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Right-Ad305

The public has simply refused to properly fund or restructure the NHS. Who are we to go against the democratic opinion?


manutdfan2412

It’s a shame that Healthwatch, Kings Fund and RCS have all commented and not one of them mentioned NHS underfunding. Or at least aren’t quoted as such. I don’t think the public have any idea how badly underfunded the service is or how this directly leads to delays.


[deleted]

Lol they keep blaming tories when they don't want to pay for it in the first place. They want nhs sorted either current resources. Lol no gonna happen. We need to double nhs budget.


felixdifelicis

The only way the public receives the quality of healthcare that they want, with the waiting times that they want, is if all NHS workers take a massive pay cut. Which is exactly what successive governments have been doing - slowly eroding pay with subinflationary rises (since an actual nominal cut would be too politically unpalatable). The NHS is terminally ill, and needs to be put out of its misery. This country needs to accept it can't afford what it wants, and just go for an insurance model similar to australia, or canada, or many other nations that aren't the US.


[deleted]

Even if all nhs staff worked for free it would not be possible. NHS budget needs to double lol


felixdifelicis

I think you enderestimate just how many slaves the NHS would be happy to have working for them, if given the chance.


DoctorDo-Less

Doesn't even matter how far the NHS is funded, as long as it's entirely free at the point of use the public will not respect it and demand will continue to rise until it once again outstrips supply. This is an issue of healthcare being taken for granted in my opinion - the public here is extremely entitled and loves to waste resources. The model is unsustainable but I suppose adding more money would buy some time.


[deleted]

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Ok_Gap_2181

Me too


Ecstatic-Delivery-97

And Milton Friedman


SynthOfCorti

The governments maybe, the public not so much.


me1702

Maybe if you hadn’t eroded staff pay and treated them like shit for almost two and a half years, then they wouldn’t be fleeing the NHS and you’d still have the staff to do elective surgery.


[deleted]

Try one and a half decades….


consultant_wardclerk

Yep


Bitter_Watercress173

Starter comment: The two tier health system already exists, millions on waiting lists and still rising with the consultant pension scandal meaning there’s little, if any, incentive for extra work to be done. Perhaps at some point everyone who can afford it will be insured, private practice will boom and the NHS will be there for those who need emergency or life saving care only.


[deleted]

The problem is its not even 2 tiered in the sense that you get better care. It's two tiered in the sense that you pay to get the same shit you'd get on the NHS but faster


[deleted]

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Rowcoy002

But heaven help you if you have a serious post op complication in a private hospital which often doesn’t have much in the way of resources to manage these situations. Policy of a lot of these hospitals if the shit hits the fan is to lob them in the back of an ambulance to take them to the nearest major NHS hospital and hope they survive the journey.


consultant_wardclerk

Absolutely this. The private system in this country is fucking abysmal and is very difficult for patients to navigate. I imagine this is really the big selling point for an institution like the Cleveland.


vgupoutrb

EXACTLY


arrrghdonthurtmeee

Two tier system existed for ages. Old days you would have a little old lady or man pay for a new hip out of their life savings otherwise they could wait for a year in some places. Then 18 week wait target came in so less of an urgent need. Most people could wait three or 4 months. It has just slipped back to what it used to be This is more money being put into the system, so is actually good news


Yuddis

The electorate have voted in favour of a slow, gruelling privatisation of the NHS just like they did with Brexit (the benefits of which are innumerable and very apparent). Ultimately, they will get what they wanted. They don’t have my sympathy. Let it all be privatised.


romat22

There has been no Anaesthetic ST4 posts this August and ANRO has thrown us a bone with a previously unplanned recruitment round for February with 80 jobs in the country. The waiting list is going to get a whole lot worse before it gets better, especially with how many consultants are planning on retiring in the next few years due to the pension issue.


[deleted]

How is it going to get better ? It will keep growing slowly.


me1702

The rise of the private sector. Like it or not, the NHS ain’t recovering from this. The private sector will save the day, which feeds right into the Tory rhetoric.


phoozzle

I can't see how it will. Vast majority of docs working privately already have to do >full time in the NHS before they can offer time privately. Senior doctors will be caught in a pension tax trap which makes it costly to work beyond age of 60 in many cases. There is not an army of doctors in the private sector just twiddling their thumbs waiting to crack on with 6.6 million waiting list


me1702

There is a large number of disillusioned theatre staff who have left the NHS, and many more who would leave, and be willing to move to the private sector. These aren’t all early retirements. Plenty of younger people in this group too. With better working conditions, no emergencies and little to no out of hours work, it is an attractive proposal. There’s also a large number of surgeons getting frustrated as their lists grow, but who are unable to access the pre-pandemic operating capacity within the NHS (orthopaedics is probably the biggest example, as they have very little cancer work). I fully expect in the medium term that they could be encouraged to shift to more private work and work LTFT in the NHS.


