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American using Britain’s NHS (2015)
91–100 of 116 posts
Re: American using Britain’s NHS (2015)
#92As a Brit using the NHS I can only add that I trust, and expect, every government to make the NHS worse whilst they talk of how marvellous it is. I would really like it given to an independent cross-party body, or the civil service, to try distance it from politics and The Treasury. I'd like to see legislation to heavily penalise drug companies seeking 20,000% price increases and the like. Both sides fiddle with it,…
> I would really like it given to an independent cross-party body, or the civil service, to try distance it from politics and The Treasury.
They did that. The governmental bit (in England) is the Department for Health and Social Care.
NHS England is the qango that runs the NHS in England. They provide money to CCGs to commission most services. NHS England directly commissions some (so called "tier 4" services) - eg inpatient mental health services for children; medium and high secure mental health services; etc.
I genuinely have no idea what happens in Wales, Scotland, or NI. Health is devolved and they run their systems independently.
Re: American using Britain’s NHS (2015)
#93As a Brit using the NHS I can only add that I trust, and expect, every government to make the NHS worse whilst they talk of how marvellous it is. I would really like it given to an independent cross-party body, or the civil service, to try distance it from politics and The Treasury. I'd like to see legislation to heavily penalise drug companies seeking 20,000% price increases and the like. Both sides fiddle with it,…
Imagine how well an NHS organised as it was in 1948 would function in today's world. Although there is no doubt that it could be better managed setting it in aspic will kill it surer than a nail in the back of the head. The NHS will face massive challenges in the next 30 years from demographic pressure on demand and staff, technology change and citizen behaviour and expectation. Radical "fiddling" is going to be need…
Sure, but pretty much everyone (even current Conservative party) agrees the Lansley reforms (The Health and Social Care Act) were a fucking mess and are currently causing problems.
Re: American using Britain’s NHS (2015)
#94I have never seen such a bureaucratic/inefficiently operated institution - and there are plenty to choose from in the UK. My electricity company replaced all Vs with Ks in letters to us for 7 months. The NHS is much worse (try even getting a letter to arrive within a month - to the right address - let alone receive any medical treatment). I have not dealt with US healthcare but having experienced other countries' I'd…
It's a myth to suggest the NHS is heavy on bureacracy. The NHS has less management than most UK business, and often those managers are dual role clinicians / managers.
https://www.kingsfund.org.uk/projects/health-and-social-care...
> The NHS Information Centre shows that there were about 43,000 NHS managers in 2009 (about 3.7 per cent of the total workforce), although this figure does not include many clinical managers. How does this compare to other sectors?
> According to the Office for National Statistics, the proportion of managers in the UK workforce as a whole in June 2010 was 15.4 per cent. These statistics also show that there were 77,000 hospital and health service managers across the United Kingdom, or 4.8 per cent of the NHS workforce. In other words, the NHS has a managerial workforce that is one-third the size of that across the economy as a whole.
Your letter taking a month to arrive is something that you can complain about. Did you make a complaint about it to the relevant trust?
Re: American using Britain’s NHS (2015)
#95Earlier quoted context omitted.
I wouldn't. Any time that independent body fucked up or did a bad job, they'd simply claim they didn't get enough money from the government to do the job. Whether that was the truth or not. The "cross party" oversight would then take positions according to their party priorities, if in power blame the independent body for doing a bad job, if not in power blame the government for not giving them enough money. Unless o…
I think it's axiomatic that every human endeavour is flawed. It's pretty clear NICE works rather well and is now accepted by both political sides and the profession. Let's start there. In terms of funding the NHS spends a smaller proportion of GDP than most developed nations. If we can nail defence and overseas development as x% of GDP, why not also for the NHS? Perhaps consider increasing to the average EU spend?
For one example of politicians chosing to ignore NICE look at the Cancer Drugs Fund.
The CDF makes available cutting edge new technology to people dying from cancer. These meds are very expensive. They often fail the NICE appraisals. The CDF pays for the meds.
