Almost Canadian

So he was doing what he was contracted to do. One assumes that the NHS could not compete with his private work on price for the other two days.

Are you advocating for doctors and support staff to be limited to work for a single employer that sets their wages on a take it or leave it basis? If so, why should medical staff be any different to other workers with their ability to negotiate their earnings with their employer?

R I C H

My wife had private surgery in Kamloops, within a few months of moving here, to have some metalwork taken out of her leg from previous a operation in the UK. Because we had no residency status it was acceptable to pay for the surgery as a private patient and elect a time and day to suit her. It was performed by the same surgeon that works for the local Interior Health hospital.

R I C H

I'm advocating nothing, just answering your question and point about people being bumped and the reasons why.

iaink

Er. no, as I stated, my friend works an afternoon less now on the NHS (in addition to the time he allocates to his private clients) because his private income allows him to. Were private insurance not allowed I expect he would be putting 5 days a week into his NHS list, but its not worth his while to do that if someone else will pay him more. Cant say I blame him, thats just how the system is there.

On this one, I think you have been shown to be wrong. Finite resources that get allocated in part due to wealth rather than medical necessity clearly has a detrimental effect on those who cannot afford to pay.

Then again, often NHS surgeries are cancelled through no fault of his due to lack of support staff availability or recovery beds, and then he can fit in a private job or two at the BUPA hospital where that doesnt often happen.

Almost Canadian

Your friend may do but, one assumes, another doctor works his "lost" shift. Rather than have 5 doctors working 7 shifts, you have 7 doctors working 5 shifts, for example.

Now, if you believe that all medical staff are duty bound to work for the good of the public, rather than in their own financial interest, your position works. But why not apply that to every occupation? Why should I have to pay market rates for a plumber to fix issues at my house, why is there no "one price fits all"?

muffback

Thanks for replies.

Honestly some things about Canada do my head in- no private healthcare, unbelieveable that people (including senior politicians) go the US. Car insurance in BC- needs to be done via a broker cost a fortune. Post so expensive people buy off US ebay, pay tax and get US post to ship - as it is still cheaper than Canada post. It's like the dark ages! Rant over....

Cheers
Gary

JonboyE

I said nothing of the sort, and you know it.

Remove the ability to pay for preferential service at the point of treatment then people are treated according to medical need.

Three options:

a) Earn £50,000 working part time for the NHS
b) Earn £100,000 working full time for the NHS
c) Earn £50,000 working part time for the NHS and work part-time earning whatever you can from patients that can afford to pay you because you don't have time to treat them as you are only working part-time for the NHS.

Your argument might have some validity if you removed option c) and all the medics decided on option a) and playing golf the rest of the time. The reality is the vast majority would work full time.

JonboyE

It is called civilization.

iaink

You think the NHS managers are going to hire a couple of extra bodies? I hope so, but somehow I doubt it.

I dont know about duty, but lets not forget the tax payer paid for 8 years of university medical education for this guy...

I dont think "the market" works in some cases to be honest, it just encourages finite resources to be used up fastest by those with the most money. Its good for somethings, but its not the be all and end all. Actually, thats a bad choice of words as its leading us down a path to ruin. David Suzuki is a lot more eloquent on the subject then I am. Try watching Force of Nature if you get a chance.

JonboyE

The market system works when people have choices. It does not work in health care because ill people do not have choices.

Almost Canadian

I have just re-read what you posted and I think I got the wrong end of the stick. It appears that you were comparing one system with another. I thought you were stating that, if no private healthcare was available, rich buggers would still get treated faster. I apologize for my error.


This is still limiting the medics ability to earn money, when few others occupations are limited in such a way. I believe that people should be able to earn whatever they are able to earn. I appreciate we disagree on this.

Almost Canadian

One assumes the tax payer also paid for your university education too. Should the State be able to dictate for whom and what amount you work?

How is your argument affected by tuition fees in the UK?

Here's a question for you? It is wrong for people resident in Canada to fly to the US for medical treatment or should the rich bastards have to suffer with the rest of the population?

bats

The Canada Health Act only allows charges to be made for services not covered by the provincial system.

Consultants in the NHS do not work 35 hours a week. Their contracts allow them to spend time in private practice. ie 4 sessions a week at the NHS place and 2 at their private practice. This does not mean that NHS patients are bumped to make room for private ones. Where private wards are included within NHS buildings, or private work done within the NHS complex then that is done as income generation for the NHS.

Where people do try to queue jump is buy paying for the initial consultation with the doc and then falling back onto the NHS for their expensive tests etc.
Some docs don't allow this and will only refer the patient to a private hospital for those tests.

bats

NHS consultants have never worked full time. They have always had at least one session to see private patients, as well as their lunch break of 2 hours. This was part of the carrot offered way back in the beginning to get them on board with the NHS and being employees. Consultants contracts were revised around 10 years ago but they still made provision for less than 10 sessions a week in the NHS.

Doctors used to abuse the system and spend more time with private patients than they were supposed to, but this does not happen anywhere near so much as previously.

The carrot offered to Canadian doctors was that they remain self employed and billed the Province for their services. ie OHIP in Ontario. This saved them from the shame of being employees but added a cumbersome layer to the Canadian Health Service as well as encouraging more referrals etc than is needed as the majority are paid by the number of patients they see.

JonboyE

No worries on the first bit.

Yes it is, but I don't agree that this restriction is unique. I contract to provide services and it is common for the contract to include a provision that I don't solicit my client's clients.

We can all accept there are rights that go with citizenship and/or residence that should not be dependent on the amount of money someone can afford to pay. Access to due process of law is one. The right to medical treatment based on need is another in my opinion.

The day may come where doctors refer complicated, long-term chronic conditions to their private practice and leave the quick and profitable acute conditions in the public system. Until such time I am convinced that private health care is more about private profit than public good.