Future of the NHS

Old Mar 24th 2014, 10:14 pm
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Default Re: Future of the NHS

Originally Posted by Editha
I'm not a big fan of the NHS. I appreciate that we are lucky in the UK compared with the USA, but if health care was the only factor in deciding where to live, I'd move to France or Germany or just stay in Canada, though the waiting lists for operations here worry me.

My experience of NHS care for myself and members of my family, in the decade before I left in '06, was dire, particularly of the GP service. My GP here in Edmonton is in a different league to any I had in the UK. She has picked up a serious condition that my husband suffers from, that his GP in the UK could have diagnosed through a simple blood test that he never ordered. She also orders the right test to monitor my chronic condition, instead of the wrong one used by my UK GP, and as a result my own health has improved enormously.

I don't have the skill or knowledge to analyse exactly why I've had better health care in Alberta. It might just be that I've been lucky with my GP here and was unlucky in the UK. But I'm returning to the UK more enthusiastic about introducing competition into the NHS through private tendering, and shaking up some of the complacency that seems to exist among NHS staff.
I am a huge fan of the NHS and have had virtually no issues with it at all. We have great GP's in the village or in the next town so perhaps you were unlucky?
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Old Mar 24th 2014, 11:49 pm
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Default Re: Future of the NHS

Originally Posted by bigglesworth
The deficit was running at ELEVEN percent a year (compared to 5 now). It is entirely possible that the mess they left is so great that it simply cannot be fixed.
A bit misleading. The deficit hit 11% of GDP in 2010, it was not running at that level for a long time. It only rocketed when the GFC was starting to make itself known.

For example, in 2007 the Labour government borrowed a total of £37.7bn - 75% of which was invested in big projects. In 2013 the Tories borrowed £91.5bn - 26% of which was invested (both lower percentage and lower figure invested).

(source of figures - although some other posters like to make wild statements without any evidence)
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Old Mar 25th 2014, 2:03 am
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Default Re: Future of the NHS

Originally Posted by bigglesworth
Rather than the last lot of self seeking numpties who screwed everything up?

The IEA estimate that tax rises of a further 15 percent or spending cuts of 20 percent of gross are needed within the next five years to pay for the mess left by the last Government. The deficit was running at ELEVEN percent a year (compared to 5 now). It is entirely possible that the mess they left is so great that it simply cannot be fixed.
It will be fixed but will take time, we just need to hope the electorate dont have short memories and vote Labour back in to start the cycle all over again. I dont think that will happen though.
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Old Mar 25th 2014, 2:15 am
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Default Re: Future of the NHS

Although the NHS is centrally funded, I am surprised at how variable the standard of treatment seems to be, depending on where you live, and/or where you go for treatment. Within my limited experience I have seen the following:

South Wales - horrible, grim local GP office with cr*p waiting times (even if you had an appointment) and completely unsympathetic GP's (maybe because they were overworked?). I'm glad I didn't live there for very long.

Glasgow area - excellent local GP, possible to get a same-day appointment if urgent, or within a week if not. Referrals to Glasgow area hospitals took forever and the hospitals seemed very outdated and a bit grimy. It took over 2 years to get from referral to surgery for my TKR.

More recently, I asked for a referral to Larbert Hospital (over by Stirling) and had a completely different experience. The referral appointment took much less time to receive and I was in and out of the hospital (two occasions) within a half-hour. A friend's wife recently had a hip replacement at the same hospital and she had a similarly very efficient and thorough experience.

From these three different sets of experiences, I think it is very difficult to generalise about the NHS.
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Old Mar 25th 2014, 2:24 am
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Default Re: Future of the NHS

Not wanting to add the expected cliché but that would be true of any system anywhere in the world. You cant standardise something like that. Where we are the GP's are lovely, friendly and keen. When my son broke his arm the hospital experience was a million times better than the equivalent when my other son broke his arm, although we are talking about a different country. The point is that there will be differences between 2 GP's in the same practice never mind in 2 different locations. I agree with your point though, it is impossible to generalise about the NHS.
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Old Mar 25th 2014, 2:35 am
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Default Re: Future of the NHS

Originally Posted by chris955
Not wanting to add the expected cliché but that would be true of any system anywhere in the world. You cant standardise something like that. Where we are the GP's are lovely, friendly and keen. When my son broke his arm the hospital experience was a million times better than the equivalent when my other son broke his arm, although we are talking about a different country. The point is that there will be differences between 2 GP's in the same practice never mind in 2 different locations. I agree with your point though, it is impossible to generalise about the NHS.
Oh come on, who are you trying to kid?
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Old Mar 25th 2014, 2:37 am
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Default Re: Future of the NHS

Originally Posted by dunroving
Oh come on, who are you trying to kid?
Not trying to kid anyone, it's just the way it is and unfortunate that so many cant see it or accept it.
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Old Mar 25th 2014, 2:40 am
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Default Re: Future of the NHS

Originally Posted by roaringmouse
A bit misleading. The deficit hit 11% of GDP in 2010, it was not running at that level for a long time. It only rocketed when the GFC was starting to make itself known.

