The end of the NHS - Privatisation

[Sirius]

Originally Posted by martyh

I really wish Arthur would join a debate instead of just popping up with unsubstantiated claims that amount to nothing more than the rantings of lunatic.

@Arthur ,if you are going to make claims on a subject then at least have the decency to back them up and argue your point .The whole point of a debate is to hear different viewpoints ,for people to defend theirs and rebut others ,not to insert a unsubstantiated claim and then bugger off leaving people wondering what the hell you are talking about

Well said

Originally Posted by the_neurotic_cat

State controlled of course.

I'm not sure how this applies to the real world. I've never heard of a health service that only treats terminal cancer patients. The NHS has fantastic efficacy compared to private healthcare providers. The USA spends about $2tn on health insurance per year whereas the uk spends about £120bn on the NHS. Calculating exchange rate and adjusting for population the Americans spend over twice the amount per person and don't get nearly as much coverage as we do here in the UK.

£4£ you can have profit, or treatment, not both. Sorry.

I'm having genuine difficulty deciding whether you completely missed the point or are deliberately refusing to engage with it. Let's have another go.

If one model treats 60% of those that need it, and the other treats 90%, with money left to financially reward those that made it so efficient, do you seriously contend that the system that fails to treat 40% of those in need is better than the one that fails 10%, simply because in the former system there is no profit incentive?

This is the only way I can rationalize the position you're apparently wedded to. It's not one we're ever going to agree on as you appear to want to put your ideology ahead of making a pragmatic choice to work more efficiently.

Nice try re: the straw bogeyman of the US health system by the way; I never mentioned, nor advocated that system as being one to import into the UK, therefore in the context of this discussion there's little point in you wasting your time constructing arguments against it.

[Chrysalis]

obviously treating more for less cost is better, the problem is that its all theory.

What would put me at ease is 2 things.

1 - if this was trialled first, dont do it nationwide but pick a few areas first to try it out.
2 - if there was a way out if it doesnt work out, usually if something is sold off aka privatised there is no easy way back as then someone legally has took ownership, this is about offloading the management of the nhs to GP's who in turn are likely to outsouce a degree of stuff to private companies as well as the fact typically GP's themselves are part of private business already. If this can be reversed if it doesnt work then thats not so bad either.
also of course accountability, how accountable will this new setup be eg. will FOI requests still work.

[AdamD]

Never understood how the NHS is so inefficient as far as money goes, but, having worked in a fairly large hospital in the I.T department, I saw massive waste on a day to day basis, so it didn't surprise me, but it did anger me.

There was never any real care about money being wasted, nor any real effort to save money.

Example being, all computing related purchases had to go through the I.T department

They would put in an order for a computer or peripheral through us, we'd order it, it'd arrive, then we'd install it

We'd never query why they'd need a computer with a dvd/cd rom, or sound card (all extras at that time), or if they needed a colour printer, we'd just order it

If they had an old computer that they wanted replacing, we'd take said computer away, install the new one and keep the old one (even if it was fully operational) in a store room.

Those computers would then stay in the store room and never be reissued, if a department needed another computer, we would tell them no, we don't carry any spares (Despite the fact the store room had over 250 computers) and they'd have to order a new one.

Taking into account the two sites i worked at, had probably excess of 1500 computer users, you can imagine just how much waste took place.

Another bizarre example is the ordering process for supplies, if a department ran out, or was running low, on say.....pens, they'd raise an order (called an SD7), which would cost the department/taxpayer £20, then whatever they wanted on top.

So a large pack of pens might only cost £5, but then you'd add that to the order cost, so it ended up costing the department £25.

Never understood that

[the_neurotic_cat]

The NHS is inefficient compared to what ? ... Americans spend over twice that of the British on healthcare and still have less access to treatment than we do.

I think there comes a point where people have to stop obeying the rules and just do what makes sense. The bureaucracy needed to be material resource efficient would be prohibitively complex. The law of diminished returns applies to regulation as much as anything else.


---------- Post added at 23:47 ---------- Previous post was at 23:45 ----------

Originally Posted by Chris

I'm having genuine difficulty deciding whether you completely missed the point or are deliberately refusing to engage with it. Let's have another go.

If one model treats 60% of those that need it, and the other treats 90%, with money left to financially reward those that made it so efficient, do you seriously contend that the system that fails to treat 40% of those in need is better than the one that fails 10%, simply because in the former system there is no profit incentive?

This is the only way I can rationalize the position you're apparently wedded to. It's not one we're ever going to agree on as you appear to want to put your ideology ahead of making a pragmatic choice to work more efficiently.

Nice try re: the straw bogeyman of the US health system by the way; I never mentioned, nor advocated that system as being one to import into the UK, therefore in the context of this discussion there's little point in you wasting your time constructing arguments against it.

I'm being ideological? ... I'm not the one making 'if' arguments. Why hand out financial rewards when there's still 10% that need treatment? my referencing the US healthcare system isn't a strawman at all, you're advocating a for profit healthcare system so I referred to one that actually exists, not the one you created in your 'if' fantasy, you know, the one where you considered the last 10% of untreated patients less important than a cash reward.

---------- Post added 21-04-2011 at 00:02 ---------- Previous post was 20-04-2011 at 23:47 ----------

Originally Posted by martyh

so healthcare can be profitable ,if your original statement about "healthcare cannot be profitable" was directed at the NHS ,then i'm sure your aware that it's not meant to make a profit ,just operate within a budget .Hospitals in the USA are mostly paid through medical insurance but even their they have a version of our NHS for those who have no insurance or cannot afford it ,that is way i think we will go .I think we will end up with a means tested NHS ,those who can afford insurance will have to take it to cover some illnesses ,possibly things like cancer, heart disease could still be covered by the NHS but lesser illness ,broken limbs or non life threatening illness could be covered by insurance .Thats just a thought not sure if it is workable or not

Yes, healthcare can be profitable if it refuses to treat those in need. If you're referring to Medicaid in the USA it only covers immediate need treatments and a hospital is only allowed to spend a limited amount. Once their limit is reached, they literally dump patients on the street. They also charge at the same rate that they charge insurance companies so treatment still has lower fiscal efficacy. Obama almost had his arse ripped out over his attempts to improve the healthcare situation in the USA.

---------- Post added at 00:13 ---------- Previous post was at 00:02 ----------

[Sirius]

Originally Posted by the_neurotic_cat

the one where you considered the last 10% of untreated patients less important than a cash reward.

And yet in your world you would support a system that would allow 40% to go untreated. I find that shocking and very worrying.

[Chrysalis]

Some parts of the nhs need more spent on it.

There is evidence that the service feels budget squeezed by the level of care been offered.

eg. GP's refusing to come out to patients, obviously if a GP comes out to see patients then he/she cannot see so many in a given space of time so that obviously is cheaper for patients to go to the GP.

When I last was in hospital and had drops put in my eye, ideally the nurse should have put one drop in one eye first, given me 10 minutes or so to see how I reacted and then do the other eye, instead both eyes were done right after the other in a rush, even tho I was in agony right after the first eye and I was then lumped back into the waiting room whilst still in agony. That is a nurse possibly working under pressure (or just been lazy). A lack of personal attention/time given to me by medical staff. Defenitly district nurses the ones who come out to people are under financial constraints and need more help.