they use could be provided on site by the use of solar PV panels and ground source heat pumps and in the summer months they may even make a profit by selling the electricity back to the grid - I know it would mean a big financial outlay in the first instance but this would be recovered in only a few years and thereafter they would be running at much reduced costs.

 

These items call for a business plan if you like and the investment could be borrowed relatively cheaply at today's low rates but it means that you have to think a few years ahead which appears to be something alien to these types of concerns.

 

Perhaps if hospitals were to have two separate budgets, one a clinical budget and the other a maintenance budget it may make it easier to do these kind of things.  

Edited by mike Meehan

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I agree Mike. It's the commissioners this case needs to be put to. We try and tell them this all the time but they never listen.

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I am of the opion that our present government or any of the main parties are totally unable to run at type of service efficiently. The NHS is a massive out of control beast with poor management right through from Hospital level to its governmental department. If you throw more money at it, it will simply waste more. i would much rather have my money back and go private, and be treated properly.   

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I think it was Neil Kinnock, of all people, who said that you could easily spend the whole government budget on the NHS & it would still need more. So a blank cheque would be ridiculous. Perhaps if politicians stopped meddling for a while, instead of constantly Implementing "reforms" & "improvements" & just let a system settle down & have a chance to work, we might be a lot better off.

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I am of the opion that our present government or any of the main parties are totally unable to run at type of service efficiently. The NHS is a massive out of control beast with poor management right through from Hospital level to its governmental department. If you throw more money at it, it will simply waste more. i would much rather have my money back and go private, and be treated properly.   

The problem with private health insurance HP is that they do not cover all eventualities so if you have something that isn't covered or only covered up to a certain value you will be shafted.

 

For myself I could not fault the treatment I had, and is still continuing re a prostate cancer - don't forget that the insurance will be run by private companies who will be in it to make a profit - basically the NHS is a good system let down by those who run it - there is no doubt it does need a substantial cash injection.

 

Health care is bound to cost more these days because there are so many treatments that can keep people alive whereas in the past they would have died - I believe they say now that 50% of cancer patients survive whereas a few decades a ago it was a death sentence for many and this figure will continue to improve. 

 

I would hate to guess at the cost of my treatment with all the scans and the radio therapy from those big machines which must cost a bomb but I am thankful for it and suspect that a private medical insurance company would draw a line along the way.

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I think it was Neil Kinnock, of all people, who said that you could easily spend the whole government budget on the NHS & it would still need more. So a blank cheque would be ridiculous. Perhaps if politicians stopped meddling for a while, instead of constantly Implementing "reforms" & "improvements" & just let a system settle down & have a chance to work, we might be a lot better off.

You have a point there actually. Services regularly go up for tender, meaning different trusts bid to run them. Then when that happens all staff have to be transferred over, there are redundancies etc. Everyone has to go to training, all the paperwork and systems change etc and it takes many months to get back to normal. But the contracts are only for 2 years, which barely gives it time to work itself out and run. If commissioners aren't happy after 2 years the whole thing goes out to tender again.

Not enough responsibility is hung on their heads. They hold the budget, they set the targets, they shift the blame on to managers who are doing the gest they can.

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I think it was Neil Kinnock, of all people, who said that you could easily spend the whole government budget on the NHS & it would still need more. So a blank cheque would be ridiculous. Perhaps if politicians stopped meddling for a while, instead of constantly Implementing "reforms" & "improvements" & just let a system settle down & have a chance to work, we might be a lot better off.

 

But this is the point I've made previously. Chucking money at the NHS, much of which disappears down a black hole, while there have been deep cuts to local authority budgets that has resulted in a reduction of £3.7 billion in the social care budget solves nothing. In fact it acerbates the problem.This ridiculous policy, along with associated problems, has hugely impacted efficient running of hospitals with them acting as primary and secondary carers. When elderly people are kept in hospital for weeks when they could be discharged  simply because there aren't any care facilities within the community says to me there is something drastically wrong in the State of Denmark.

 

And don't get me started on the out of hours fiasco.

Edited by knocker

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