Brexit

[tonyw]

To be fair....even as a staunch remainer, it's fair to say that this BMW story has been blown out of proportion.

They always have an annual shutdown; they've just brought it forward for 2019 so that they can use that time to take stock of the implications of Brexit (which - especially in the case of a No Deal Brexit - are rather challenging to predict).

Looks simply like a sound 'Wait and See' business decision to me.....

 

[Marked Ox]

https://www.theguardian.com/politic...-radical-plan-for-us-uk-brexit-trade-deal-nhs

Not a surprise that one of the cretinous leavers, Daniel Hannan's think-tank would want this considering his clear hatred of the NHS. Also not surprised Liam Fox is involved either.

I'm not suggesting this is representative of the mainstream view of leavers but would you accept the NHS being opened up like this as a result of Brexit?

 

[Essexyellows]

Everything is fine.

https://twitter.com/x/status/1042020675500826625

Nothing to do with electric Mini`s or similar refurb work then?

 

[Essexyellows]

https://www.theguardian.com/politic...-radical-plan-for-us-uk-brexit-trade-deal-nhs

Not a surprise that one of the cretinous leavers, Daniel Hannan's think-tank would want this considering his clear hatred of the NHS. Also not surprised Liam Fox is involved either.

I'm not suggesting this is representative of the mainstream view of leavers but would you accept the NHS being opened up like this as a result of Brexit?

The NHS HAS to change & throwing money at it isn`t the answer.
I speak from working in it & the waste/unnecessary spend is staggering.
My wife recently had her hip replaced at a private hospital (waiting list management plan), the comparison in efficiency and management was staggering.
Of course nobody dares touch the NHS so it remains like the British Leyland of its day................

 

[Marked Ox]

The NHS HAS to change & throwing money at it isn`t the answer.
I speak from working in it & the waste/unnecessary spend is staggering.
My wife recently had her hip replaced at a private hospital (waiting list management plan), the comparison in efficiency and management was staggering.
Of course nobody dares touch the NHS so it remains like the British Leyland of its day................

But would you want it opened up to the cheapest bidder which would be the very likely outcome in this case?

I wouldn't want any change in the NHS being planned or implemented with the likes of Hannan or Fox anywhere near it.

That said it does need changes but the start of that is to take it out of being a political football. Set up a Parliamentary cross party body to overlook it, give it a longer-term budget (ie. 10 years minimum) and let it manage/change for this over the mid to long term.

Councils and the NHS have been arguing for longer term budgets since the 90s (if not before) so they can properly change their organisations over time proactively rather than reactively. The annual budget system means these public bodies are always playing catch-up and having to react stopping proper planning. The annual system effectively encourages just slicing a little off each budget rather than fundamentally reviewing the organisation, one of my bugbears when working for a Council. Just look at the annual battles to make savings against people campaigning to keep services open in the Oxford Mail.

 

[Essexyellows]

That said it does need changes but the start of that is to take it out of being a political football. Set up a Parliamentary cross party body to overlook it, give it a longer-term budget (ie. 10 years minimum) and let it manage/change for this over the mid to long term.

This is the sensible answer.
Unfortunately it will never happen as "We will look after the NHS" wins votes.....and then they do the opposite when in power.

 

[Essexyellows]

I should add, my wife was funded by the NHS to have her treatment done privately. That cost roughly £16,000 all in.
The reasoning is that the punitive "fines" for breaching waiting list targets cost the Trust more than outsourcing a relatively simple procedure. She was operated on on Tuesday & home on Thursday, although the package included a 3 night hospital stay so Spire Healthcare made a saving straight off!
The "easy stuff" is easily outsourced............ but that leaves the NHS to pick up all the complex (and very costly!) stuff.

 

[ZeroTheHero]

The NHS is an endless conundrum. It's not only the ageing population, but also the increasingly complex, personalised and expensive treatments that medical advances have made possible. IMO there will never be a time when the NHS will be able to afford to provide all of these services. So there has to be rationing (however you dress that up) - distressing as that will be to those who have hugely complex/uncommon/expensive needs. I'd like to see there being more concentration on preventative medicine where possible (I am sure they are doing as much as they can though). But I would hate to see the baby being thrown out with the bathwater - the NHS is a wonderful, if flawed, organisation. Privatising the whole thing (or the more 'profitable' parts of it) would not improve health care provision for the vast majority of us.

 

[Marked Ox]

I should add, my wife was funded by the NHS to have her treatment done privately. That cost roughly £16,000 all in.
The reasoning is that the punitive "fines" for breaching waiting list targets cost the Trust more than outsourcing a relatively simple procedure. She was operated on on Tuesday & home on Thursday, although the package included a 3 night hospital stay so Spire Healthcare made a saving straight off!
The "easy stuff" is easily outsourced............ but that leaves the NHS to pick up all the complex (and very costly!) stuff.

