Do you want to discuss boring politics? (18 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?

 

---

[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.

https://www.pulsetoday.co.uk/analysis/pulse-careers/the-human-toll-of-the-employment-crisis-on-newly-qualified-gps/

 

[PVA]

Such a grubby little man

Nigel Farage reported to police over 'election fraud' allegations​

The Reform UK leader, 61, has been accused of falsifying his election expenses during his successful bid to become an MP last year.

 

[ccfc1292]

Hilarious how Radio 1 reported the Heathrow incident as a scuffle etc, that the people knew each other....

 

[chiefdave]

Such a grubby little man

runs in the party it seems

Seaham Reform councillor's firm fined over illegal worker

Durham councillor Andrew Harrison says the worker was legal and he is appealing against the fine.

www.bbc.co.uk

 

[Sky_Blue_Dreamer]

We really ought to establish charges for GP, A&E and even overnight stays in hospitals. Prescription charges were introduced because demand was too high and people would get medicines they didn't need e.g. paracetamol.

A Government serious about 'fixing' healthcare provision in the UK needs to consider getting as many younger people on PHI and incentivised via employers or tax rebates and so on. This government is already doing by the back door by getting private sector practices to fill the gaps - at significant cost to the tax payer.

But have you thought that through?

You charge for GP, A+E etc. and what you're basically doing is making healthcare inaccessible for the people that are most likely to need it - the poor and the elderly. The elderly often need multiple appointments so how much are they going to have to spend.? Basically you're advocating a cull of the poor, the sick and the elderly because they won't have access to the necessary healthcare services. It becomes wealthcare, not healthcare.

And a lot of the private healthcare is by the same doctors and consultants in the NHS, so it's not like you're increasing capacity, you're just moving it from the NHS to private healthcare.

What would be the admin costs and bureaucracy associated with collecting these fees?

I agree that having the NHS free at the point of delivery does make people complacent about their health and healthcare and we need to do something about that. People who go out and get drunk/do drugs/get in fights on a night out. can do so knowing that they will be cared for without additional cost to themselves. People eat crap and don't do enough exercise or take care of their bodies and that results in huge healthcare costs down the line.

But I think just charging a flat fee for a doctors appointment or an A+E visit isn't going to help matters. Those most in need of help would just not get it and then they end up being an even bigger and costly problem down the line.

Missing an appointment without a very good reason - fair enough (though I disagree with them being taken off the list if they miss an appointment as again it's not thinking long term as to what the consequences would be.

Charging people who get admitted due to alcohol/drugs or for injuries caused while under the influence of them, again I think that would be fine. If they are admitted three times due to alcohol or drug related issues they have to accept enrolment in an alcohol/drug abuse programme.

It would be useful to also be able to charge people that go to the doctor for trivial ailments, but I think that needs a huge amount of thought as it could very easily result in some of the most vulnerable people being put in difficulty. I mean, how many of us have made an appointment with a doctor only for the problem to not be apparent in that brief 10 minute window? Maybe there could be a points system and if the person makes an appointment for something trivial they get points added to their record. Reach a certain number of points and you get fined. It would have to be a number of spurious appointments (say at least five) before the fines came in though. And I think you'd find that in cases where those fines came into play more often than not there would be some other issue, most likely mental or even just isolation and loneliness, that would be the cause.

 

[Sky_Blue_Dreamer]

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.

SOME employers offer PHI.

IMO ALL employers with large workforces should have to provide healthcare for their employees. If there are sites with lots of workers on even employing an onsite doctor. And the biggest selling point of that is the amount of money companies lose each year due to absenteeism, although there probably should be some form of tax break for both the individual and the business to incentivise it too.

And as I said elsewhere expanding the private sector doesn't increase capacity - it's the same doctors and consultants. So either they can't spend that time on private healthcare patients, meaning people still have to rely on the NHS, or they do spend that time with private healthcare meaning less people are seen on the NHS and the waiting lists don't go down.

 

[Sky_Blue_Dreamer]

lol - even though the budgets were never actually cut. 'The Left' blames everything on 'austerity' when in reality its been an exercise to reduce the rate public expenditure was increasing. The bigger issue is that public bodies are spending money like drunk sailors and there's usually v little accountability on where the money is going.