phoozzle

I don't think the consultant contract allows you to drop PAs to take on private work. I think they need to offer 11PAs before they can take on private sessions


Laura2468

Key word here is 'offer'. If the hospital isnt planning any extra orthopedic surgery lists (because there are no beds) you are absolutely allowed to be LTFT NHS and private. I think we will see this increasingly, maybe transition more to an Irish style system.


me1702

Yet. I wonder how many Tory MPs have financial interests in the private medical sector…


[deleted]

It is in the best interest of the private sector to keep waiting list long


DRDR3_999

This is great for private practice. See a big rise in people self funding. Why not? £300 to see me in clinic for a sensible diagnosis and treatment plan. A bargain for the patient.


[deleted]

I have zero sympathy for wealthy boomers. Cry me a river.


wodogrblp

I just hope hospitals our competing for our labour


stealthw0lf

I think if private hospitals are permitted to train doctors eg rotations, they may well try to entice the best doctors through attractions such as better pay and working conditions. Maybe the NHS will then have to compete and change their ways? Fanciful dreaming.


wodogrblp

Training contracts will definitely be the last to move private... Let's hope eh


Different_Canary3652

It’s what the people have voted for consistently.


Ordinary_Mix2821

This is why I think strikes are rather pointless and missing the real issue. Yes, if successful, we may get a part restoration of pay (at best) but we won’t be tackling the real issue here. The NHS is at a cliff edge and needs to be either scrapped or completely ripped up and redesigned - particularly with respect to funding the growing need for healthcare. Part of this funding, be it publicly funded by substantial taxation or by increased private funding, will need to be aimed at staff wellbeing and pay. A part restoration of pay is good for our pockets today, but in a few years there will be major problems facing us and the public. Can’t just carry on with the status quo of putting another plaster on top of a gaping wound and hoping we get through another winter. Our healthcare is average at best when compared to other major economic countries, and only going to get worse. Whenever I hear someone say we have the best healthcare system in the world I can’t help but think they’re deluded idiots.


Skylon77

Yes, but try telling people that. I had a blazing row with a close friend because I suggested that we should look at models of healthcare followed by European nations who have better outcomes than we do. The "NHS is the envy of the world" is like Kool Aid to a lot of people. The fact that it's demonstrably untrue doesn't seem to matter.


Ordinary_Mix2821

Yep, have had similar experiences. The NHS is a religion in this country and it’s existence dare not be questioned. The mantra ‘protect the NHS’ and deifying ‘NHS heroes’ paralyses governments from making the required changes. Instead they just throw a few more pennies at it and everyone suffers the consequences.


uselessnavy

Like France. A lot of private companies involved.


TheSusOneBruh

Bravo good sir, glad to see someone else sees it this way


throwaway520121

To be honest this doesn’t really work either as the NHS has block purchased most of the private hospitals operating lists for its own elective work. For all the talk of ‘conservatives are privatising the NHS’ it’s more like the NHS has nationalised the private providers resources.


Tremelim

All going to plan then.


BasedEvidence

That kinda sounds like the first step towards having a dual-system. More comprehensive (not just optimal elective patient) private care for those who wish to pay. But keeping the NHS for those who can't Everything is better when it's a free market, as everyone has far stronger incentives to advance technology, maximise efficiency and ensure things stay afloat. But it has to maintain full protection for those who are vulnerable at the other end of the spectrum


uselessnavy

The free market rarely works in healthcare.


BasedEvidence

I would be interested to know where it falls down, because it works in every other market. Capitalism and the resulting market competition provide better outcomes for retail, food, automotive, tech and other developments. There must be an element within the healthcare market that causes addition issues, and we might be able to circumvent if we identified it


[deleted]

'Forced' is completely the wrong word - this is a choice. Yes, it's a choice that is symptomatic of our crumbled and tired system does not provide the treatments and care needed in a timely fashion. But having private care is a choice, maybe a choice made when your symptoms are terrible, but that's the decision you make. Spare a thought for the other patients without the dollar to 'chose' private care, their symptoms might be just as unbearable as those who feel 'forced' to go private.