NHS 'at breaking point'

stickywicket

I know it's said regularly but it's WHO is saying it now that is scary. Today, in a letter to The Independent, it is sixteen of the very top health professionals including:

Chair of council, British Medical Association
Chief executive and general secretary, Royal College of Nursing
President, Royal College of Physicians
Chair, Royal College of General Practitioners
Chief executives, Alzheimer’s Society, MS Society, RNIB.
http://tinyurl.com/q9zvo95

My proposal (OK, Mr SW's :oops: ) would be a specific 1p in the pound NHS tax on all alcohol (ouch ), cigarettes and anything containing sugar as these three inessential commodities account for a huge amount of health problems.

What would you do?

Slosh

I would be quite happy to pay a bit extra in my nat ins if it was ring fenced for the NHS. While unpopular I also think perhaps the funding for treatments such as IVF needs to be looked at.

dreamdaisy

We have an increasing population who are living for longer (with more and more health problems due to age) so of course the costs are going to rise. I reckon the medicos can take some blame for this, they've found cures for things that would usually finish us off.

I agree with Mr SW, he has a very valid point but I think the sugary stuff should be more highly taxed because it is so insidious; all biscuits, ready meals (there's the salt factor too), fizzy drinks and other such dross should attract VAT at the very least to deter people from living on them.

I also agree with Slosh: I know that infertility is a very distressing condition (our very best friends paid for three private bouts of IVF and got nowhere apart from making other people richer) but it is not an illness. DD

theresak

Our GP has been warning of this for ages now. I would go along with Sticky's suggestion about alcohol/ tobacco/sugar. I would look at Slosh'suggestion about IVF - I'm not sure how many attempts one is allowed, but as DD says, it's not an illness. I'd also stop NHS funding for cosmetic surgery apart from if it's needed from a health point of view - if it's for reasons of vanity it should be funded by the individual concerned.

I'd also ban these " health tourists."

Slosh

NICE reccomend 3 cycles of IVF, although not all areas fund this. As I don't smoke or drink and eat very little sweet food or processed food I'm quite happy with the tax to be raised on these, again as long as it is ring fenced to the NHS.
Heard an interesting report on radio 4 today about how hospitals in Scotland now have their own chain of coffee shops in them, staff are on NHS contracts, produce is fairtrade wherever possible, food meets healthy eating guidelines and all profits go back to the hospital.
Seemed like a really sensible idea to me.

LignumVitae

This is a really tricky one because we have overwhelmed the NHS to medical science provider and beyond the consideration of simply illness or accident which was it's original role.

I agree with the 1p tax, I also think there needs to be some corporate social responsibility in that a polluter pays principle could work - alcohol companies, sweet manufacturers, donating towards addiction related treatment and diabetes/ obesity treatment. It's tricky but I think it needs to be done, possibly by taxing the companies otherwise the NHS is basicallly providing an antidote to poisoning. I also think that the overburdening of the A&E departments at weekends or evenings needs to be addressed. If you arrive needing to detoxify because of overindulgence you will be treated but payment will be sought - people will say they can't pay but if you can afford to get over-drunk/ high then you must be able to afford to pay for any care consequently required.

IVF is so hard because it must be heart breaking but this is an example where medical science and ailment treatment are considerations. Maybe there should be a half way house so there is a means tested payment for those that can afford and this helps to fund those who cannot afford.

Then there are various issues in terms of personal responsibility that the NHS and it's amazing provision helps people to abdicate for example if you smoke throughout your pregnancy then shouldn't you be accountable somehow for the risk to your child in terms of providing at least a token payment towards the specialist care required for prem and poorly babies that result from smoking during pregnancy? This was something I saw that really shocked me on the mat ward and which seemed to be a bug bear of the midwives. There is plenty of smoking cessation aid and support given, if you don't take it shouldn't you then be penalised if your actions affect your baby?

barbara12

Im with Theresa on this..I'd also ban these " health tourists."my NHS trust needs to save 20 million ..and is owed much more than that from the health tourist ..has for tax..the government love this they will tax us for breathing next :shock:

stickywicket

Thank you. I think you've all made some really interesting points. I can't reply to each one but:

Slosh wrote:

hospitals in Scotland now have their own chain of coffee shops in them, staff are on NHS contracts, produce is fairtrade wherever possible, food meets healthy eating guidelines and all profits go back to the hospital.

My son's local hospital, in Scotland, takes in laundry. Makes sense if they're doing their own.

LignumVitae wrote:

the NHS is basicallly providing an antidote to poisoning.

Then there are various issues in terms of personal responsibility that the NHS and it's amazing provision helps people to abdicate

I think you've hit several nails on the head, here. And maybe extended and deepened my original point. We cannot abdicate responsibility for our own health, hand it all over to the good old NHS and expect it to pick up the bill for the consequences of our own actions and lack of actions.

barbara12 wrote:

as for tax..the government love this they will tax us for breathing next :shock:

Actually, the current government is against taxation not in favour of it

dreamdaisy

People expect more and more of the NHS - I was listening to the radio the other day and a man was being interviewed about the long wait for an ambulance he and his wife had experienced after she had a massive stroke: apparently it was delayed due to new parents ringing 999 and asking for their crying baby to be taken into hospital so they could get some sleep. This didn't surprise me, I'm sure we've all read about the 999 calls made on Christmas day, my 'favourites' being 'We forgot to by batteries for the toys, can you bring some round?' and 'I've lost the remote control for the telly.' Hardly emergencies, methinks.

