Privatisation of the NHS

[ChezGiven 0]

Where can I place a bet that the next step will be making those working for companies offering health insurance or over a household income of 50k before tax (the same as child credit?) will need to pay to see a GP or use A&E for non medical emergencies.

 

If you put that figure at income over 500k would you think it was fair? 

[Rayvin 5219]

Sure but if you talk about insurance people shit themselves which is essentially the same thing. The money comes from Tax its ok. The money comes from state run insurance 'mutuals' and people think its an issue. I'm not saying thats the solution but there is an aversion to private elements in the funding model which is not coherent with where taxes come from. 

 

There are options is what i want to say. 

 

I agree, if the issue is people getting bent out of shape about insurance then yes, that's pointless. Assuming of course that those who can't afford insurance are still covered.

[Rayvin 5219]

If you put that figure at income over 500k would you think it was fair? 

 

I'd say no but then those people are probably shelling out a lot more than we are anyway, on NI.

 

Also, if we end up doing this, and people are effectively covering their own premiums, if someone is willfully fat, a smoker, eats poorly, does drugs, enjoys base jumping, etc - all manner of potentially life shortening issues, do they get a higher premium? They probably would do, I expect.

[ChezGiven 0]

I agree, if the issue is people getting bent out of shape about insurance then yes, that's pointless. Assuming of course that those who can't afford insurance are still covered.

 

Which is the model followed by the European countries who have this sort of system. FYI there are 2 systems in Europe, NHS systems like in Nordics, Spain and UK and what we call SHI systems. Social Health Insurance as per France and Germany.

 

As the French and Germans follow this model, they raise directly 10 to 12% of GDP to go on health. As our health budget is negotiated through the CSRs (Comprehensive Spending Reviews which are Whitehalls internal bun fight over money), our NHS is politicised as the total allocated is traded off against other political objectives. Politically the govt says its ring fenced but in fact its targeted in real terms for future projections.

 

A SHI system is a form of hypothecation and allows more money to be allocated and for those who earn to contribute more. The trade off is equity as poor people get no choice but richer people get better services and can top up to go private etc. 

[ChezGiven 0]

I'd say no but then those people are probably shelling out a lot more than we are anyway, on NI.

 

Also, if we end up doing this, and people are effectively covering their own premiums, if someone is willfully fat, a smoker, eats poorly, does drugs, enjoys base jumping, etc - all manner of potentially life shortening issues, do they get a higher premium? They probably would do, I expect.

 

Regulation is the key. Obamacare fails where it does fail as the Republicans watered out the good regulation. All markets need a form of regulation where market outcomes have social importance. If we want to avoid a socially bad outcome relating to lifestyle choice and premiums, regulation can intervene.  

[Rayvin 5219]

Which is the model followed by the European countries who have this sort of system. FYI there are 2 systems in Europe, NHS systems like in Nordics, Spain and UK and what we call SHI systems. Social Health Insurance as per France and Germany.

 

As the French and Germans follow this model, they raise directly 10 to 12% of GDP to go on health. As our health budget is negotiated through the CSRs (Comprehensive Spending Reviews which are Whitehalls internal bun fight over money), our NHS is politicised as the total allocated is traded off against other political objectives. Politically the govt says its ring fenced but in fact its targeted in real terms for future projections.

 

A SHI system is a form of hypothecation and allows more money to be allocated and for those who earn to contribute more. The trade off is equity as poor people get no choice but richer people get better services and can top up to go private etc. 

 

Interesting and sensible. Is it politically achievable over here? Presumably the barrier is that it's just too hard a sell for one of our two relevant parties?

[Rayvin 5219]

Regulation is the key. Obamacare fails where it does fail as the Republicans watered out the good regulation. All markets need a form of regulation where market outcomes have social importance. If we want to avoid a socially bad outcome relating to lifestyle choice and premiums, regulation can intervene.  

 

Fully agree, but do we want regulation for this? Shouldn't people have some personal responsibility for their lifestyle choices? I know this debate exists now as we're all paying for it anyway, but I feel like it'd be more pronounced if people were 'actively' paying for health insurance rather than effectively doing it passively through PAYE.

[ChezGiven 0]

Interesting and sensible. Is it politically achievable over here? Presumably the barrier is that it's just too hard a sell for one of our two relevant parties?

 

Too hard a sell when people shit themselves at the thought of NHS reform. 

[Dr Gloom 21915]

The NHS sorely needs private sector thinking from the albeit limited discussions I've had with friends who work in it. One of my mates heads up a radiology department in his hospital, and the number of inefficiencies he has to deal with day to day are staggering. He was telling me about how consultant radiographers are supposed to audio record their report on each case they look at so that a machine can type it up for them later. Instead though, most of them refuse, and insist on dictating the notes to a typist. While this is latter option is about 25% quicker at the time of processing the report, it requires the consultant to re-read each report at a later date, before it is issued. So in reality it takes up more of the consultant's time (despite looking quicker initially), causes up to two weeks of delay in the report being issued to the patient (versus 1-3 days) and costs more (for the typist).

 

That kind of thinking can only happen because the management structures aren't strong enough to exert control over the consultants in this case and force them into line. This is just one hospital but I can't imagine the experience is unique.

 

You would hope that we could reform it without privatising it through the use of consultants, except that they seem to be more interested in buttering their bread in the long run - and so their solutions are not often the best ones.

I've seen private consultants do the same thing. It isn't an inefficiency unique to the NHS

[Gemmill 44853]

The consultant I last saw would only accept payment by cheque. I mean wtf arsehole, this is the 21st century. I had to order a cheque book from the bank to pay the twat.

