The Great NHS debate

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  • Should the NHS be privatised?


    How would the NHS be funded in the future?


    What should the NHS do?


    Do we even need a NHS?


    Can the NHS afford to continue in its current form for much longer, surely the breaking point is soon?

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  • Not if it keeps doing this sort of loonatic waste:



    Jane Moore's column


    I'm sure that this nonsense goes on all over the NHS and the civil service. I've heard of £20 bills to change a light bulb.

    History is much like an Endless Waltz. The three beats of war, peace and revolution continue on forever.

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  • It does. The NHS is really wasteful which is why I don't think it will survive.

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  • Not so much waste by the NHS, as the effects of being tied up in so many PPP/PFI deals, under both Tory and Blairite governments in the 90s.

  • There is enormous waste Plastic, but you raise another very good issue in regards to the PPP/PFI deals.


    My local hospital was newly built about 10 years ago under a PFI deal. The hospital is "administered" by the private company on behalf of my local NHS trust. It will take the NHS about 30 years to pay back the costs of the hospital, which are about about ten times the real cost of construction and equipping it. A total mess.


    Surely, there must be a better way to do things?

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  • .....just to add to that comment from last year, in this year's Budget, the chancellor said that he will not and never has, signed any PFI deals.


    So, we're stuck with the ones we've got, but that's it. No more of them.


    Ok, onto today's news.

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  • Should the NHS be about preventing disease, rather than treating it?

    People in England are being told to cut back on alcohol, sugar, salt and fat in a bid to boost the nation's life expectancy by five years.

    Health Secretary Matt Hancock will set out his long-term vision for the NHS on Monday - and it will focus on preventing illness.

    He will say that 10 times more money is spent on treating disease than prevention - which "doesn't stack up".

    Should the NHS concentrate more on preventing disease, rather than treating it? What about schools here? Shouldn't they be the primary method to educate the young uns about health? What about the policy of allowing unlimited takeaways etc etc?


    If the NHS becomes about givng vouchers for gyms, where do we go to if we fall ill?

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  • Something has to be done to try and stop the meteoric rise in demand. Too many people are literally killing themselves with drink, drugs, food etc.


    This graphic shows the depth of the potential chrisis:



    It is a fact that the NHS could swallow the entire public service budget and still have unsatisfied demands.

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  • Something has to be done to try and stop the meteoric rise in demand. Too many people are literally killing themselves with drink, drugs, food etc.

    Could one solution be to tax those that do these things?


    I'm thinking that the State should assist people to stop drinking, smoking etc and get them on courses to help them, but if that doesn't work or they refuse to go to them, should they then should they be taxed extra for the inevitable extra money they will cost everyone else?


    The NHS has always been universal, but how sustainable is this?. If mountain climbers go up Ben Nevis in the middle of winter and have a accident, there is no cost on them for their stupidity. We all have to pay for it.


    At what point do we say no? This is what the State pays for and this is what the individual pays for? Or should it just continue as it is now and that graph shows what will happen if it does.

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  • Could one solution be to tax those that do these things?

    Many of those things are already taxed and quite heavily in the case of tobacco and alcohol. I think limits as to what the NHS is there for will have to be applied. That can start with elective surgery: Unless there is a sound medical reason this should all be done privately at the patient's own expense.


    Although with the rise in anti-biotic resistance much surgery may become simply too risky to carry out.


    Those who engage in dangerous sports should have compulsary accident insurance.


    Schools have their place in this too educating the young that you can't abuse your body and expect the state to somehow pick up the pieces. If someone is obese then they must be told that. Not pussyfooting about in case it hurts their feelings.

    History is much like an Endless Waltz. The three beats of war, peace and revolution continue on forever.

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  • Many of those things are already taxed and quite heavily in the case of tobacco and alcohol.

    I should've been clearer there. I meant tax the person directly, rather than indirect taxes on products.

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  • I meant tax the person directly,

    I think that would be unenforcible because of the matter of degree whereas taxing the product automatically punishes those who consume the greater amount.


    How about obesity? Do we routinely put people on the scales and then tax the amount of excess blubber? I can immediatly hear shouts of stigmatising the fat.


    I've said jokingly in the past that fast food establishments should only have a 12" wide doorway and food cannot be passed out. Maybe we need that.:/

    History is much like an Endless Waltz. The three beats of war, peace and revolution continue on forever.

