The NHS

[Remix]

Now, while this topic is aimed at our more British posters, anyone's free to comment on it.

I want to know what your opinions on this institution. What you think's good about it, what's bad, and what changes you'd make to it. For those interested it's relavent because for the first time it was instituted its budget isnt being increased in this financial year.

Since the good and bad to me are obvious (free healthcare weighed against it being massively expensive and its cost rising faster than inflation for various reasons), so I'm not going to comment too much on them and focus on the latter. Honestly, the system does need a bit of a retooling. While its more efficient and more affordability focused than it used to be, it's still insanely costly. The first thing I'd do is either reduce the prescription charge and remove the exemptions, or remove it all together. Now, while you might think that's a bad idea, let me explain why it's not. The prescription charge initally existed to dissuade people from going to see their GP to get a prescription and costing the government millions of pounds. This was quite an effective money spinner as it was funding roughly 25% of the NHS. However, after it was raised the amount of the NHS its been paying for has been droping substantially, mainly because if you're under 15; 16, 17 or 18 and in full time education; over 65; living off benefits; or are being treated for cancer (the list goes on by the way) you dont pay it. This is why some places in the UK (like Scotland) there is no charge for the items on a prescription, because the money made off it isn't worth it (and it makes people smugly content that they don't pay a damn thing for their tablets). What I'd do instead is drop the prescription charge, but make the patient pay for medicines they could just buy themself if they walked into a pharmacy (i.e. GSL and P medicines) and charge to see a GP. This would likely have two effects (other than reducing the amount of money spent on drugs). Firstly, sniveling hypochondriacs will waste less of GPs' time (getting kicked in the wallet repeatedly should help them gain common sence), or at least have to pay for aforementioned timewasting; and secondly people wouldn't go to the GP so often, and would instead see their friendly neighbourhood pharmacist. This would be good for two reasons; the first being that pharmacists would serve as a shitfilter to doctors (people with cold can be flogged an OTC drug to relieve their symptoms and told to fuck off, whereas someone who's actually ill can go see a doctor); and the second being that pharmacists would do something other than look at prescriptions to make sure that GP's havent done something stupid with their prescriptions (wrong dose, wrong time taken, not contraindicated...) and dispense drugs. We do get a lot of training which isnt put into practice if all we're doing is clinical checks and dispensing. I'd also give community pharmacists the ability to dispence generic drugs rather than branded ones if there's a choice (e.g. if a prescription says panadol, the pharmacist can dispense generic brand paracetamol instead), which is something a hospital pharmacist can do which a Community one cant.

Hospital visits shouldnt be paid for by the patient though, and the current measures for improving hospitals (both in efficiency and financially) that I know are both logical and I cant think of any improvements to them specifically at the moment.

 

[HBK-aholic]

I LOVE the NHS and people who bitch about it generally do my head in. Sure, it has some negatives, but show me an institution or company as large that doesn't. In fact, show me any institution or company that doesn't. My little girl was quite ill and was saved by those doctors - after that, how could anyone say the NHS isn't needed? Isn't useful? I'll be forever grateful to those who helped her, and me, and the millions of others whose lives are better because of them. This is the one place I believe we're so far above most other 'Western' countries, even America. You hear the scare stories, but I've stayed in hospital a few times and the doctors have always been polite, the wards clean. The scare stories I hear about Americans not getting treatment or not being able to afford insurance are what scare me the most.

 

[Morpheus101]

I am a British expat living in the US and I WISH we had an NHS equivalent over here. For all its faults, it's sole purpose is to treat the sick, rather than make a profit.

The US is a great country, but I'm not in favour of "for profit" healthcare. You cannot control whether or not you get sick, so it is naturally unfair to penalise those who cannot afford treatment, or who are uninsured (due to financial circumstances) or those who have not-so-great health insurance.

 

[Deexter Jorgan]

My issue is where the money is going, Im not going to bitch about the NHS service but the fact is the service needs improvement, more staff, more care, more doctors and Nurses.

I worked within the NHS for a couple of years in the IT department and what i saw within the trust was horrendous, CEO's taking money that should be implemented on doctors and nurses, Taking cars for rides to meetings that are given to on call doctors.

Six people doing the job of one CEO and all being paid around 40 k each is even more of a joke.

I'm happy the government is implementing a change in regards to the overall budget but they also need to look at why the NHS is in such financial trouble and I don't mean because the high amount of drunks that visit AE I mean actually look at why money has been spent and where it all is going not just cater to voters to get a quick rub in order to keep your party in power.

The fact is the overall state of the Public sector is financial debt and it isn't because of the banking system used, it's also because every department has abused the tax payers money, we have given the public sector a sizable amount of tax and it has been abused to no end even by our own goverment officials.

If an external audit is made in order to help bring areas such as the NHS in to a sizable project and something that could take care of the overall public and not just a big black whole that drains cash then maybe the country can get back into a good position financially and a good stance in the EU then maybe we'll thrive, and I don't mean by cutting staff, I mean by cutting the guys in charge who do nothing at their desks and abuse the system. Hopefully the government will listen one day but i doubt it.