That last part would be me and I dread to think how much I've cost the NHS over the years but at least well over £1m. At least I'm repaying it slightly by being sufficiently weird that I'm contributing to medical/science research.

 

[Marked Ox]

This is the sensible answer.
Unfortunately it will never happen as "We will look after the NHS" wins votes.....and then they do the opposite when in power.

There is some hope as there is significant and growing support for a cross party commission from all parties. Hammond as Chancellor is not against a long term budget for the NHS although it would require any following to continue which is where the problem may be.

 

[Essexyellows]

From a personal perspective there are lots of things the NHS should NOT fund.
Fertility treatment/IVF.
Treatment for the clinically obese/smokers where their life style choice has caused their ill health.
Any form of cosmetic surgery or the consequences thereof.

Sounds harsh but it would wake up a lot of folk to "rationing & responsibility".

 

[m]

.... the NHS should NOT fund.
....Treatment for the clinically obese/smokers where their life style choice has caused their ill health.

Difficult one this, where do you draw the line?

Should a footballer injured while playing be treated?

A cyclist? A driver?

 

[Gary Baldi]

Someone needs to define what the NHS is, what core issues it treats, how each part is funded/costed and then educate people about how to use it properly. Only then, can it be looked at and helped to modernise itself.

It also needs to grow an attitude with some patients who don't turn up to appointments or refuse to follow a treatment plan because they know best.

 

[Essexyellows]

Difficult one this, where do you draw the line?

Should a footballer injured while playing be treated?

A cyclist? A driver?

The footballer, cyclist & driver are (normally) accidents.
The 25 stone lump who smokes 40 a day and needs his foot amputating is no accident.
My triage would be very hard!!

DNA`s (Did Not Attend`s) would be invoiced at £50 a pop for 3 strikes, after that sent to the back of the queue.

 

[m]

The footballer, cyclist & driver are (normally) accidents.
The 25 stone lump who smokes 40 a day and needs his foot amputating is no accident.
My triage would be very hard!!

DNA`s (Did Not Attend`s) would be invoiced at £50 a pop for 3 strikes, after that sent to the back of the queue.

Completely agree with that last line!

 

[Peterdev]

It’s common knowledge that the NHS is cutting back in so many ways. They no longer offer ear wax removal for those with ear problems. Instead patients have to pay £80 or so to have the procedure carried out privately which takes around ten minutes.
This at the same time May is saying the EU contribution of £10billion will go to the NHS. Funny how Hammond is also rumoured to be considering large tax rises for motorists in petrol duties, the balance of which will also go to the NHS. I don’t believe for one moment that all this money will end up in the NHS coffers.
Difficult to,judge who should get help. Smokers arguably deserve no help, but then again they contribute billions of pounds in revenue.

 

[tonyw]

One somewhat suprising thing to note about the NHS, compared to any other comparable healthcare system in the world, is that actually, it's incredibly cheap.

Healthcare spending per capita in the UK is less than any other comparable country - and a ridiculous 2.5x less than the US. In fact, the US government actually spends more per person on healthcare than the UK government does.

There's a bunch of reasons for this - but first and foremost it's a combination of the minimal need for an insurance industry (it's estimated that almost half a million Americans work in the dedicated healthcare insurance sector) and the bargaining power of the NHS depressing prices from suppliers, particularly big pharma.

Yes there's big challenges with such a massive, unwieldy body - and actually something like the French public/private model would seem to be an overall more effective healthcare system - but there's probably more good than bad with the NHS, and changes to it should be incremental not radical, lest costs spiral in the pursuit of corporate profits......

 

[Marked Ox]

Linked to funding the NHS and the lack of a joined up approach, ie. Social care/substance misuse which should be NHS, not Council run:

https://www.bbc.co.uk/news/education-45573921

So the Govt is continuing to slash Council budgets and hide further austerity whilst demand for Council services like social care increase. By forcing Councils to cut services for substance misuse support etc all the Govt is doing is forcing greater pressure onto the NHS, Police etc with more people ending up in A&E or in the Police cells.

Also when complaining about potholes and state of the local roads, don't forgot to blame the Govt for plenty of it as well as always blaming the Councils.

 

[Gary Baldi]

And with a better than anticipated tax take in July, there is a sliver of funding relief there that the Govt should be utilising at the local level to reduce some of the cuts.

 

[Mojofilter]

Someone needs to define what the NHS is, what core issues it treats, how each part is funded/costed and then educate people about how to use it properly. Only then, can it be looked at and helped to modernise itself.

It also needs to grow an attitude with some patients who don't turn up to appointments or refuse to follow a treatment plan because they know best.

This seems like a decent start