Bud the Wiser

Leaving aside personal anecdotes of yourself, friends or family and without calling into question the care provided by the nurses and doctors at the front end of providing health care, how do people see the future of the NHS?

My own personal view is that eventually we will see more and more procedures falling into a co-pay bracket, subject to means testing or simply not approved for treatment by the NHS.

I found the following recent documentary quite disturbing as to the way hospitals are funded.

http://www.youtube.com/watch?v=tFoiVKbd6xw

N.B. There's a break for adverts in the middle of the you tube clip.

Editha

I had a look at that documentary. Disturbing though it is, I'm not sure how you reach the conclusions that you do from it.

The fact is that health care is not means tested or 'co-pay' in the UK, and none of the major political parties have plans to introduce measures of that sort.

Personally, I think that it would be a good thing to bring in some competition into the NHS, which might achieve more than targets have done, but tendering work to commercial firms does not mean the consumer pays.

Here in Canada for the last few years, all my regular checks -- blood tests, x-rays, breast scans and bone scans, ecg, physical therapy, and anything else I've forgotten except visits to my GP, have been done by private companies contracted to Alberta Health Care. I've generally had a better service than I had getting similar work on the NHS in the UK.

paul32x

What I find disturbing is the new guy in charge of the NHS comes from a big Healthcare company in the USA and has already said how many huge changes need to be made!

Giantaxe

Agreed, the knee-jerk reaction to anything that tries to introduce competition into the NHS is very counterproductive. Private provision of public services can indeed work well. Ironically, It's the reverse of the problem in the US where any solution that isn't based on unfettered capitalism is deemed to be evil socialism.

roaringmouse

NHS dentistry is already co-pay, has been for a long time. There is a major issue with the way NHS dentists are funded though, which basically encourages to undertreat as many people as possible, leading to declining standards.

I wouldn't be against introducing a co-pay system for GPs (e.g. £10/visit with certain exemptions and reductions), however there would also need to be at the same time an introduction of a payment system (significantly higher amount than GP co-pay) at A&E when people present with obviously stupid things that either need a GP visit or no medical visit (how you determine what constitutes that is a different question).

However, the priority before any more co-pay services needs to be on the way services are funded, and more say given to front-line staff rather than politicians on finding the right way for the money to flow.

mikelincs

People making REGULAR visits to A&E for spurious complaints should be billed, amd also those people who have appointments booked at GPs or the hospital and who don't turn up or don't cancel.

In our GP practice they had a notice up about just this, one patienbt of the practice had been to A&E 12 times in the previous 6 months for minor complaints that really didn't need even a doctors visit, and there were around 12% of their GP appointments where there was a non turn up without cancellation.

rebs

It's true about payments for dentistry, and patients also make a contribution towards prescription charges. However, I think it would be a bold move to introduce any kind of regular payments for core medical treatments/appointments - and a difficult one politically.

I shouldn't think there is much in the way of existing infrastructure to introduce any kind of billing/payment systems either - I guess there would be a cost to create that infrastructure.

If any kind of billing were to be introduced, and infrastructure created, I bet it would not be long before more and more things were added to the list of billable items though...

Regarding costs in the current NHS, I was listening to piece on the radio the other day about the costs of bed blocking - I forget the exact figure but a huge sum of money involved there...

roaringmouse

The only way you can enforce a "pay if you don't turn up" approach is by charging at time of making the appointment. The only potential alternative is for it to be kept on central records, and charged before any future medical needs are provided (with exception of an actual emergency).

Bud the Wiser

By 'my conclusions', did you mean my thoughts on the future of the NHS or about my concerns as to how the hospitals are funded? Either way, I have had these concerns for some time, based on several factors, not least being how it, ( the NHS ) will cope with the demands of a growth in the aging population, a growth which, ironically, in no small part, is due to better health care.

Of course, the consequences and concerns about a growing percentage of an elderly population are not solely confined to health care.

Editha

Both.

bigglesworth

At a recent visit to my medecin traitant (GP) here in France, where one does pay for appointments, I mentioned that when I was at my old (British) GP a few weeks earlier, there was a sign indicating the percentage and number of missed appointments there had been in the previous week.

He looked at me in some surprise, and said, "Why does the doctor continue to see these people? I would remove them from my list and not see them again".

chris955

That's because he is French

roaringmouse

I don't see an issue with doing that, if the person has missed something along the lines of 2 appointments within a 12 month period - and disallow them from registering at that practice for a suitably long time.

scot47

Bear in mind that within the UKOGBANI, there are different NHS systems !

holly_1948

Right.
NHS England is not the same as Scotland, Wales, N.I.

As a general comment, in the medium term (5 years or so), I think that NHS policy will, like many other things, be subject to worldwide Force Majeure. The world will change more in the next 10 years than it has in the last 40.