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    If my post is in this colour  it is moderation. Take note.

  • I think that would be unenforcible because of the matter of degree whereas taxing the product automatically punishes those who consume the greater amount.


    How about obesity? Do we routinely put people on the scales and then tax the amount of excess blubber? I can immediatly hear shouts of stigmatising the fat.


    I've said jokingly in the past that fast food establishments should only have a 12" wide doorway and food cannot be passed out. Maybe we need that.:/

    :D:D:D what if someone squeezed in but ate and was traped inside ^^

  • Horizon

    Set the Label from Super Topic to Central Thread
  • What do you expect

    As Thatcher used to say "They are not one of us". She could well have said that about people who depend on the NHS
    I still wonder why Johnson used the NHS, folk like him usually go private

    A Hand Up Not A Hand Out

  • It's not a dispute over conservative or labour as they are all the same selfish c***s. This is how all politicians work. Professional bullshitters and blatant liars.

  • It's not a dispute over conservative or labour as they are all the same selfish c***s. This is how all politicians work. Professional bullshitters and blatant liars.

    But it is

    The politicians rarely use the NHS unless for some publicity gimmick, they all go private

    The service is for us plebs so the more money that goes in the better the service

    Ok, it needs the top heavy management, inefficiency sorting out and more spending on the front line but that is another issue

    A Hand Up Not A Hand Out

  • Sorry if this upsets anyone, but I'm going to say it anyone. Every Thursday night we have millions of people stood on their doorsteps like idiots applauding people who can't hear them. I am sick of being told how wonderful our NHS is, especially as we have the highest death toll in Europe as a result of COVID, and second worst in the world. You lefties out there are no doubt going to blame the government for lack of funding, mainly because you have no concept of finance. However, that is neither here nor there, the NHS is the NHS, and goes further than the doctors or nurses. I heard on television this morning the reason so many people are dying in care homes is because they have been sent home early. There hasn't been a shortage of beds, especially with the Nightingale hospitals, so sending them home early can only be contributed to the incompetence of NHS staff. From a personal point of view, my own experiences with the NHS have been terrible, almost to the point of third world treatment. They aren't bad at sorting you out if you have a life threatening disease, but anything else is a hit and miss situation. If your unlucky enough to require a knee or hip operation, good luck. If you are unlucky enough to have a mental health problem, it's possible you may go completely nus before you get to see anyone. Even getting a doctors appointment is a task in it's self, and it just shouldn't be.


    Again, don't politicise this, the subject is about the quality of our NHS, NOT the political party in charge at any one time. I am now in my sixties and can't remember it ever being any good, and I have lived through many governments, both red and blue. Most people understand that the growth in population has been far quicker than any health service could keep up with, although perhaps they don't. So how do you rate our NHS ?????

    White lives matter

  • The NHS is not fit for purpose. It is inefficient and often ineffective. You can't get appointments at doctor's surgeries for love or money, which leads to people to go to A&E for their non-life threatening illnesses (and waiting about 4+ hours for the privilege). Medical records are contained in huge paper files instead of on computers. The information that does find its way onto computers is not shared between hospitals or with GPs. Letters from consultants to GPs and patients are delayed because all letters go to a typing pool instead of being typed up by the consultant and sent by email. Appointments with consultants in hospitals are often changed for no apparent reason and when they are eventually honoured, you can be waiting one or two hours for your consultation.


    The list goes on and on. Porters swanning around pushing empty trollies back and forth, staff talking in huddles in hospital corridors. Patients not being properly attended to. Meals being brought to patients who cannot feed themselves, but with no-one to feed them. Patients being discharged far too early, before they have recovered sufficiently. Mental health services virtually non existent.


    It is not a happy story at all. We do need a Royal Commission set up to report urgently to consider how we can reform the NHS and merge it with our care services, and if this is best achieved by increasing the use of the private sector, so be it.


    What we all deserve is an efficient health care and dental service which is free at the point of delivery for all British nationals. All foreigners should be required to have health insurance before being admitted to the country to pay for any treatment they need on the NHS. Cosmetic treatments should not be permitted unless it is for the purpose of rectifying a deformity or for reconstruction surgery. People failing to attend their appointments without good reason should be fined and refused any further appointments until paid.


