Gps choose how many patients they take. They choose how long they see a patient. They are not a part of the nhs. They are small businesses that charge the nhs.
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Politics, politics, politics (so long and thanks for all the fish)
- Thread starter SpurMeUp
- Start date
Gps choose how many patients they take. They choose how long they see a patient. They are not a part of the nhs. They are small businesses that charge the nhs.
SpurMeUp
Jimmy Cantrell
It was an attempt at privitisation. And I don't think it has delivered value to you and I, and needs a shake-up. GP businesses might be doing well from it?
They charge the nhs for every patient they see. The more they see the more they charge.
But lets say we do it your way. Charge a patient £30 each time they see their gp. They'll see them less. Especially the poor. That means that illnesses that might be treated cheaply if caught early on are not treated. Leading to very expensive treatments later on. Or death. People will go to hospitals instead of their gp's.
Does it need a shake up? Yes the whole thing does. More investment for a start. Actually have enough doctors and nurses to provide healthcare for the population. That don't work 70+ hours a week so they are not tired and make mistakes. Stop the government from trying to chip away at it and make it unworkable so they can sell it off to their donors.
SpurMeUp
Jimmy Cantrell
My way was £5 to £30 other than those on benefits. So poorer people wouldn't pay. Everyone not on benefits can afford say a tenner for an appointment.
When you give something away for free it devalues it. People take it for granted. And people abuse it too. Those delivering the care are inundated, have too many appointments and can't actually deliver real considered care because of it. Meanwhile, it's inefficient and costly. £5 an appointment is a token amount, wouldn't cover the costs, but it changes the dynamic. You are paying for something. And there would be greater onus on GPs to treat you as a customer, rather than some schmuk who they have to process. The value relationship needs a reboot.
Currently, some people take the pizz with GPs getting appointments every week - because they can. Others don't even bother because the level of care is often so poor. Twice in the last year, GPs have told me to go private because of wait times or inadequate facilities. I was quite amazed. But it just shows what a poor setup it is. I remember going to the Doctor as a kid. You got time. You got to sit down with an esteemed practitioner who would try to work things out for you. That isn't the case anymore, you are simply processed in a tight window. There is no reason it has to be like that. We should have a health system that allows caregivers to care, rather than act like bureaucrats.
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So it will be free for people on benefits but not those that work?
Who are these working people that take doctors for granted, that take time off work to go to see them when there is nothing wrong with them?
I don't know any.
SpurMeUp
Jimmy Cantrell
It is all done on the phone right now. Appointments are say a 15-minute phone consultation, booked via an app. Demand has spiraled. There has never been such high demand. So plenty of people are booking appointments, I am sure many are working.
Because the speedy appointments often don't address the issue, with the doctor rushing, another appointment is needed fuelling the increase in appointments. There is no reason why a better system and level of care can't be provided.
Put it this way: are you happy with a care system that can't focus on health, but instead focuses on sickness? We have an inefficient system that helps people who are sick, but doesn't have the time to prevent people from getting seriously ill. So much is missed or rushed, the level of care is declining.
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Why do that when, as someone who pays for and occasionally uses the NHS who also have private insurance to compare and contrast, I know just how brick it is.
In terms of the US - I've experienced their healthcare (well, tagged along whilst someone else had to use it) on a couple of visits and the level of care surpasses anything I've ever seen in the UK by lightyears. I would happily spend what the US does on a healthcare system like theirs, over what we spend one one that exists purely out of misplaced sentimentality.
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It's been debated on here before but the NHS loses millions just by people not turning up for appointments, a simple £10 charge or something like that for missed appointments should be brought in.
The NHS needs to invest more in prevention rather than being re-active but that requires huge up front investment with payback that would likely take years to measure. Take obesity, one reason is that people don't cook from scratch as much anymore because they don't have time too. How much of that is because people working longer or taking multiple jobs etc due to the cost of living here. I mean our nursery costs are like having a 2nd mortgage, everything is expensive so people have no choice but to work.
But really nothing will change, we're a low tax country and realistically to sort things out requires higher taxes but the public wont' swallow it so we dance around the edges.
You'd be happy to pay more in taxes for health care. Yet still have to pay to receive health care before you are 65?
Just some of the prices.
- ambulance $2,500+.
- have a baby $10,000 - $30,000.
- hold your baby after giving birth $40.
- 2 epipens $700.
- $3000 a month for insulin.
Now you probably would because you play the caricature of the right wing capitalist that doesn't mind paying. As long as poor people don't get anything. But normal people wouldn't want to.
SpurMeUp
Jimmy Cantrell
Thing is we are not that low tax! Huge amounts are taken by the exchequer. We should use the tax revenue better, and improve services with people taking more responsibility as you say. 300 million GP appointments a year, we could invest billions with just a £5 charge for those that can afford it.
Or we could just get large multi national companies and the super rich to pay their fair share of tax.
We are compared to most of Europe who spend more on public services, we do have a lot of stealth style taxes here but you can avoid them e.g. congestion charge.
Ultimately public services are funded from taxes so if you want them to be better funded the money has to come from somewhere though agreed the money needs to used better. I don't know if it's still the case but in the NHS I think they do procurement by Trust for many items rather than for the NHS as a whole which would get them much better prices, they also have teams in each Trust who manage things like the NHS pension scheme rather than combining the management into one central team etc.
Local councils are even worse, goes up every year but now my bins are collected every fornight and I have to pay extra for them to pick up garden waste. Local tip used to just be able to turn up now you have to book an appointment and the number of times you can go each year is now capped.
I would suggest (as I already did) a model in line with the German one.
I've never had to pay for healthcare in the US outside of the insurance that covered everything I needed.
The problem with naïve measures such as "fair" is that they're entirely subjective.
A politics student may perceive "fair" to be "a lot," whereas a director who is legally bound to maximise shareholder wealth might interpret it as a lot less than that.
Fortunately we have a taxation system which (whilst the underlying numbers are far too high) defines what a company is legally obliged to pay. Those who do not do so find themselves in court opposite HMRC and lose.
Diamond Lights
Didier Zokora
Vodafone to follow EE and bring back EU roaming charges.
Still at least our passports are blue.
Sitting on my porcelain throne using glory-glory.co.uk mobile app
Still at least our passports are blue.
Sitting on my porcelain throne using glory-glory.co.uk mobile app
I'm with Vodafone and there are absolutely no roaming charges in Europe - I spoke to my account manager this morning.
Are you talking about those council estate contracts where you have to pay when you use it?
monkeybarry
Ian Walker
Those costs are all covered by insurance - so you just pay the co-pay (aka excess in the UK).
@scaramanga has a valid point about the quality of healthcare provision surpassing the NHS, with the following exceptions:
- don't live in or get sick in a poor state or poor area as the quality is lower because of lower investment incentivisation.
- don't get sick somewhere remote.
- don't be unemployed, you won't be covered.
- don't be in the first three months of a new job, you won't be covered.
- don't be a new permanent resident, you won't be covered
- don't have any pre-existing health conditions (you know, the reason you go to a medical professional), unless you can afford the higher premiums
- don't be in a lower paid job if you want healthcare via your employer
But the actual healthcare itself is usually very very good
monkeybarry
Ian Walker
They are not subjective if you are using the correct subject.
Measures are created using qualitative and quantitative data to set levels that best serve society, because an individual needs society to survive and prosper.