Do you want to discuss boring politics? (31 Viewers)

[Brighton Sky Blue]

Look at how France manage it. It's capped at a low level so it's not exclusionary but equally, stops overconsumption of services.

Continually bringing up the boogeyman of US style, purely privatised healthcare is genuine barrier to reform and risks the long term future of the NHS imo.

For example, I'm happy for prescription style exemptions/refunds be in place for pensioners, children, low/no income individuals.

There’s a separate thing I find interesting about the idea of asking employers to fund PHI instead. Surely the more business friendly approach is to say that the state covers healthcare costs so businesses don’t have to?

Is your thinking that people are spending more time in hospital than medically necessary?

 

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[Mucca Mad Boys]

There’s a separate thing I find interesting about the idea of asking employers to fund PHI instead. Surely the more business friendly approach is to say that the state covers healthcare costs so businesses don’t have to?

Is your thinking that people are spending more time in hospital than medically necessary?

Employers already do offer PHI, my current role has PHI and my next role does. My view point is to incentivise PHI by scrapping VAT on it and to give tax breaks to businesses, self-employed and individuals who get PHI.

The idea is twofold; expand the private sector and get less people relying on long NHS waiting lists.

Which again makes it all the more stupid that benefits in kind and salary sacrifice schemes are going to taxed more from 2029.

 

[SBT]

Is your thinking that people are spending more time in hospital than medically necessary?

I mean, of course they do in some cases.

There is without a doubt contempt for these people that will inform some people’s feelings on this, but the real question is whether the costs they incur outweigh the costs of dissuading people from seeking medical care that they might actually need.

 

[Brighton Sky Blue]

Employers already do offer PHI, my current role has PHI and my next role does. My view point is to incentivise PHI by scrapping VAT on it and to give tax breaks to businesses, self-employed and individuals who get PHI.

The idea is twofold; expand the private sector and get less people relying on long NHS waiting lists.

Which again makes it all the more stupid that benefits in kind and salary sacrifice schemes are going to taxed more from 2029.

That’s their choice in part made possible by offering inferior pension schemes, but you’re still effectively asking the state to cover health insurance costs through a third party. Why the need for a middle man?

 

[skybluetony176]

About 28 million people attended A&E in the UK last year. Charging people £10 a visit in some moronic idea it will possibly stop 200K possibly attending A&E to improve everyone else’s experience is for the birds. Aside from the fact that 200K is not even trimming around the edges you’re not going to stop 200K because people will still come and pay it. Then there’s the wider issue that poverty and health are intrinsically linked. Here’s a statistic for the experts on here, 14 million. 14 million is the number of people living in the UK with health issues linked to poverty. Now try engaging your brain, not even your heart, just your brain. Is charging £10 a visit going to deter the 200k who don’t need to attend A&E or the potentially 14 million people living in poverty with health conditions and a far higher likelihood of needing A&E.

It boils down to what kind of country you want to live in. A compassionate country with free healthcare or a fucked up place like the US.

 

[Ccfcisparks]

About 28 million people attended A&E in the UK last year. Charging people £10 a visit in some moronic idea it will possibly stop 200K possibly attending A&E to improve everyone else’s experience is for the birds. Aside from the fact that 200K is not even trimming around the edges you’re not going to stop 200K because people will still come and pay it. Then there’s the wider issue that poverty and health are intrinsically linked. Here’s a statistic for the experts on here, 14 million. 14 million is the number of people living in the UK with health issues linked to poverty. Now try engaging your brain, not even your heart, just your brain. Is charging £10 a visit going to deter the 200k who don’t need to attend A&E or the potentially 14 million people living in poverty with health conditions and a far higher likelihood of needing A&E.

It boils down to what kind of country you want to live in. A compassionate country with free healthcare or a fucked up place like the US.

Tonester where have you pulled this 200k figure from?

 

[Grendel]

There’s a separate thing I find interesting about the idea of asking employers to fund PHI instead. Surely the more business friendly approach is to say that the state covers healthcare costs so businesses don’t have to?

Is your thinking that people are spending more time in hospital than medically necessary?

On that basis then you must say that the state to should pensions for everyone and private companies shouldn’t have to?

 

[Grendel]

About 28 million people attended A&E in the UK last year. Charging people £10 a visit in some moronic idea it will possibly stop 200K possibly attending A&E to improve everyone else’s experience is for the birds. Aside from the fact that 200K is not even trimming around the edges you’re not going to stop 200K because people will still come and pay it. Then there’s the wider issue that poverty and health are intrinsically linked. Here’s a statistic for the experts on here, 14 million. 14 million is the number of people living in the UK with health issues linked to poverty. Now try engaging your brain, not even your heart, just your brain. Is charging £10 a visit going to deter the 200k who don’t need to attend A&E or the potentially 14 million people living in poverty with health conditions and a far higher likelihood of needing A&E.

It boils down to what kind of country you want to live in. A compassionate country with free healthcare or a fucked up place like the US.

I think you’ve had a bang on the head Tonester - I suggest you go to A and E

 

[Grendel]

Tonester where have you pulled this 200k figure from?