    If it is not possible to fund such a service despite these efficiences, then it may be necessary to set an excess charge for each hospital procedure carried out. If that was not acceptable, then the kind of treatments available on the NHS should be limited. Compensation payments should always be related to the costs of looking after an individual damaged by medical negligence and for nothing else.


    Whatever happens, we have to get to a situation whereby we can get the care we need in a more timely manner and with courtesy. I can't see it happening in my lifetime, unfortunately - I dread getting ill.

    Black lives matter

  • The NHS is a lumbering most inefficient organisation yet it is the best we have got, and admired worldwide. Treatment is available that does not depend on the ability to pay

    Critics forget what it was like before it was created

    Under the Tories for the past ten years it has been badly underfunded which has led to the present difficulties, a situation Johnson has recognised and promised massive investment to rectify

    A Hand Up Not A Hand Out

  • The NHS is a lumbering most inefficient organisation yet it is the best we have got, and admired worldwide. Treatment is available that does not depend on the ability to pay

    Critics forget what it was like before it was created

    Under the Tories for the past ten years it has been badly underfunded which has led to the present difficulties, a situation Johnson has recognised and promised massive investment to rectify

    Don't start that "It's all the Tories' fault again. We've already had this argument. Labour would have put less money into the NHS after the 2010 government came to power, and they admitted this at the time.


    The NHS has been getting steadily worse over the years under both political parties. The problem is, we cannot continue to afford to put more and more money into it. Root and branch reform is long overdue, but the problem is how to go about it.


    Politicisation of this dilemma is not wanted by the NHS staff themselves on the whole, they just want the whole system to work better, as do most people. Despite what you say, Bryan, it is no longer the envy of the world. We need to regain that status instead of simply watching the whole thing decay.


    Incidentally, I did say in my post that it needs to continue to be free at the point of delivery. Most people are agreed on that.

    Black lives matter

  • Nigel Lawson called the NHS "The nearest thing to a national religion that Britain has." I can see where he was coming from.


    The Tories tried to kill it at birth and failed. Ever since then they've been trying to get rid of it. Labour have made mistakes in its administration too. Mostly, I believe, due to political pressures rather than any ideological reason. In Labour ideology, the NHS is the primary example of a state run service which is popular and has a direct and necessary benefit to the people. They have never wanted to get rid of it, they have just allowed their sense of purpose slide when faced with political pressure. Shamefully for them, at those times they put party before country.


    The Tories do have an ideological reason for wanting to kill it though. State owned. Expensive. Monolithic. A political minefield to run and a black hole that money disappears into at a - for them - terrifying rate.


    But the British people love it. We love it because it we know that it is run by magnificent people who put our well being above any other consideration. If one of us is in a car crash, the ambulance team that arrive don't ask us for a credit card. They just care for us. When we get into hospital for an operation of any kind, we are made to feel that we matter. Our life matters. They are going to do all they can to restore us to health. We know the staff are overworked and underpaid and yet they never fail to give us their all.


    We TRUST our doctors and nurses.


    This is why the NHS is a political dilemma neither party can quite get right.


    Down the years, Labour have done their best, although their best has been found wanting at times. The Tories want to get rid of it but can't because whenever they have had the will and the opportunity, they have known they'd be signing their death warrant for the next election.


    I am in no doubt that the Tories were planning to sell the NHS out to the USA as part of a trade deal. American Big Pharma wants to take control of the nation's medication and American insurance companies were licking their lips at the thought of a potential 66 million new customers to exploit. I am in no doubt at all that that was going to be the price of our hormone injected beef and chlorinated chicken.


    But Coronavirus has changed all that. I dare Boris Johnson to sell out the NHS now. I double dare him. I double-dog dare him. He might as well get a gun and blow his own brain out (although I'm not entirely sure he's that good a shot) if he so much as hints at a sell off.


    Coronavirus has put any sale of the NHS back by at least ten years. Minimum. ....and only then if there is a Tory government. Between now and then, the government is going to have to do something that they'll choke on. They're going to have to fund it. And smile while doing it.


    Because if they don't, there will be plenty of people ready to remind everybody about the events of this year and hold them to account. Those images of Johnson standing on the steps of Downing Street at the Thursday clap-in, or going on TV and telling us all how grateful he is to the "magnificent" people who saved his wretched life will ring hollow indeed. The word 'betrayal' wouldn't get anywhere near the half of it.