For example, in 2007 the Labour government borrowed a total of £37.7bn - 75% of which was invested in big projects. In 2013 the Tories borrowed £91.5bn - 26% of which was invested (both lower percentage and lower figure invested).

(source of figures - although some other posters like to make wild statements without any evidence)
What an imaginative post. If I am stopped doing 110 down the M1 all I need to say is that when I was driving round Manchester I was only doing 25.

Nobody knows how high (or low) the deficit would now be under a Labour administration. All we do know is that the last Government had increased public spending by 6 percent a year since 2003. As Mr Balls and Mr Milliband have spent the past four years claiming that Plan A would not work, it is likely that they would have continued spending (if someone was prepared to lend them the money).

I am not sure what the point of your reference to "big projects" is. When what the Left likes to call the GFC hit, most Western economies went into recession, with a consequent lack of demand. The Coalition rightly in my view continued the automatic stabilisers and actually increased the levels of many benefits.
The only possible conclusion from your remark is that you think the amount spend on capital expenditure should have been increased. Unless they simultaneously reduced the amount spent on the automatic stabilisers this would have raised the annual deficit substantially. It is very doubtful indeed that the markets would have accepted that.

I wonder how you will react next year when the EC rules that the debt incurred by the theft of Network Rail must be shown as a percentage of GDP. That will increase the proportion of capital spend, but will focus attention on the many little tricks Gordon Brown used to keep debt off the books.
The situation will in fact turn out to financially and socially far worse than present figures suggest. Financially worse because of all those little tricks.
financially and socially because if capacity has indeed been lost in the economy, as some suspect, that will translate into a still higher structural deficit.

All you have done is reinforce my belief that the mess Gordon Brown left is so dire that it quite possibly never can be fixed. Economic cycles generally last between 15 and 17 years (leaving out supercycles), from high to high or low to low. We are therefore nearly half way through it, and have not even managed a stable budget yet. We have at most seven or eight years to not merely reduce the deficit but to pay down at least a sizeable part of the accumulated debts. A pretty tall order.
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Old Mar 25th 2014, 2:52 am
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Default Re: Future of the NHS

Originally Posted by dunroving
Although the NHS is centrally funded, I am surprised at how variable the standard of treatment seems to be, depending on where you live, and/or where you go for treatment. Within my limited experience I have seen the following:

South Wales - horrible, grim local GP office with cr*p waiting times (even if you had an appointment) and completely unsympathetic GP's (maybe because they were overworked?). I'm glad I didn't live there for very long.

Glasgow area - excellent local GP, possible to get a same-day appointment if urgent, or within a week if not. Referrals to Glasgow area hospitals took forever and the hospitals seemed very outdated and a bit grimy. It took over 2 years to get from referral to surgery for my TKR.

More recently, I asked for a referral to Larbert Hospital (over by Stirling) and had a completely different experience. The referral appointment took much less time to receive and I was in and out of the hospital (two occasions) within a half-hour. A friend's wife recently had a hip replacement at the same hospital and she had a similarly very efficient and thorough experience.

From these three different sets of experiences, I think it is very difficult to generalise about the NHS.
The problem is I think what you identify. We all see the NHS through the prism of our own experience. My own had been pretty positive until the last five years, but since then it has been anything but. I still believe that free at the point of need/ use/ delivery is a great concept, but do wonder how we can afford to pay for it.
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Old Mar 25th 2014, 2:58 am
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Default Re: Future of the NHS

Originally Posted by bigglesworth
I am not sure what the point of your reference to "big projects" is. When what the Left likes to call the GFC hit, most Western economies went into recession, with a consequent lack of demand. The Coalition rightly in my view continued the automatic stabilisers and actually increased the levels of many benefits.
The only possible conclusion from your remark is that you think the amount spend on capital expenditure should have been increased. Unless they simultaneously reduced the amount spent on the automatic stabilisers this would have raised the annual deficit substantially. It is very doubtful indeed that the markets would have accepted that.
You're being too harsh on Brown and somewhat too soft on the current coalition. The reality is more nuanced in that the deficit went up to the level it did almost completely because of the financial crisis, with the bailing out of the banks (which you're strangely silent about) being a major contributor.

