Should the NHS change

[fallen-archie]

Don't know about others but on the odd occasion I have needed to go to my local hospital I have been astonished by how busy it is. In recent years demands placed on the NHS seem to have mushroomed leaving us with a service which is failing in many areas.
I admire those who founded the concept but can we save it for future generations or is it time to return to a system where only the successful can afford treatment?

[evoman3957]

I agree with you, if they continue to pay NI contributions here ( and those are the contributions I think should go wholly to the NHS ) then there is no Law / rules / regulations that says they can't retire to wherever they wish to. As with most things, it's a minority that tarnish the majority...............I hope you got your problem sorted out, by the way, and that you are now fighting fit.

[bookhunter2007]

---

@lhasa.one wrote:

---

Actually, reading the channel 4 fact check link doesn't really show a true picture, it would seem to me, as this government NHS link provides a huge list of charge exemptions along with reciprocal agreements with countries who are not necessarily EU members. 

http://www.legislation.gov.uk/uksi/2011/1556/made

Perhaps the government (NHS) could tighten up on getting their money back both from the reciprocal countries and also from those countries where there is no agreement.

---

Possibly, but then you'd have to take into account the amount of resources which are to be spent on clawback. The last thing the NHS needs are more funds spent on bean counters and lawyers chasing amounts that don't make that much of a difference in the big scheme of things.

Biggest challenge the NHS faces are from costs associated with treatment of long-term conditions, such as cancer, diabetes, mental health, & cardiovascular disease.

http://www.theguardian.com/society/2014/jan/03/nhs-overwhelmed-long-term-medical-conditions

Alot of these conditions are preventable, but problems arise when any initiative to drive prevention, or raise taxes on unhealthy products results in cries of "nanny state".

[lambsy_uk]

---

@evoman3957 wrote:

I know retired people ( including expats ) have paid into the system all their working lives ( at least I hope they have ) and as I said, should therefore be entitled to free treatment. However, I guess with them; it's this feeling that, at a time of their lives when they are practically guaranteed to have medical problems ( over one thing or another ) they chose to leave the Country, whose medical services they need so badly, to go and live elsewhere.

This may actually reduce the liklihood that they will require medical treatment if they are living in warmer climes. I just don't get this "How dare they" approach to them wishing to live elsewhere in retirement. The NHS serves the people not the country; they serve the people who paid for it not the country in which they live!

I agree they have earned the right to choose where they live and how they spend their Money, but as with everything in life.......with choices comes consequences........cause and effect....and all that.

Yes but there's no reason why the consequences should be anything more than the inconvenience of having to travel back here to access the service. Currently there are no prohibiting consequences and so why do you wish to introduce some?

Going back to the Car Insurance example, you pay to insure your Car to drive it in THIS Country; OK, most companies allow you a certain amount of cover abroad during that year. However, if you live broad and have an accident; you can't expect to bring your Car back here and have it fixed and paid for by an Insurance Company in THIS Country.

You can if you still have an existing policy which covers you to do so. Anyway this is comparing chalk with cheese; comparing annual motor insurance with life-long medical insurance. If they were living abroad but had valid medical cover from a private policy they had paid for to have treatment here, would you begrudge them of that?

Also, doesn't it seem just a little unfair; that expats spend all their money into the coffers of another Country ( including contributing to all it's amenities ) but come back here, when that Country falls short on the one thing that's most important t their age..........Health Care.

No it does not seem at all unfair to me but then I'm a very reasonable person! They have already paid into the coffers here during their working lives.

---

[lhasa.two]

---

@evoman3957 wrote:

I agree with you, if they continue to pay NI contributions here ( and those are the contributions I think should go wholly to the NHS ) then there is no Law / rules / regulations that says they can't retire to wherever they wish to. As with most things, it's a minority that tarnish the majority...............I hope you got your problem sorted out, by the way, and that you are now fighting fit.

---

Yes thanks, fighting fit - when I have the energy 

[evoman3957]

They say that the Star that burns twice as bright, burns half as long..........so from an energy point of view; we'll just keep a nice warm glow for a long time.