    Johnson's words and actions during these last three months will come home to roost if he puts a foot wrong.

  • The NHS is a lumbering most inefficient organisation yet it is the best we have got, and admired worldwide. Treatment is available that does not depend on the ability to pay

    Critics forget what it was like before it was created

    Under the Tories for the past ten years it has been badly underfunded which has led to the present difficulties, a situation Johnson has recognised and promised massive investment to rectify

    Bryan, like you no doubt I used the NHS under many governments, and it's always been useless. Prior to the last Labour government losing the general election I had a problem. Every time I needed an appointment with a specialist it took three months, it then took 6 months for an operation. I eventually had two operations on my testicles only to find out I had a bad back. I am not suggesting things have got better, but they also haven't got worse. If every penny of our taxes went into the NHS it still wouldn't be enough. You advocate the lock down, and any future extension, meanwhile four super hospitals could be built EVERY DAY with what it is costing the economy. Ultimately, we have 67 million people using an NHS service designed for 50 million. Pumping more money isn't the answer, partial privatisation and a halt to immigrants using it probably is.

    White lives matter

  • The Tories tried to kill it at birth and failed. Ever since then they've been trying to get rid of it. Labour have made mistakes in its administration too.

    You are right to say that the Conservatives did not support the creation of the NHS at the time. However, I am not sure where you get the idea from that they have been trying to get rid of it after it was set up. Surely, had they wanted to do that, they had plenty of opportunity to do so during their lengthy periods of rule between 1950-1964 and 1979-1997. There has been absolutely no evidence that the present government want to privatise it either. Where do you get these views from?


    The Tories want to get rid of it but can't because whenever they have had the will and the opportunity, they have known they'd be signing their death warrant for the next election.

    One good reason why they wouldn't get rid of the NHS, presented in your own words.


    I am in no doubt that the Tories were planning to sell the NHS out to the USA as part of a trade deal. American Big Pharma wants to take control of the nation's medication and American insurance companies were licking their lips at the thought of a potential 66 million new customers to exploit. I am in no doubt at all that that was going to be the price of our hormone injected beef and chlorinated chicken.

    Well, you should be, because again, there is no evidence to support this claim. Corbyn's clumsy attempt to sell that lie failed miserably. I don't buy it. The public doesn't buy it.


    And by the way, we will not be getting chlorinated chicken - this has been confirmed by the UK government. As for hormone injected beef, I'm not sure where the government stands on that, but if it considers that to be undesirable, that will become a condition of any trade deal with the US. We are perfectly able to set the standards for our imported goods, as other countries, including the EU, do.


    Coronavirus has put any sale of the NHS back by at least ten years. Minimum. ....and only then if there is a Tory government. Between now and then, the government is going to have to do something that they'll choke on. They're going to have to fund it. And smile while doing it.

    I have no doubt that there are a few people on the right of the Conservative Party who would privatise health, but it's a minority view. It is not on the government's agenda and won't be in the future. Private sector involvement may well happen, and there's nothing wrong with that, but wholesale privatisation is not anywhere on the horizon.

    Black lives matter

  • Again, don't politicise this, the subject is about the quality of our NHS, NOT the political party in charge at any one time.

    As requested by the OP please try not to politicise this thread.

    History is much like an Endless Waltz. The three beats of war, peace and revolution continue on forever.

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  • I have no idea why you think any party wants to sell the NHS. Perhaps you believe some ridiculous unfounded propaganda put out by a certain political party. However, I think you may find that some of the best public health services in the world are a combination of public and private services. Frankly I am confused why anyone would have a problem with anything that works better than what we already have. I suppose it's some sort of socialist ideal ?

    White lives matter

  • Re: My sections highlighted in red


    You don't really connect up the dots in your arguments sometimes, old chap.


    You have argued that they could have done away with the NHS in the lengthy periods in office, and then you agree with me when I said that had they done so they would have cut their own electoral wrists.


    Your second response denies the first.


    But rather than sell the NHS off wholesale at those times (and knew they couldn't do overtly) they instead attempted to kill it by the death of a thousand cuts. Selling off parts of it piecemeal or starving it of funding until it became so run down and inefficient that the usual Tory argument that "private enterprise is the only thing that works" would enable them to get their way in the end with a public worn down by the tactics of "starve and chip away".