More to the point how does he correlate that 14 million people visit as they have health issues linked to poverty? Cant they see a GP as they can’t afford the bus fare?

 

[fernandopartridge]

It’s incredible when you look at it

NHS England » A&Es under siege from hiccups and ingrowing toenails

NHS England » A&Es under siege from hiccups and ingrowing toenails

www.england.nhs.uk

I think that's NHSE saying "don't blame us for the unending decline of the NHS since we got hold of it"

 

[Grendel]

I think that's NHSE saying "don't blame us for the unending decline of the NHS since we got hold of it"

I must admit the only other time I had to go was in 2001 and it wasn’t great then either

 

[fernandopartridge]

That press release has got Wesley Streeting written all over it, absolutely his MO.

I don't disagree that some people will attend A&E when they don't need to, it was ever thus. What that press release does not address is the elephant in the room, which is the complete failure to keep GP FTEs up with the size of the patient lists, despite there being more than enough graduates applying.

 

[PVA]

I was speaking to a bloke the other day who lives in Melton Mowbray.

He said there's only one GP surgery in the town, with something like 30k patients! It's the largest 1 practice town in the country apparently.

You currently get offered appointments for March!!

 

[fernandopartridge]

I was speaking to a bloke the other day who lives in Melton Mowbray.

He said there's only one GP surgery in the town, with something like 30k patients! It's the largest 1 practice town in the country apparently.

You currently get offered appointments for March!!

Yeah, I think the average list size is ~ 10k

I think that in time it's probably likely that primary care becomes a privatised service (it's already run by private practices) but I can genuinely foresee that it will be funded privately too.

 

[chiefdave]

A simple charge of £10 per A&E visit should suffice

It's like the whole £10 'no show' fee the Tories tried to introduce, if you just charged that for a GP appointment, who cares if someone turns up or not?

Sounds simple in practice, how would it work in reality. Firstly who is responsible for the administration of this charge and how much does doing that admin cost. What happens if people can't / won't pay, does an expensive debt recovery process start for the sake of £10? Presumably you can't just ignore non-payment or nobody will pay.

What happens if someone who needs treatment turns up at A&E but they've got outstanding payments?

How about people with ongoing health issues who need multiple appointments a month, are they exempt?

Same with pensioners, are you going to add the charge on for them. When I can get a GP appointment a very high percentage of people attending appear to be pensioners.

What about people on benefits, are they exempt?

I can absolutely see the point of it but I don't see how it can work effectively. You can't refuse people treatment so non-payment will be rampant.

 

[chiefdave]

I think that in time it's probably likely that primary care becomes a privatised service (it's already run by private practices) but I can genuinely foresee that it will be funded privately too.

When I go to pick up my prescription there's an ad playing for 'be seen immediately, private GP appointments at £65 a go.

If I go on to the app my surgery uses for basic admin it pushes a similar service. Not hard to see the direction that GPs want to push things in.

 

[fernandopartridge]

When I go to pick up my prescription there's an ad playing for 'be seen immediately, private GP appointments at £65 a go.

If I go on to the app my surgery uses for basic admin it pushes a similar service. Not hard to see the direction that GPs want to push things in.

I don't think it is the direction GPs necessarily want to go in TBF. NHSE has created a range of new posts described as medical associate professionals (MAPs) these are not qualified doctors or people with a medical degree. They provide funding specifically to employ these roles whilst not recruiting GPs.

Perhaps the plan is for a poverty NHS primary care service provided by these people with GPs reserved only for those who pay.

 

[fernandopartridge]

It's pretty normal in social insurance based systems (e.g. France/Germany) to have symbolic charges in place. Like most things that are completely FOC, people take the piss.

It's like the whole £10 'no show' fee the Tories tried to introduce, if you just charged that for a GP appointment, who cares if someone turns up or not?

It still doesn't solve the capacity issue of a full appointment book does it?

 

[fernandopartridge]

Employers already do offer PHI, my current role has PHI and my next role does. My view point is to incentivise PHI by scrapping VAT on it and to give tax breaks to businesses, self-employed and individuals who get PHI.

The idea is twofold; expand the private sector and get less people relying on long NHS waiting lists.

Which again makes it all the more stupid that benefits in kind and salary sacrifice schemes are going to taxed more from 2029.

There is no major private sector capacity that is untapped waiting to be used

 

[chiefdave]

I don't think it is the direction GPs necessarily want to go in TBF. NHSE has created a range of new posts described as medical associate professionals (MAPs) these are not qualified doctors or people with a medical degree. They provide funding specifically to employ these roles whilst not recruiting GPs.

Perhaps the plan is for a poverty NHS primary care service provided by these people with GPs reserved only for those who pay.

They have these at my surgery and give you no indication you are seeing on of those rather than a qualified GP. Unless you hit the point of them telling you 'I can't do that, you need to see a GP'.

Read an article a while back that we now have qualified GPs struggling to get jobs because surgeries would rather take on MAPs, who they get funding for, rather than GPs.

System is a mess.