[lhasa.two]

---

@bookhunter2007 wrote:

---

Possibly, but then you'd have to take into account the amount of resources which are to be spent on clawback. The last thing the NHS needs are more funds spent on bean counters and lawyers chasing amounts that don't make that much of a difference in the big scheme of things.

Biggest challenge the NHS faces are from costs associated with treatment of long-term conditions, such as cancer, diabetes, mental health, & cardiovascular disease.

http://www.theguardian.com/society/2014/jan/03/nhs-overwhelmed-long-term-medical-conditions

Alot of these conditions are preventable, but problems arise when any initiative to drive prevention, or raise taxes on unhealthy products results in cries of "nanny state".

---

Yes agree about the bean counters as there are enough of those already within the existing NHS system.

Seems to me diet is where it should start, namely at home followed closely by education. We have a generation of younger people who don't know how to look after themselves or understanding the basic components of food. It's easier/quicker to buy something ready made without thinking about the longer term  consequences.

The Supermarket cartels need to take a long hard look at themselves but of course they won't because of their enormous profit incentives.  Ban fast food outlets, dreadful places!  I can't remember where I read it now as it was quite sometime back but there was an experiment in an area in California where they banned fast food outlets and monitored the health of a sample group both before the ban then about 4 months where the changes in their health were quite staggering.

[lambsy_uk]

---

@lhasa.one wrote:

---

Yes agree about the bean counters as there are enough of those already within the existing NHS system.

Seems to me diet is where it should start, namely at home followed closely by education. We have a generation of younger people who don't know how to look after themselves or understanding the basic components of food. It's easier/quicker to buy something ready made without thinking about the longer term  consequences.

The Supermarket cartels need to take a long hard look at themselves but of course they won't because of their enormous profit incentives.  Ban fast food outlets, dreadful places!  I can't remember where I read it now as it was quite sometime back but there was an experiment in an area in California where they banned fast food outlets and monitored the health of a sample group both before the ban then about 4 months where the changes in their health were quite staggering.

---

Nothing wrong with fast food outlets if used properly!

I don't believe diet related problems are as bad as some would have us believe, a lot is just typical media hype. There may be a significant number of kids who will struggle to look after themselves in later life but it is a minority.

Fast food outlets are not the problem, stupid people are their own problem!!!

[evoman3957]

Now there's a thought, which reasonable people can't take issue with............refuse all the STUPID People treatment ( especially the ones with self inflicted conditions ) Drug Addicts, Alcoholics, Compulsive Eaters, Smokers......................Pot Holers that go down when it's raining...........People over 60 who want to climb "Ben Nevis" in December ( Yes I've watched Helicopter Rescue )...........Problem solved NHS restored to it's former glory !!

[lambsy_uk]

Sounds good to me!

[bookhunter2007]

---

lhasa.one wrote

---

The Supermarket cartels need to take a long hard look at themselves but of course they won't because of their enormous profit incentives.  Ban fast food outlets, dreadful places!  I can't remember where I read it now as it was quite sometime back but there was an experiment in an area in California where they banned fast food outlets and monitored the health of a sample group both before the ban then about 4 months where the changes in their health were quite staggering.

---

Yes, fast food outlets are a problem. Not only via adding to obesity & other health problems, but the tax paid back into the system does not seem cover the damage.

The bonus (if you can call it that) with smoking is that the tax revenues offset the costs to the NHS. However, fast food outlets (e.g McD) employ people on minimal wages (topped up by tax credits), only to then dodge large amounts of Tax via creative - but "all within the rules" - accounting.  On the plus side, at least McDonalds bags & wrappers left strewn around the place are biodegradable on occasions.

---

@evoman3957 wrote:

Now there's a thought, which reasonable people can't take issue with............refuse all the STUPID People treatment ( especially the ones with self inflicted conditions ) Drug Addicts, Alcoholics, Compulsive Eaters, Smokers......................Pot Holers that go down when it's raining...........People over 60 who want to climb "Ben Nevis" in December ( Yes I've watched Helicopter Rescue )...........Problem solved NHS restored to it's former glory !!

