British Expats

British Expats (https://britishexpats.com/forum/)
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-   -   Future of the NHS (https://britishexpats.com/forum/rovers-return-111/future-nhs-829043/)

roaringmouse Mar 31st 2014 12:04 am

Re: Future of the NHS
 

Originally Posted by Bud the Wiser (Post 11197899)
Planting the seeds of a co-pay/deductible system?

http://www.telegraph.co.uk/health/he...-suggests.html

The approach suggested is a bit ridiculous, as people already pay a "membership" fee in the form of income tax.

Pistolpete2 Mar 31st 2014 12:11 am

Re: Future of the NHS
 

Originally Posted by roaringmouse (Post 11197937)
The approach suggested is a bit ridiculous, as people already pay a "membership" fee in the form of income tax.

What portion of the population actually pay income tax? Plus, I would hazard a guess that those who don't are the biggest users of the NHS, so being a contributor isn't a pre-requisite to being a user.

Wasn't this the whole reason that there was an under-current suggesting that ALL-COMERS should have access to basic services as a basic human right as they in fact pretty much NOW do.

Pistolpete2 Mar 31st 2014 12:21 am

Re: Future of the NHS
 

Originally Posted by Bud the Wiser (Post 11197899)
Planting the seeds of a co-pay/deductible system?

http://www.telegraph.co.uk/health/he...-suggests.html

Reading of the plans in the Guardian, because I can't access the DT until April Fools Day ;), it seems the thrust of this is to provide funding for local council programmes to generally enhance health awareness and change bad health habits, to ultimately reduce demand for services. Selling it any other way would be perceived as just another POLL TAX.

Bud the Wiser Mar 31st 2014 1:01 am

Re: Future of the NHS
 

Originally Posted by roaringmouse (Post 11197937)
The approach suggested is a bit ridiculous, as people already pay a "membership" fee in the form of income tax.

Is it any different from when they introduced prescription charges? I wonder if there are records kept between the amount of prescriptions written and the amount that are actually paid for, not including exempt from payment prescriptions.

An attempt to reduce demand for services as Pete pointed out, maybe?

roaringmouse Mar 31st 2014 1:56 am

Re: Future of the NHS
 

Originally Posted by Bud the Wiser (Post 11198019)
Is it any different from when they introduced prescription charges?

Not all parts of the UK charge for prescriptions.

roaringmouse Mar 31st 2014 2:00 am

Re: Future of the NHS
 

Originally Posted by Pistolpete2 (Post 11197942)
What portion of the population actually pay income tax? Plus, I would hazard a guess that those who don't are the biggest users of the NHS, so being a contributor isn't a pre-requisite to being a user.

Indeed, which is why I think the suggested "membership" fee is ridiculous, as the health service is already provided by taxation. A membership fee is not the same as a "co-pay" approach - membership, if you will, is currently derived from residence.

Suggesting that people who reside in the UK but do not pay income tax are not entitled to NHS treatment, is the same as saying such people are not entitled to be defended during a war on the UK. Both health and defence in the UK are paid for primarily via taxation.

Pistolpete2 Mar 31st 2014 2:14 am

Re: Future of the NHS
 

Originally Posted by roaringmouse (Post 11198105)

Suggesting that people who reside in the UK but do not pay income tax are not entitled to NHS treatment, is the same as saying such people are not entitled to be defended during a war on the UK. Both health and defence in the UK are paid for primarily via taxation.

But in fact, as I have intimated, it is now the other way around. Since contributing is not in of itself the pre-requisite to current 'membership', there is no reason why the NHS should not be available to all-comers, namely visitors too, up to a point.

Therefore we have reached a state where the already over-burdened facility is to become ever more over-burdened, without any further contribution to support it, which hardly makes sense.

Hence Lord Warner's input.

rebs Mar 31st 2014 2:19 am

Re: Future of the NHS
 

Originally Posted by Pistolpete2 (Post 11198122)
But in fact, as I have intimated, it is now the other way around. Since contributing is not in of itself the pre-requisite to current 'membership', there is no reason why the NHS should not be available to all-comers, namely visitors too, up to a point.

Therefore we have reached a state where the already over-burdened facility is to become ever more over-burdened, without any further contribution to support it, which hardly makes sense.

Hence Lord Warner's input.

I disagree with your assessment of the current situation - 'membership' is currently based on permanent residence, so not 'open to all comers'.

Editha Mar 31st 2014 2:20 am

Re: Future of the NHS
 
That's only a think tank piece. I think it is misleading to call it a 'plan'.

