NHS 101 please!

**BeanOfJelly** · 18-11-2008, 03:35 AM

The NHS copes in that if I get hit by a car, they'll save my life without financially crippling my family. If I get cancer, I won't have to think about how much chemotherapy I should have based upon my income. If someone in your family gets sick, you won't have to choose a less effective treatment because you can't afford a decent one.* You don't have to have to have three jobs to pay for your kids diabetes medication.
(I know I'm being dramatic, not to mention you probably don't have diabetic children, but don't you see what I mean?)

*Or at least there was a time when this was true, before some people were made to pay (privately of course) for more expensive drugs just because of where they happen to live)

**NorthernLight** · 18-11-2008, 03:35 AM

Originally Posted by art-of-the-table

You can argue to death that the Private Sector is a load of tosh but no one can dispute that the NHS has not been able to cope.

Au contraire. I'm waiting for the evidence of the imminent collapse of the NHS, or examples of it failing to cope on a large scale.

**Arch_Angel** · 18-11-2008, 03:38 AM

Originally Posted by art-of-the-table

Arch-angel - Well done for understanding the principle of mortgaging. Of course you pay more, in the same way that you pay more for your house when you take a mortgage. But you have the ability to use the facilities straight away. Of course you could pay upfront, but you need to find the money for that (though, to counter this argument, one has to wonder why we didn't use the money spent in Iraq or to rescue the banks on the NHS in the first place.

I made it quite clear that the money could have been made available, if not the argument is a non-starter.

Try reading the post next time.

**art-of-the-table** · 18-11-2008, 04:25 AM

Originally Posted by NorthernLight

Au contraire. I'm waiting for the evidence of the imminent collapse of the NHS, or examples of it failing to cope on a large scale.

Okay, here is an example: An hearing test at St Helier's Hospital in Carshalton. Simple stuff. Waiting list 565 days. Almost 2 years!

The NHS will not collapse, but it can be really inefficient. This simple test could be done by any trained technician and the private sector can take that on for a fixed fee.

**art-of-the-table** · 18-11-2008, 04:27 AM

Originally Posted by BeanOfJelly

The NHS copes in that if I get hit by a car, they'll save my life without financially crippling my family. If I get cancer, I won't have to think about how much chemotherapy I should have based upon my income. If someone in your family gets sick, you won't have to choose a less effective treatment because you can't afford a decent one.* You don't have to have to have three jobs to pay for your kids diabetes medication.
(I know I'm being dramatic, not to mention you probably don't have diabetic children, but don't you see what I mean?)

*Or at least there was a time when this was true, before some people were made to pay (privately of course) for more expensive drugs just because of where they happen to live)

None of the services you mention are being privatised. A&E, cancer remain under the control of the NHS and were taken out of the competitive environment. The bulk of the stuff that is being privatised is the simple elective (i.e. non urgent) work

**art-of-the-table** · 18-11-2008, 04:28 AM

Originally Posted by Arch_Angel

Try reading the post next time.

Ooooh are you swinging your handbag now?

**Arch_Angel** · 18-11-2008, 04:36 AM

Originally Posted by art-of-the-table

Ooooh are you swinging your handbag now?

You essentially accused me of not understanding what a loan is...or at least to the point where I didn't recognise one when I saw one.

I, of course, did no such thing.

PFI is simply a way to pay for something seven times tomorrow what we could pay for once today. There are obvious benefits, but only in the same way borrowing from a loan shark has benefits. Small instant reward, long painful pay off.

Simply another example of short term thinking, which I thought would have been clear from my post....

....obviously not.

**art-of-the-table** · 18-11-2008, 11:55 AM

Originally Posted by Arch_Angel

You essentially accused me of not understanding what a loan is...or at least to the point where I didn't recognise one when I saw one.

I, of course, did no such thing.

PFI is simply a way to pay for something seven times tomorrow what we could pay for once today. There are obvious benefits, but only in the same way borrowing from a loan shark has benefits. Small instant reward, long painful pay off.

Simply another example of short term thinking, which I thought would have been clear from my post....

....obviously not.

Saying that you end up paying 7 times more is misleading and scaremongering if you don't put this figure in perspective.

Of course you will end up paying more, like for any mortgage. When you buy a house at normal interest rates you probably pay twice what you would have paid if you;d bought it cash. Official statistics show that the cost of PFI is 30% more than what it would have been if publicly funded. Still more money than would normally be spent, but with some added benefits.

Where some Trusts went wrong with PFI is that some of them had to borrow money to make the first repayments. And we all know what happens when you borrow money to repay existing debts. It's called the credit crunch. But that is not the case for everyone.

**Sticks** · 18-11-2008, 10:19 PM

What is the closing of A&E departments if not failure?

**art-of-the-table** · 19-11-2008, 12:38 AM

Originally Posted by Sticks

What is the closing of A&E departments if not failure?

OK I hear you but you must ensure that you think with your head rather than your heart (and remain critical about what you read in the papers). Here are several reasons why it is not necessarily a bad thing and why, in fact, may emergency doctors are in favour of the centralisation of A&E services. Consider them as a package rather than individually:

1 - The vast majority of emergencies are not life-threatening and therefore patients can travel slightly further without being endangered.

2 - When emergencies are life threatening, what matters most? That they are treated quickly but in a place which may not be fully equipped or slightly later but in a better centre? Many emergency doctors and the government believe that the skills of paramedics have sufficiently increased to enable patients to travel slightly further so that they can receive the best care possible. In fact it is the US system too. In the US you are not taken to the nearest hospital but to the hospital that is the best equipped for you in the area.

3 - If you spread services around too much, you limit the availability of skills. In other words, if you are taken in a bigger centre you are more likely to have all you need at your disposal, rather than having to be transferred later on.

4 - Centralising services means better training for doctors as they see many more cases.

So you see, it is not all bad. In fact, numbers being quoted around tend to say that only really 1 % of patients need absolutely immediate care but that the increased paramedic skills (e.g. being able to intubate patients at the road side) are enough to make the difference.

There are always several sides to consider and this is one of the areas where media hype is not helping. As mentioned earlier, most A&E physicians are actually in favour of the move for the above reasons.