---

Well, this unreasonable person thinks denying treatment to drug addicts and alcoholics will add 'costs' to other areas. In crude terms, it's more cost-effective a 'smackhead' is treated via methadone on NHS, rather than left to their own devices to raise their own funds through other means - burglary, sex-trade, etc.

Sometimes it's important to look at the value rather than the cost alone.

[bankhaunter]

When you start talking about not covering treatment for those who are considered the undeserving, you go down a very dangerous road.

"Sorry you will have to pay for the treatment needed for your leg ulcers as they were caused by damage you sustained playing cricket thirty years ago".

[bookhunter2007]

---

@bankhaunter wrote:

When you start talking about not covering treatment for those who are considered the undeserving, you go down a very dangerous road.

"Sorry you will have to pay for the treatment needed for your leg ulcers as they were caused by damage you sustained playing cricket thirty years ago".

---

Yes, especially when the political focus is on recouping costs via denial of treatment of *insert scapegoat here*, rather than other means. PFI interest rate repayments for instance, takes up a fair proportion of the budget of some local health authorities:

http://www.if.org.uk/archives/3453/new-figures-reveal-weight-of-pfi-burden-on-nhs-trusts

[fallen-archie]

Lots of views confirm the complexity of the NHS. Is it trying to do too much, should weekend partygoers who get bladdered and end up calling an Ambulance be charged. Should the police have the power (as they do) to take a much needed ambulance and crew out of service for hours because they witnessed a basic crime scene. Should hospitals be required to display directions and provide written guidance in a range of languages? Nobody wants to penalise the genuinely sick but how many of us know a hypochondriac, how many people block up the local surgery because they have a blocked nose or sore throat? The list is endless

[upthecreekyetagain]

A lot of posts are based on the erroneous idea that NI contributions pay for the NHS and therefore contributors are entitled to its services.

The sad truth is that NI payments are nowhere near enough to cover the cost of the NHS.

Last year the NHS budget was £137 billion but income from NI was just £107 billion, coincidentally the same as the cost of the state pension which is also "paid" for by NI contributions.

The simple truth is that we have an amazing health service which is not being paid for.but being funded almost entirely by borrowings.

[vamo48]

Very true. bankhaunter, a very dangerous road indeed.  It would be better to start by reducing waste in hospitals.  I know people employed by the NHS and have heard of many examples - perfectly good chairs being thrown out and replaced, a treatment room being kept heated and lit but empty, and staff being paid overtime to use it after their normal working hours, financial rewards being offered to any employee who can recruit a nurse, doubled if the nurse stays 6 months...  Too many managers who are not up to the job.  The higher up their career ladder they go, the further removed they are from real life.

[bhgardeners]

So you tell me how my son could have avoided diabetes?.  Be born to different parents?  Pity there is absolutely no history in either family of either type 1 or 2 diabetes.  

Mental illness?   maybe, maybe not - actually spending money on it earlier rather than waiting for meltdowns would be more cost-effective.

No easy answers are there.

[fallen-archie]

Commerce must spend billions on H&S equipment along with risk assessments, SOPs, training courses, in fact I cannot understand why this huge investment has not resulted in quieter A&E departments.
Also are we just becoming soft, unable to manage a hissing in the ear or a headache caused by bad posture. If you cut your finger is a trip to A&E really necessary?

[joe_bloggs*]

A few years ago I was visiting an elderly uncle in hospital,near the end of the visit a Chinese man in the next bed suddenly sat up shouting ************ (in Chinese) then slumped down,
On the way home I called into the local Chinese takeaway for sweet and sour chicken,I said by the way do you know what **************** means? She said yes "you're standing on my oxygen line"

[bankhaunter]

There is nothing soft about being unable to manage a constant whistling in the ears though admittedly going to A&E is unlikely to help, I've had it for a number of years and at times only a conscious effort stops me from screaming.

[fallen-archie]

Tinnitus is very irritating, As is Depression, both conditions are at best annoying and at worst life threatening. Sadly both are also used regularly describe much lesser problems often without foundation.