N H S - Should It Always Be Free? Discuss.

[sunny-dave]

As a lifelong supporter (and for many years a worker in) the UK NHS, I always espoused the "Free at the Point of Use" mantra - it seemed the best way to provide a decent service for everyone.

Now living with a rather different system here in Ireland, I'm no longer so sure.

In Ireland :

Everyone pays something for prescriptions (even pensioners and people on those on benefits) - it does seem to stop the routine over-prescribing of repeat medications and also cuts out the OTC items.

There is a charge for GP visits - it varies according to age and circumstances - but it means that it's much easier to see a GP and they can give proper time to patients, as 'frequent fliers' are less of a problem.

There is a charge for A&E visits - again it varies - but it stops the routine clogging of A&E with the worried well and 'fell over whilst in drink' brigade.

The HSE is far from perfect - there are delays and shortages in many elements of secondary care - but the NHS (at least viewing from the outside) seems to be overwhelmed with no chance of supply ever matching an apparently endlessly increasing demand.

Is it time to think about some form of charging to mange demand on frontline services?

[gness]

Can't answer for everywhere in Ireland, Zacs but I do know that our present GP and the previous two that I had dealings with are good at reducing or forgetting to charge in some cases. :-)

[douglas9401]

I had cause to see a GP in Australia many moons ago and like all things Australian it brought back happy memories of a bygone age.

$25 for a proper look over, diagnosis and solution.

Saved my holiday.

Yes there's a case for a nominal charge but it must be protected from profiteering insurance companies.

What we're relying on is decision making by politicians and the spine to stand up to newly invented pressure groups draining resources when they shouldn't even be allowed across the threshold and that hasn't been going too well just recently, even disregarding the jobs for the boys angle.

[Zacs-Master]

That’s good.
Zacs Google’s house prices in Eire.

[youngmafbog]

Well its not free as per the headline on the post, but corrected below.

If charges are going to be bought then the amount paid into the current system needs to be reduced. Otherwise we end up with the worst of both worlds.

The NHS could be fixed, BUT, it is treated like a political football by the main party's and so never will be. It needs a top down shakeup, reduce the managers dump the PR and diversity people. Stop paying for cosmetic surgery (unless for things like cancer) and certainty no sex changes which will only cause more problems down the line when it is sued. Stop the health tourism, stop the DNA's and make A&E for just that. If GP's dont want to do their job then get rid (yes we are short but no point in throwing good money after bad).

I really think the grass root doctors and nurses genuinely want to provide a good service but the management structure is often against them. The fights my daughter has to get beds for people is time wasting and quite frankly ridiculous.

One other thing I think would help would be to build separate 'recoup oration' wings on to hospitals. Wings where people only need a be and minimal care with no machines and just careers. If by the hospital this could be done as Doctors/more experienced staff could be called over in an emergency. This setup would be far cheaper than using ward beds.

To be honest I really dont know what the answer is with the situation the way it is at the moment. Anne is correct, take out private care if you can.

[gness]

Zacs. The church by my old family home has been turned into a fantastic house. Bit pricey I'll send you the details. ;-)

[jno]

ZM, I'm going to see a knee clinic tomorrow about a knee I twisted last March. Probably not a serious matter, but nobody knows because nobody's seen it since my first visit to the GP. The wait was not by choice.

I'm also having some heart investigations but have opted to use my health insurance. This is because, of the two investigations my GP wanted me to have, the first couldn't be done for six weeks; the second they had no dates for at all. Maybe it will turn out to be a minor problem; but in the meantime it involves breathing difficulties, so I rate it as urgent

[Zacs-Master]

Zacs contemplates being within range of Gness’s crockery.

Zacs reconsiders.

[Zacs-Master]

I hope you get sorted, jno.

[jno]

thanks, ZM, I do too. But I'm pretty sure that, say, five years ago, I would not have been hanging around for months in an NHS queue waiting for a physio or an ECG monitor - not the big-ticket, years-in-med-school things, just the basics.

[Zacs-Master]

You don’t know that for sure tho. A couple of cases like yours and Anne’s (or was it maggie’s) don’t prove that there are no good news cases in the NHS.

[sunny-dave]

You can always tell when the NHS is in trouble - just look at the number of Private Health Insurance adverts, and what they are majoring on.

Back in 2011 (when waiting lists were at an all time low and A&E waits were aiming at 3 hours maximum) the adverts were relatively few and they were just banging on about getting cash payments whilst the NHS treated you, a form of income insurance really.

Now it's all about 'avoiding the queue' and 'see the specialist of your choice' - a sign that the NHS has been overwhelmed.

I agree that it's an impossible task (or a bottomless money-pit) to provide everything for everybody.

My experience over here tells me that part of the solution might be to manage expectations and some aspects of demand - modest payments for treatment might be a start?

[anneasquith]

Good luck jno. Using your money wisely. ( though you shouldn’t have to .

[pixie374]

I haven't yet read the whole thread- it should obviously be free at the point of use, for all British residents. That is the whole point of it.

[Zacs-Master]

He’s, pix but the premise is ‘should we adopt Irish style payments to help it survive?’

[pixie374]

Ah, no- having read through- I am sick to death of mental health needs coming second to physical needs. I also have a genuine problem with elderly people wanting to "bother" the GP.
If someone is consistently demanding attention that they don't need- they should be moved to a mental health assessment.

[pixie374]

My answer would be no, zacs- I believe we should take "more" notice of apparent timewasters and treat them appropriately. Not less.

[Paigntonian]

Idiotic to think it's free.

[gness]

I do agree with you, Pixie. Until it becomes unusable for many. I have friends who are desperate for a face to face GP appointment but can't get one. One friend, fit, walked, swam til two weeks ago she woke up unable to move with back and leg pain. Son took her to hospital. Discharged next day. Now at home, zimmer frame, frame around the toilet. Can't sit or lie down properly. Promised home visits not happening. Promised pain relief not delivered. Something needs to be done to manage needless demand so that deserving cases get treatment. A small fee might help.

[Canary42]

How much of the current NHS funding is trousered by Rich Shareholders as the Tories slowly but relentlessly and stealthily privatise it.

[Canary42]

A fee to deprive the poor - Typical Tory Toff's mantra.