One such example is the NHS spent £1.3bn on decarbonisation and it's yielded no results. Or, the massive increase on middle managers on 5 figure salaries (e.g. Directors of DEI on £100k+).

Budgets going up below inflation while demand due to an increasing and ageing population getting ever higher. It's a reduction in the per patient spend and in effect austerity and in many cases over the last 15 years designed to further enable the creep of private healthcare. As I've said before you give private healthcare the scope and scale of the NHS and I guarantee it would be less effective in outcomes and less efficient in working than the NHS is.

A+E is now in the state it is because the elderly don't have access to the social care needed and they end up bed blocking. Similarly there are numerous people clogging up A+E who should be under mental health services but the funding for that has been slashed. A poster on here has highlighted the work their partner used to do in that sector until their funding was stopped and now the people they were responsible for are once again part of the problem.

No-one is saying the NHS was ever perfect, but it's got so much worse over the last decade or two partly due to the increase in demand but also because its funding hasn't kept pace. We're in this shit BECAUSE we didn't spend the money needed.

 

[Grendel]

SOME employers offer PHI.

IMO ALL employers with large workforces should have to provide healthcare for their employees. If there are sites with lots of workers on even employing an onsite doctor. And the biggest selling point of that is the amount of money companies lose each year due to absenteeism, although there probably should be some form of tax break for both the individual and the business to incentivise it too.

And as I said elsewhere expanding the private sector doesn't increase capacity - it's the same doctors and consultants. So either they can't spend that time on private healthcare patients, meaning people still have to rely on the NHS, or they do spend that time with private healthcare meaning less people are seen on the NHS and the waiting lists don't go down.

The take up would be negligible amongst most workers due to cost

 

[Sky_Blue_Dreamer]

The take up would be negligible amongst most workers due to cost

Not if it's provided free by the employer and you exempt it from any kind of BiK.

 

[Sky Blue Pete]

There’s loads across other social media Oete, it needs collating and cataloguing or it might just look a bit salty after a loss. I saw one list from a lady saying her grandson had lost teeth and others about being hit.

Police are on it

 

[fernandopartridge]

We really ought to establish charges for GP, A&E and even overnight stays in hospitals. Prescription charges were introduced because demand was too high and people would get medicines they didn't need e.g. paracetamol.

A Government serious about 'fixing' healthcare provision in the UK needs to consider getting as many younger people on PHI and incentivised via employers or tax rebates and so on. This government is already doing by the back door by getting private sector practices to fill the gaps - at significant cost to the tax payer.

Prescription charges were introduced purely because medicines are expensive. If it was about them being inappropriately prescribed it would be dealt with another way.

Charges for various services can sometimes be a false economy, e.g. Person cannot afford GP appointment, becomes seriously ill and requires urgent emergency care (this can and does happen and I have bitter first hand experience of it).

Why are you so keen for the government to subside the insurance industry?

How would this grand plan for employee PHI deal with the costs in the NHS which are mostly attributed to the ailments suffered by elderly people?

 

[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.

Try and sell your plan to a local SME, I'm sure they'll be buzzing about the VAT saving

 

[fernandopartridge]

She worked at the bank of England you know

UK households cut spending at fastest pace in almost five years, says Barclays

Bank reports 1.1% drop in card spending despite Black Friday boost for retailers

www.theguardian.com

 

[chiefdave]

Unwelcome, if not unexpected news

Covid scheme fraud hit almost £11bn but much 'beyond recovery', report says

The response to the pandemic led to "enormous outlays of public money which exposed it to the risk of fraud and error", a report says.

www.bbc.co.uk

 

[wingy]

Unwelcome, if not unexpected news

Covid scheme fraud hit almost £11bn but much 'beyond recovery', report says

The response to the pandemic led to "enormous outlays of public money which exposed it to the risk of fraud and error", a report says.

www.bbc.co.uk

Ah but that's on the BBC what are the others saying?

 

[fernandopartridge]

Good blog here on PFI which of course New Labour mkII wishes to revive

The UK Government's Plan to Resurrect the Public Finance Initiative (PFI) Is the Definition of Financial Insanity | naked capitalism

The Starmer government, desperate to keep its public borrowing in check, is bringing back (in the words of a senior City of London banker) a "fraud on the people."

www.nakedcapitalism.com