We know that these meds often don't work at all, and sometimes cause harm, and are fantastically expensive.
https://www.theguardian.com/science/2017/apr/28/cancer-drugs...
Re: American using Britain’s NHS (2015)
#96The NHS will try many things to avoid expensive options like MRIs and more expensive medications.
For Multiple Sclerosis I was given one MRI and NO medications over the course of 12 years as I went from relapsing remitting to secondary progressive. Total postcode lottery so fuck the NHS.
Re: American using Britain’s NHS (2015)
#97Earlier quoted context omitted.
I wouldn't. Any time that independent body fucked up or did a bad job, they'd simply claim they didn't get enough money from the government to do the job. Whether that was the truth or not. The "cross party" oversight would then take positions according to their party priorities, if in power blame the independent body for doing a bad job, if not in power blame the government for not giving them enough money. Unless o…
I suppose the TV license system is very close to an independent body with "tax" raising powers (including the ability to jail people for non-payment). No longer quite so popular.
Strictly speaking you can't go to jail for non-payment of tv licence. You'd get a fine, and go to jail for not paying the fine.
You're right that people get a criminal conviction for non-payment of the licence fee, and that's a bit worrying when it happens to so many people.
Re: American using Britain’s NHS (2015)
#98Earlier quoted context omitted.
You can't put a figure on it. The system interfaces with every area of life, and with capitalism. Western Capitalism says the amount spent on healthcare should grow until all available money becomes profit for the Capitalists. Meanwhile there's always some new area of life that impacts health - spend on sport, then on encouraging sport by paying for teachers, then on improving colleges where the teachers train, ... b…
> Meanwhile there's always some new area of life that impacts health - spend on sport, then on encouraging sport by paying for teachers, then on improving colleges where the teachers train, ... before you know it the NHS is funding a deep mine in Siberia In other words, central planning doesn't work[1]. NHS was a "special case" that tends towards the general case, as is the tendency of all untouchable mandates. [1] h…
The NHS (in England) hasn't been centrally planned for some time now.
That's what CCGs are for.
Also, a bunch of stuff (drug and alcohol services, weight loss, smoking cessation, suicide prevention, sexual health, etc etc) isn't even NHS any more, and is part of Public Health which is part of local authorities.
Re: American using Britain’s NHS (2015)
#99Earlier quoted context omitted.
The NHS spends £11Bn/year on type-2 diabetes, 80% of which according to Diabetes UK is caused by or could be addressed by lifestyle choices. Not just diabetes of course, I don't mean to pick on one subset, I mean the NHS has to spend an awful lot of money on things that really shouldn't be things in the first place. People who really love "our NHS" eat right, exercise, and get enough sleep... The rest are just trying…
>eat right, exercise, and get enough sleep Of these three, diet has by far the most impact on t2 diabetes. The focus on casual exercise ("10k steps per day") is relatively useless compared to a low-inflammation diet. But there seem to be a lot of perverse incentives and special interests who keep the conversation muddled or focused elsewhere.
We're not just talking about diabetes though, we're talking about preventable illness, and good exercise does help prevent heart disease and stroke and some other stuff linked to high blood pressure.
Re: American using Britain’s NHS (2015)
#100By comparative metrics to the rest of the world the NHS comes out either top or pretty damn good. By comparison to whatever the metrics of whatever government is in power at the time the NHS always looks terrible. Budgets can be set arbitrarily by the government so it’s easy to make the NHS look like it is over budget (in fact all you need to do is increase the budget by less than inflation and talk about absolute nu…
>By comparative metrics to the rest of the world the NHS comes out either top or pretty damn good. Ish. The NHS is remarkably cost-effective, but has relatively poor survival rates for cancer, stroke and myocardial infarction. International comparisons seem to damn the NHS with faint praise - it's cheap and the patients are happy, but it's not very good at keeping people alive. http://www.qualitywatch.org.uk/sites/fi…
In 2011 life expectancy in the US was 78.8 years, which was below the OECD average of 80.1 years.
The UK's was 81.1 years.