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?

[sunny-dave]

mange !!! "manage"

[davebro]

Yes. And non-residents requiring treatment should be charged its full cost (providing insurance details or adequate funding up front).

[davebro]

the YES is to your final question - not the heading!

[jno]

it depends what might be thought reasonable charges. Would £5 be a reasonable fee to see your GP? How about £50, because sooner or later that's what £5 would become as GPs need more diagnostic machinery and the council rates go up: the user would end up paying.

As for A&E - is falling over while in drink better/worse than being stomped under a scrum or tipping off a ladder while cleaning the guttering?

There seem to be to be huge questions involved in deciding what might be acceptable risks in everyday life, and never-ending ones in deciding how much you should have to pay when the risks go wrong.

[Zacs-Master]

The GP charging system sounds excellent. There needs to be something similar here. And fast.

[pastafreak]

Do you expect this to turn into a 'natter and nonsense' thread?
Sorry...just fed up with the endless AB discussions...and not having a happy Monday.

[ToraToraTora]

I agree with the sorts of charges you are talking about but not the wholesale move to the barbarity of most of the world. The charges you are talking about are mostly to stop spurious usage and I get that.

[sunny-dave]

Sorry Pasta - should probably have put this in Body and Soul - I'll ask the Ed to move it

[sunny-dave]

It's free for children and pensioners, jno and reduced for other people on benefits.

For others it's perhaps around €40 for GP visits (and that's a proper consultation, not a 5 minute phone chat) and up to €100 for A&E treatment if you have not been referred by a GP or other appropriate medical practitioner.

[Zacs-Master]

I’ve just read that it costs between €40 and €70 to see a GP. I do wonder whether such amounts put off genuinely Ill people from going. I think £10 would put off the ‘frequent fliers’.

[Zacs-Master]

Ha! Crossed posts.

[maggiebee]

The 7 core principles of the NHS

The NHS provides a comprehensive service, available to all irrespective of sex, race, disability, age, sexual orientation, gender reassignment status, religion or belief. It has a duty to each and every individual that it serves and must respect their human rights.

My understanding is that Nye Bevan set up the service to be free at point of delivery. Having said that, things have changed considerably since 1947. I certainly don't have the answer

[anneasquith]

My advice for any youngish people is, take out private health insurance , much as it pains me to say.
The NHS is now unable to cope .

[Zacs-Master]

Unable to cope with what, Anne?

[anneasquith]

The physical/ psychological requirements of patients/ clients .

[ToraToraTora]

anne: here is an excellent film by Michael Moore that shows the barbarity that ensues with private insurance based systems.
https://www.imdb.com/title/tt0386032/?ref_=nv_sr_srsg_0

[Zacs-Master]

All of them? Every single one? Is this personal experience or did you hear it from Edna down the hairdressers?

[maggiebee]

//Unable to cope with what, Anne?//
I think the NHS is unable to cope with the daily demands made on the service.
I broke my wrist a couple of months ago and only today received a letter from my GP advising me to have a DEXA scan to check for bone thinning. Fair enough, but the downside is that I have also been advised there is at least a 10 month waiting list. Agree it is not "urgent" but still quite a wait.

[gness]

Just checked with our receptionist, Zacs. Twenty five euro to see our GP if you have to pay. We do have an excellent pharmacist...also on call at home...and minor things that don't need a GP can be dealt with by him initially if you wish. He will treat you or send you to "himself" as he calls the GP. ;-)

[Zacs-Master]

Thanks, Gness. I do still wonder, in these stringent times, whether such an amount puts genuinely ill people off being seen.