NHS 101 please!

[NorthernLight]

40% if you earn a reasonable amount- but not that much I think its about £34k and they take 40% it is scandalous

Well, since the average wage these days is around £25k most people probably don't have to worry about this terrible scandal, eh?
Also, you do realise that you only pay 40% on anything over the £34,600 threshold don't you? So the first 34,600 is taxed at 20% and then the rest at 40%.

Well, maybe some people disagree but I don't think it's scandalous.

[Sticks]

Singh Simran, I fear you are being a little optimistic. The state is taking steps to dismantle and privatize the NHS - within a generation, two at the most. The infrastructure for LIFTs (Local Improvement Finance Trusts) is already in place. These are essentially methods of channelling private investment into primary healthcare. They are the next phase of PFI for the NHS. I know this because I am involved with it at work on a daily basis - much to my regret.

If you look at the way the state has forced PCTs to go to private finance in order to obtain funding for infrastructural improvements - often at usurious rates - it's hard to avoid the conclusion that it is a deliberately run long-term project to destroy the NHS as a financially viable institution. The service is in debt to private organizations to the order of tens of billions of pounds. This is not a debt the government will service forever.

Sub-contraction is the reason why I say Tesco is the biggest threat to the NHS.

[Luci]

Does your insurance premium go up if you claim on it a lot in NL? ie does it cost more the iller you are?

no, it doesn't; thankfully.

I have seen many terms here that I don't understand at all..
PCT's
under budget
PFI
MP
MoD

could someone clarify these??

And tesco is a supermarket, right? why is it a threat?

[ben_]

PCTs - primary care trusts (NHS primary care trust - Wikipedia, the free encyclopedia)

under budget - you could probably work this one out, to be honest, but in our context it just means that the NHS has ended up costing less money than it was budgeted to for a particular financial year

PFI - private finance initiative. Basically private funding of public projects such as schools, hospitals, prisons etc.

MP - Member of Parliament

MoD - Ministry of Defence

[art-of-the-table]

All these arguments make one assumption: that private means bad and than public means good.

In reality, one cannot have an efficient service without some form of competition. In the 20th century the NHS was so inefficient that long waiting lists were plaguing it, doctors were themselves abusing the system by ensuring that waiting lists did not get cleared so that they could then treat the patients privately *the worst examples being ophthalmologists* etc etc. So anyone who thinks that a public NHS ia good cannot be right.

There is some good in the private sector, firstly that it encourages efficiency. Of course private also means profits, but to be honest, the NHS would just be wasting the money that the private sector would pocket as profit. Private also means better investments. You can borrow to invest; you don't have to wait until you have collected all your pennies to buy a new scanner. What is important though is that the move to a more privatised system is carried out with sufficiently checks in place to ensure that those profits are made through efficiency and not by cutting corners, which could be detrimental to patient care.

One has to keep a broad view of all of this. The old, free for all NHS might have been a good idea but it did not work.

[ben_]

The private sector is absolutely amazing at producing material goods efficiently and cheaply. When it comes to turning out 'widgets', you can't beat capitalism - and indeed this was a major factor behind the collapse of the planned economies. However I don't believe that healthcare really has the characteristics of a commodity like a television or a car. Treating it like it does runs the risk of a situation like that in the US where people are afraid to go to the doctor because they can't afford the fees if something is wrong with them, or where you only get health insurance if your employer gives it to you. Private provision will inevitably disadvantage the poor.

[BeanOfJelly]

Private healthcare is brilliant. Its clean, its cosy, everyone pays attention to you. The waiting lists... what waiting lists? Who could ask for anything better?

(If you can afford it that is)

I have a cat. Every now and again he gets hurt, and my parents debate whether or not they can afford to take him to the vet or whether they should chance it he gets better by himself. It disgusts me to think of people in a "civilised" and certainly wealthy country such as the US, that people have similar discussions about themselves.. or their elderly parents.. or their children.

People being afraid to go to the doctor because of financial worries/ not being able to afford chemotherapy (yes there are ppl in the US who just die because they cannot afford treatment) = people dying because of their financial status, not because of how sick they are. How can that not be wrong?

That's we why should be grateful for the NHS, and should protect it as one of the best institutions we have. Personally, I am more than happy to pay tax (which I can afford) so that someone else will go to the doctor about that (insert anything here) which they're sure is probably nothing but might just be something that could kill them

(I apologise for the rant)

[BeanOfJelly]

Private = out to make money. Its the nature of businesses. How does that help patient care? Surely it means they are more likely to cut corners.. rip off patients.. Take the pharmaceutical companies for example. You couldn't argue them as being a good example of private healthcare could you?
Or the trains services.. that once privatised determined how many safety precautions were necessary, by calculating the cost of implementing them against the cost of compensating the families of dead crash victims..
A public health service will always be better for the public, because it is paid for by and aims to serve the public, not its own financial interests.

(Once again, I apologise for my ranting)

[art-of-the-table]

Private = out to make money. Its the nature of businesses. How does that help patient care? Surely it means they are more likely to cut corners.. rip off patients..

(Once again, I apologise for my ranting)

Precisely because you assume taht making money = ripping people off.
The NHS is not oout to make money but they waste a lot of it. So assume that I have a budget of 100. I can spend all of it and provide an average service, OR provide a more efficient service for 95 and pocket 5 as profit. What is the problem with that? By allowing people to make profits you give an incentive to perform. That leads to better efficiency. However, one must of course make sure that this does not lead in a mad rush for profit at all cost and therefore lower quality of care. It is not as simple as black and white. It is a trade-off between the two which cannot easily be achieved. The free NHS as failed to deliver so time to think of new ways.

Under the old system a hospital would be given a budget of say £20m and be told to do their best. If I gave you some money and told you to make good use of it, you have no reason to try your absolute best. However if I told you that you would receive a bonus if you worked efficiently then you would work your ar*e off to perform well. Because of that you would probably achieve more and manage to save money in the process. That is the principle.

Still, whether you agree or not is not the issue here. At an interview, you need to show that you can debate these issues intelligently. There is no right or wrong answer. We will only know in 50 years time whether we took the right approach

[ben_]

Unfortunately what is the most efficient service in financial terms does not necessarily = best healthcare provision