[Rayvin 5219]

I've seen private consultants do the same thing. It isn't an inefficiency unique to the NHS

 

I was thinking more that private sec. managers are needed rather than private medical consultants. People whose rewards can be tied to KPIs like efficiency, patient satisfaction and cost saving. I'm sure this happens. The question is, why isn't it happening in a way that is helping? From talking to this friend of mine, I was certain that I could make a pitch to this hospital, as a management consultant, that would save them money. What barrier comes up between people who understand processes and management well enough to help, and those in the NHS who need to sort their shit out?

Edited November 16, 2016 by Rayvin

[ewerk 30598]

The consultant I last saw would only accept payment by cheque. I mean wtf arsehole, this is the 21st century. I had to order a cheque book from the bank to pay the twat.

 

The horrors of private healthcare.

[Dr Gloom 21915]

It's like solicitors and their letters ffs

[Gemmill 44853]

The horrors of private healthcare.

I agree. Absolutely fucking appalling. Next time I'm taking a money clip and making it rain in his surgery.

[scoobos 298]

I don't agree really that the NHS needs private sector thinking. I think its private sector thinking that's fucked it up so much.

 

PCT's and the executives within them are landed "buddy" Eton arseholes who don't have a fuckin clue about anything to do with the business at hand - like 60% of the CEO / MD's in most of our private multinational companies. They come in , make their "cost savings" / Outsource, then take their bonus and get fired or leave in a year with fuckin millions after doing nothing positive.

 

Take it from me, I've seen the fuckers get milked year on year when I worked on one of the biggest NHS projects in the last 20 years - its not in, doesn't fuckin work and was never going to - but who cares at the PCT, every fucker has gone and every fucker has gone with at least a quarter of a mil in his/her back pockets.

 

Cunts, All this "businesses will have to do well or they will be destroyed by competition and market forces" rhetoric is bullshit, merely proven by the bailout of the "failing" banks at our expense and now the leeching of our social services.

 

<off bandwagon> but FUCK OFF tories.

 

Here's an idea, how about we don't starve the fuckin organisation for near on 6 years while moving all the money into your maties pockets and then say it's failing? How about using national insurance for what its meant to be used for , what , too 80's thinking for you?

 

Oh, by the way - I just paid the equivalent of 80 quid for a big plaster at our hospital, (US healthcare system) to keep a drip in place so I could go home.

Edited November 21, 2016 by scoobos

[Park Life 71]

I don't agree really that the NHS needs private sector thinking. I think its private sector thinking that's fucked it up so much.

 

PCT's and the executives within them are landed "buddy" Eton arseholes who don't have a fuckin clue about anything to do with the business at hand - like 60% of the CEO / MD's in most of our private multinational companies. They come in , make their "cost savings" / Outsource, then take their bonus and get fired or leave in a year with fuckin millions after doing nothing positive.

 

Take it from me, I've seen the fuckers get milked year on year when I worked on one of the biggest NHS projects in the last 20 years - its not in, doesn't fuckin work and was never going to - but who cares at the PCT, every fucker has gone and every fucker has gone with at least a quarter of a mil in his/her back pockets.

 

Cunts, All this "businesses will have to do well or they will be destroyed by competition and market forces" rhetoric is bullshit, merely proven by the bailout of the "failing" banks at our expense and now the leeching of our social services.

 

<off bandwagon> but FUCK OFF tories.

 

Here's an idea, how about we don't starve the fuckin organisation for near on 6 years while moving all the money into your maties pockets and then say it's failing? How about using national insurance for what its meant to be used for , what , too 80's thinking for you?

 

Oh, by the way - I just paid the equivalent of 80 quid for a big plaster at our hospital, (US healthcare system) to keep a drip in place so I could go home.

Top post rasta.

[Anorthernsoul 1221]

http://www.standard.co.uk/news/uk/nhs-hospitals-hit-by-cyber-attack-creeping-across-england-a3537876.html

[Alex 35077]

That's some special kind of cuntery if they've actually targetted the NHS like

[TheGingerQuiff 2412]

"Strong on security". Vote Tory.

[Andrew 4748]

Quote

Sadly this is bigger than a ransomware attack. This is is a zero hour attack against (what feels like) all Windows 2003 servers in Europe. All 223 of our VPS's running 2003 are currently offline.

Windows Server 2003 has been out of support for over 2 years now. Servers running this OS should have been upgraded long before the end of life. Sadly I doubt the NHS had the funding to buy the licenses.

I'll be interested to see how the NHS deal with it. They can restore back ups, but if they restore to Windows Server 2003 the vulnerability will still be there. They may be unable to upgrade to 2008+ due to compatibility issues with the software they run.

 

Friend of a friend who works in the right place to know stuff like this. Thought it was interesting.

[Happy Face 29]

That is interesting.  We still use XP for some important stuff, 9 years since it's last service pack

[Happy Face 29]

 

 

[NJS 4378]

 

 

[Rayvin 5219]

Labour should absolutely hammer them for that. Open goal.

 

Whether Corbyn has it in bin to do so is another matter.

[Happy Face 29]

That mirror report is wrong.

 

It was 3 years ago that the £5.5m cover was available.

 

It was bought by the government and Microsoft refused to go beyond that.

 

The failure was to not upgrade systems in that year or the 2 years after it fell out of support.

 

That would have been much more expensive.

 

Here's the 4 year old story from the guardian

 

https://www.google.co.uk/amp/s/amp.theguardian.com/technology/2014/apr/07/uk-government-microsoft-windows-xp-public-sector