 

[CardiffCam]

I love the NHS, tbh. It means anyone, from a tra mp on the street, can go to the hospital without worrying. Hospitals should be about helping, not busisness.
And over here in Wales, perscriptions are 100% free.
Its a great feeling knowing you can go to the doctors for the most trivial thing without having to pay a penny.
For instance, I had transientosteoporoisis in my foot last year, and to work that out, i went through about 3 x-rays, a bone scan, and an mri scan. Though i did pay for the mri, going private to avoid 2 mobnths of waiting, it would ahve been even more expensive to have payed for it all, so thankyou NHS.

 

[Remix]

I LOVE the NHS and people who bitch about it generally do my head in. Sure, it has some negatives, but show me an institution or company as large that doesn't. In fact, show me any institution or company that doesn't. My little girl was quite ill and was saved by those doctors - after that, how could anyone say the NHS isn't needed? Isn't useful? I'll be forever grateful to those who helped her, and me, and the millions of others whose lives are better because of them. This is the one place I believe we're so far above most other 'Western' countries, even America. You hear the scare stories, but I've stayed in hospital a few times and the doctors have always been polite, the wards clean. The scare stories I hear about Americans not getting treatment or not being able to afford insurance are what scare me the most.

I love the NHS aswell. It's a great idea and a better public service. Not to mention that off the top of my head my little brother, my Dad and my Uncle can all testify to its greatness (well, my Dad can't but that's because he's got Parkinson's). And I'm probably going to be working for the NHS when I'm qualified and registered.

Also it's interesting that you're advocating that the NHS is great Becca. Leeds is one of the many places in the country where there arent enough hospitals (not a slur, a fact), though they are getting closer to having as many hospitals as they need. I also hope that your little girl has a happy and healthy life.

My issue is where the money is going, Im not going to bitch about the NHS service but the fact is the service needs improvement, more staff, more care, more doctors and Nurses.

I can tell you where the money's going it you like. In 2005 £80 billion was spent on the NHS which was spend as follows: 69% on salaries, 14% on medicines, 6% on equipment, 5% on buildings, 2% on litigation and 4% on miscelaneous stuff (no idea what that would cover). So the vast majority of NHS money goes exactly where you say more needs to be spent. The only way to afford more doctors nurses and pharmacists (dont overlook them) is by either spending even more money on the NHS, or by reducing spending in one of the other areas (most of which would be near damn impossible to reduce).

I worked within the NHS for a couple of years in the IT department and what i saw within the trust was horrendous, CEO's taking money that should be implemented on doctors and nurses, Taking cars for rides to meetings that are given to on call doctors.

Six people doing the job of one CEO and all being paid around 40 k each is even more of a joke.

The last bit is rediculous, I agree. However having actual administrators in a hospital is better than having doctors and nurses who havent been trained as administrators in charge of the money. Now, at least you know where the money's being spent.

I'm happy the government is implementing a change in regards to the overall budget

The government has been implimenting change since the NHS was introduced, mainly because having a black hole that comes in over budget every year isnt something that polititions are too fond of.

but they also need to look at why the NHS is in such financial trouble and I don't mean because the high amount of drunks that visit AE I mean actually look at why money has been spent and where it all is going not just cater to voters to get a quick rub in order to keep your party in power.

well I've dealt with your last point (where the fuck the money's going), and the reason that the NHS is consistently over budget is because every year something new is invented which the NHS needs to buy, test, or use in its hospitals, and as these new things become available more profecionals which know how to use them are needed (e.g. radiographers, physiotheropists, OTs, SLTs, psychologists etc).

If an external audit is made...

there's an external audit every year. coincidentally audits are where those CEOs come into their own. Doctors cant always fill out prescriptions properly. How do you expect them to have records of everything for an audit? (see: here)

...in order to help bring areas such as the NHS in to a sizable project

It's damn hard to make the NHS into a sizable project, since new things that its got to pay for go up every year, as does the age of people that its caring for and the size of the population. Given that hospitals are becoming more efficient and PCTs are sending fewer people to hospitals (and being very budget concious in general)

something that could take care of the overall public

if there's something that the NHS does well, it's this.

and not just a big black hole that drains cash then maybe the country can get back into a good position financially and a good stance in the EU then maybe we'll thrive

The NHS is indeed a black hole, but there's no way to feasibly reduce its size. The population's not going to suddenly shrink, and people are going to live longer (and you can probably thank the NHS for both of those) and require more care. The only way to reduce the cost to the tax payer is to reduce the cost of care (say, keeping people in hospitals for a day less than currently), or to make the customers pay for more services (which kind of defeats the purpose of the NHS, though it's inevitably going to be done)

and I don't mean by cutting staff, I mean by cutting the guys in charge who do nothing at their desks and abuse the system. Hopefully the government will listen one day but i doubt it.

The pencil pushing beurocrats are needed (ironically) for an efficient NHS, so they're pretty much untouchable (unfortunately). Cutting unneeded staff would be a good way to reduce costs though. If a ward can get by with fewer nurses, then fire the unneeded ones.

one way that you could reduce the amount that the NHS spends is to visit your friendly neighbourhood pharmacist as your first port of call not your GP. We cost the NHS less than GPs.