Pistolpete2 Mar 31st 2014 2:23 am

Re: Future of the NHS
 

Originally Posted by rebs (Post 11198130)
I disagree with your assessment of the current situation - 'membership' is currently based on permanent residence, so not 'open to all comers'.

ANYBODY can get an appointment to see an NHS GP, assuming he has space. We've had NHS-related discussion on here umpteen times and I've posted the NHS link regarding access for Visitors on almost every related thread.

On top of this, UK State pensioners typically don't have to be resident to gain most of full-service treatment.

Giantaxe Mar 31st 2014 2:44 am

Re: Future of the NHS
 

Originally Posted by Pistolpete2 (Post 11197951)
Reading of the plans in the Guardian, because I can't access the DT until April Fools Day ;), it seems the thrust of this is to provide funding for local council programmes to generally enhance health awareness and change bad health habits, to ultimately reduce demand for services. Selling it any other way would be perceived as just another POLL TAX.

It would be hard for it to be perceived as anything but a "poll tax", especially as its effect would be more pronounced on those with the lowest income.

dunroving Mar 31st 2014 3:02 am

Re: Future of the NHS
 

Originally Posted by Bud the Wiser (Post 11198019)
Is it any different from when they introduced prescription charges? I wonder if there are records kept between the amount of prescriptions written and the amount that are actually paid for, not including exempt from payment prescriptions.

An attempt to reduce demand for services as Pete pointed out, maybe?

Off the top of my head from hearing this discussed frequently on the news, in England, I think it is something like less than 20% of people who pay prescription charges.

Bud the Wiser Mar 31st 2014 4:41 am

Re: Future of the NHS
 

Originally Posted by dunroving (Post 11198199)
Off the top of my head from hearing this discussed frequently on the news, in England, I think it is something like less than 20% of people who pay prescription charges.

I probably didn't phrase that to well. What I meant was, " I wonder what percentage of those who HAVE to pay for prescriptions, don't go and get them because of the cost." In other words, has the prescription charge been, for some, a deterrent to using NHS resources.

Subsequently, would a mandatory £10 GP visit make people think twice about using the service if they felt their aliment didn't really necessitate a doctors visit and they could self medicate with over the counter medication?

rebs Mar 31st 2014 4:48 am

Re: Future of the NHS
 

Originally Posted by Bud the Wiser (Post 11198324)
I probably didn't phrase that to well. What I meant was, " I wonder what percentage of those who HAVE to pay for prescriptions, don't go and get them because of the cost." In other words, has the prescription charge been, for some, a deterrent to using NHS resources.

Subsequently, would a mandatory £10 GP visit make people think twice about using the service if they felt their aliment didn't really necessitate a doctors visit and they could self medicate with over the counter medication?

I don't know what the figures might be, but I was listening to a piece on the radio recently that suggested that people were rationing their medicines (maybe taking lower doses than prescribed) due to the costs. It was also talking about prescribing styles of doctors - whether they were more often prescribing only a month's supply for example rather than 3 months, and whether doctors in Scotland (with no prescription charges) operated differently.

Editha Mar 31st 2014 4:53 am

Re: Future of the NHS
 

Originally Posted by dunroving (Post 11198199)
Off the top of my head from hearing this discussed frequently on the news, in England, I think it is something like less than 20% of people who pay prescription charges.

When I was in the UK, I was exempt from paying prescription charges just because I have hypothyroidism, which is a chronic condition. The irony was that levothyroxine which is prescribed is very cheap, but I also suffer from migraine, which is not classed as a chronic condition (even though it can be) and the prescribed medicine for that -- triptans -- is horrendously expensive.

As far as I can see, the £10 levy suggested would fall mostly on the employed, who use NHS services the least. But, within that class it would be a regressive tax. Council tax is already inequitable because of the absence of higher value bands, which mean that millionaires get a very good deal. The £10 levy would make it worse. Then you can add the difficulty of making sure councils spend the money wisely. I don't think this idea is going to prove attractive to anyone, other than physical fitness trainers, life counsellors, and other people creating careers out of the self-improvement movement who see an opportunity for government sponsorship.

It's also unclear to me how a £10 per annum charge is supposed to cover a health "MOT" for anyone of working age. Currently, the NHS provides relatively limited screening and check-ups, compared with other countries, because they've been regarded as of limited value and uneconomic, so this turnaround would involve a significant change of culture. But, it is difficult to see how it would save the NHS money.


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