    There is more than one way to skin a cat and the Tories have tried them all.


    First, the Conservatives have consistently underfunded the NHS. David Cameron always claimed the NHS was “ring-fenced” from cuts, but the balance sheet says otherwise: spending increases for the NHS slowed dramatically under austerity, down to an annual average of about 1 per cent between 2010 and 2015, compared with an annual average of 6 per cent between 1997 and 2010, under Tony Blair and Gordon Brown.


    Second, cuts that the Conservatives have made elsewhere – to social care (and look at the effect of Tory policies on care homes during COVID-19) and welfare, for example – have put increasing pressure on the NHS. More and more people are going to hospital: the number of visits to A&E rose 40% between 2003 and 2016. Once they get there, they are waiting longer and longer to be seen: the percentage of patients seen within four hours has fallen below 90 per cent in England.


    in the 1980s, the Conservatives outsourced cleaning and catering services, now run by companies like Interserve and Serco. Then, under New Labour (just for the sake of balance), the construction of new hospitals was privatised through disastrous Private Finance Initiatives (PFIs). Since then, administrative services have increasingly been outsourced by Labour and Tory alike, while more and more hospitals hire their more expensive equipment (such as MRI scanners) from private companies.


    The coalition government accelerated healthcare privatisation. The value of private contracts awarded in the NHS has nearly doubled over three years, from £1.9 billion in 2017 to £3.6 billion today. Physiotherapy, elderly care, even cancer services, are now all facing privatisation, and £15bn worth of services have been sold off in the last 5 years. David Rowland, of the Centre for Health and the Public Interest estimates that nearly 18% of NHS services are run by private providers.


    The result has been disastrous. The introduction of the profit motive into the NHS has worsened services and increased costs. There is evidence that rates of MRSA infection are nearly 50% higher in hospitals that outsource cleaning services than in those that don’t.


    Meanwhile, an attempt in Staffordshire to privatise cancer services had to be abandoned in the face of mounting costs.


    I haven't even scratched the surface of Tory scams over the years. I can come up with more. I really can, you know.

  • But Jenny, it was equally as bad under the last Labour government, I experienced it, and I know. Your simplistic argument is lack of funding, well that's not the answer. Go into any hospital in the country and watch the nurses huddle around the nurse station. On television the other night, about fifty NHS staff stood outside the hospital clapping their hands, so who was looking after all the ill? People say there are to many managers, I would argue there aren't enough. Our doctors and nurses aren't angels, they are people doing their jobs, some well and some not.


    As a socialist greeny person you are particularly keen on immigration, and I respect your views even if my opinions differ. Now, your complaining the NHS doesn't have enough money to cope with the present population, but you are keen on the population expanding by means of further immigration. Don't give me all the the codswallop about a large % of the NHS being immigrants, because I am not proposing we don't let in the ones we need need, yes, cherry picking. Our NHS system is rubbish because the staff aren't being organised properly, and we have far to many people using it. At present we could build 4 new super hospitals every day with what the lock down is costing us, but even if we had put that money into the NHS I have the feeling I still wouldn't be able to get a doctors appointment next week.


    Remember what then telecommunications industry was like prior to privatisation, so imagine how good the NHS could be if it were run by professionals and became competitive

    White lives matter

  • The NHS has been getting steadily worse over the years under both political parties. The problem is, we cannot continue to afford to put more and more money into it. Root and branch reform is long overdue, but the problem is how to go about it.

    Have you told your great leader Boris that?

    He doesn't seem to have listened

    Maybe you've swallowed the crap that the Torys have suddenly found a money tree

    A Hand Up Not A Hand Out

  • Have you told your great leader Boris that?

    He doesn't seem to have listened

    Maybe you've swallowed the crap that the Torys have suddenly found a money tree

    So would you have rather they did nothing and saved the money? I know your answer to that, it's NO. The government have got the country into massive debt because of a pandemic. I wouldn't normally borrow money, but if it were a life saving operation for my dog, I probably would. Prior to the pandemic the NHS had more than enough money, it's was badly spent, and the NHS needs reorganising. My belief is that it needs more active managers, less back ground managers, and a lot more doctors and nurses being trained, rather than relying on immigrants

    White lives matter