There is an increasing assumption amongst far too many that the authorities will take the responsibility for our lives so we don't have to. Sadly they do, which is an utter betrayal of the basic principles of the welfare state. The NHS is creaking under the weight of so many demands, this country is far too generous with offering its services to all-and-sundry and people's expectations are far too high. DD

Roadback

I have a strong view on this.

There are two things -

1 - PPI

Outsourcing to profit making organisations for depts. and whole hospitals.

I simply dont believe that a profit making company is inherantly more efficient. It is simply poor management in the NHS.

Look at the story behind Norwich Hospital - it is shocking the profit made under PPI.

Yet if they fail - the government would have to bail them out - it is madness!

2 - Pill for all ills - and Pills for things that you haven't yet got

The recent press about a pill to suppress drinking urges for people that have 3 drink per day made me so angry - it will cost the NHS 200 million. For what?

Vaccination - I am a sceptic regarding some of the vaccinations that are being done. I am in a quandry with my own 12 year old regarding her HPV vaccine. I read that the safety review and the efficacy was undertaken buy a company appointed by the makers of the vaccine. The costs are enormous - and the true benefits and safety are unproven.

Statins?

My view is that the NHS decouple from the constant marketing drugs that get thrown at them - take a big step back and review treatment and costs more closely. They are too close to drugs companies - and validation of efficacy and research is too tied to drugs companies.

It is not a healthy situation for us as individual customers - or collectively as customers / owners (at the moment) of our wonderful NHS.

I truly believe this is a ploy for some lobbyists to want it to fail so that it can be sold off - then the drugs companies will be their own customers - selling their drugs to an NHS that they will have a big stake in.

stickywicket

Preventative medicine is a tricky area. Look what happened as a result of the spurious MMR debunking. I really don't envy you your decision re your 12 yr old's vaccination.

I'd guess that the thinking re the 'non-alcohol pill' is – better £2,000,000 spent in order to prevent much, much more money spent on alcoholism, alcohol-related diseases and the ensuing domestic violence and road carnage. Looked at in purely financial terms it's probably economically viable. But will people continue to take it?

I can't comment on the relationship between drugs companies and the NHS. I don't know enough about it. I thought NICE's function was to act as a barrier and generic prescribing was to prevent GP's getting freebies for prescribing Tweedledum rather than Tweedledee.

Slosh

People who pay prescription charges, so not those who are exempt from these or who have a prescription prepayment card, to pay a nominal charge, max £10 to see GP this might reduce non attendance as well. The same could be charged be A and E where you see a GP there ( my hospital run a GP service as part of A and E and triage you to see which service you shoukd be sent to).

dreamdaisy

I think the administration of that would be horrendous, Slosh, if not completely impractical. I guess you would pay when you book - I can't see the usually unhelpful receptionists being willing to take on banking duties too. If, however, you wind up in A&E drunk, disorderly and injured then a minimum charge of £300 for your treatment wouldn't be too strong. DD

LignumVitae

I think for most things the NHS needs to remain free at the point of service because that is one of it's greatest attributes and having had Grandparents who wouldn't call the doctor until it was usually deeply acute and needing hospitalisation, I can see the value both socially and economically of it remaining so. I do think if you DNA (do not attend) there should be a penalty charge and if you are a serial DNAer who gets repeat referrals for a problem but then doesn't attend your appointments then there should be a right to refuse treatment. It might sound harsh but I worked in admin in a busy hospital department and the number of people who would be referred, attend one or two appointments, fail to attend, get letters, rebook, fail to attend and then be discharged only to commence that process again 6 weeks later was shocking and cost a lot in admin never mind the wasted practitioner hours.
As for the med to treat 'mild' alcohol dependency issues - that might work but only if there is a significant amount of support services available. If you have sadly become addicted to something then there is far more needed for treatment than removing the chemical dependency and those services are beyond woeful in this country because it is easier to scapegoat the addict than treat the underlying causes. However, as Sticky says, treating addiction effectively (and I don't think the tablets would) could go a very long way to saving the NHS a small fortune in related treatment from repeat overdosers to malnourished children of addicts and beaten partners.

theresak

Rather than pay-when-you-book a GP appointment, I think a payment could be paid by those who fail to turn up,and who did not bother to phone and cancel.

Do people have to pay for holiday vaccinations? I've never been anywhere exotic enough to need one.

I'd be all in favour of the drunk & disorderly paying for their Saturday night spent in A & E. My dad had the misfortune to have a heart attack late at night on a Saturday a few years ago, and it was absolute mayhem among the drunks while we were waiting to go in & be with him.

stickywicket

I believe holiday vaccinations are bought though I've not done it either.

Fining non-attenders? Yes. In 68, very medicated, years I think I've forgotten two blood tests and failed to attend one orthopaedic appointment when I was delayed in the USA and could find no number or email address to contact. I'd have been happy to pay for the bloods, less so for the orthopaedic one as I made every effort while feeling like death warmed up.

Twenty four hours notice (possibly much less nowadays) of being unable to attend would ensure most GPs could fill the gap. Hospital appts would require a bit longer but not a lot. I think common courtesy also went out of the same window as responsibility.

theresak

When I went for my blood tests on Monday I was shocked to find a notice displaying how many hours had been wasted due to non-attenders - how hard can it be to let them know you don`t need your appointment?

Roadback

I agree with the other suggestions - especially the 1p on sugary stuff and alcohol - and charges for DNA is a no brainer - my dentist already does it.

Btw - the new alcohol suppressing drug is going to cost an additional 288 million for our NHS. So that's £288,000,000 - so that people don't get the effect that alcohol gives them - the leap of faith is that they'll stop drinking the extra glass or 3 that this is intended for - if it's a social need then no! That's 288 million on top of what they already pay in Scotland.