Originally Posted by bigglesworth
I wonder how you will react next year when the EC rules that the debt incurred by the theft of Network Rail must be shown as a percentage of GDP. That will increase the proportion of capital spend, but will focus attention on the many little tricks Gordon Brown used to keep debt off the books.
An ill thought out privatization that Brown inherited from the prior Conservative government!
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Old Mar 25th 2014, 3:38 am
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Default Re: Future of the NHS

Originally Posted by bigglesworth
Economic cycles generally last between 15 and 17 years (leaving out supercycles), from high to high or low to low. We are therefore nearly half way through it, and have not even managed a stable budget yet. We have at most seven or eight years to not merely reduce the deficit but to pay down at least a sizeable part of the accumulated debts. A pretty tall order.
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Old Mar 25th 2014, 3:45 am
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Default Re: Future of the NHS

Originally Posted by Giantaxe
You're being too harsh on Brown and somewhat too soft on the current coalition. The reality is more nuanced in that the deficit went up to the level it did almost completely because of the financial crisis, with the bailing out of the banks (which you're strangely silent about) being a major contributor.
I would love to see thumbs up for those in favour and thumbs down for those against this statement. Then we would have a better understanding of the result of the next election.

Personally I can't think of a single thing that can be assigned to the current coalition that relates to the (upwards) size of the deficit - in fact, on the contrary.

We could have adopted the spend your way out of recession approach and the pound could have collapsed and interest rate rises could have made things even worse, but we just don't know.

What is more, the recession, which GB put nothing aside for because he was already running a sizable deficit, was made far worse by the condition of Continental Europe.

Skeptics, like me aside, there appears to be light at the end of the tunnel which I'm not sure could have been in any way entertained given an alternative (Balls) tack. What is more, this tack appears to be one most likely to see the UK beyond the short-term outlook. My biggest concern is that the quality of jobs is such that there is not enough in taxes being paid to sustain things like the NHS.

Last edited by Pistolpete2; Mar 25th 2014 at 3:50 am. Reason: which GB put nothing aside for
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Old Mar 25th 2014, 3:46 am
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Default Re: Future of the NHS

Originally Posted by chris955
I am a huge fan of the NHS and have had virtually no issues with it at all. We have great GP's in the village or in the next town so perhaps you were unlucky?
We might have been unlucky (the bad experiences that influence my view of the NHS include my husband and father's as well as my own). But, I think probably not.

To give the example of my husband: he consulted his UK GP several times about minor skin infections which would not clear up. He was prescribed creams which were useless, and on one occasions antibiotics which were inappropriate and which caused an allergic reaction. In Canada, his GP wanted to know why my husband kept getting these infections, and ordered a blood screen which picked up a serious underlying disease.

The difference between the two GPs could just be one of competence, but I think there is also a different culture. GPs in the UK act as gatekeepers to resources and are more reluctant to order tests.
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Old Mar 25th 2014, 3:54 am
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Default Re: Future of the NHS

Originally Posted by Pistolpete2
We could have adopted the spend your way out of recession approach and the pound could have collapsed
That part has been adopted by the Tories.

The pound has collapsed, mainly due to QE (started by Labour, continued by Tories). Budget deficit has been greatly higher each year of the ConDem government. The QE approach has not only failed, it's also given more money to banks (those who caused the problems in the first place) and taken away from people (who are in a continuing cost of living crisis that is getting worse and worse).
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Old Mar 25th 2014, 3:56 am
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Default Re: Future of the NHS

Originally Posted by Editha
We might have been unlucky (the bad experiences that influence my view of the NHS include my husband and father's as well as my own). But, I think probably not.

To give the example of my husband: he consulted his UK GP several times about minor skin infections which would not clear up. He was prescribed creams which were useless, and on one occasions antibiotics which were inappropriate and which caused an allergic reaction. In Canada, his GP wanted to know why my husband kept getting these infections, and ordered a blood screen which picked up a serious underlying disease.

The difference between the two GPs could just be one of competence, but I think there is also a different culture. GPs in the UK act as gatekeepers to resources and are more reluctant to order tests.
I have a sibling who has a very significant and ongoing over decades need for varied NHS services in London and she concurs with your opinions ref GPs today. For her they are a terrible and consistent let-down.
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