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Manwork04
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NHS
« on: January 03, 2023, 12:55:57 pm »

It turns out we now live in a third world country with a health service to match, we collectively pay 12% of our GDP into this black hole of bureaucracy and mismanagement, which for balance is on par with what Germany spends on its healthcare.
Itís time for a complete overhaul and if this means privatisation then so be it, I for one donít want to be waiting 10 hours plus for an ambulance.
This goes beyond politics and should be cross party.
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Welly Cobb
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« Reply #1 on: January 03, 2023, 14:18:05 pm »

https://www.statista.com/statistics/268826/health-expenditure-as-gdp-percentage-in-oecd-countries/
America is at 18% of GDP.

We spend too much on healthcare, so therefore we should follow the route that the country that spends the most by far on GDP to improve it  Huh?

Measuring it as a GDP percentage is pointless, I only pointed about the above to show the obvious contradiction, but if we had another 2008 Financial crash as a result of bad debt or falling asset prices and GDP dropped 4%, and health spending stayed the same, health-care spending would be worth 12.5% rather than 12% of GDP. But there wouldn't be any more staff, or hospitals, or equipment, or drugs, as the actual spending has stayed the same, or any actual increase in output from that despite the figure being higher. So what exactly does that show you exactly? It's a worthless statistic to measure when looking at comparative countries.

So let's look at some more relevant statistics. Taking across parity of purchasing power and inflation, Across the EU14, average total health spending between 2010 and 2019 was £3,655 per person (this includes government, as well as out of pocket, private and charity spending). In 2019, the UK spent £3,055 per person, 18% below the EU14 average. Over the decade, only four countries in the EU14 spent less per head of population: Greece, Portugal, Spain and Italy. Finland had very similar spending per head to the UK.1

In 2017, the UK spent £2,989 per person on healthcare, which was around the median for members of the Organisation for Economic Co-operation and Development: OECD (£2,913 per person).

However, of the G7 group of large, developed economies, UK healthcare spending per person was the second-lowest, with the highest spenders being France (£3,737), Germany (£4,432) and the United States (£7,736).2

In effect, against those other Western countries, we spend less per person on health. We also have less doctors, hospital beds and nurses per population. Almost as if those two things were related. However, spending per person isn't the only thing that matters, India may have a much lower spending per person than Italy, but the demographics are in it's favour. Compared to other Western European countries with old demographics, particularly the one you alluded to in your example, we don't pay enough. However, on the plus side, having a public nationalised system actually made the administrative costs lighter, as nobody needed to take a profit cut or take a dividend.

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In 2017, the UK spent the equivalent of £53 per person on healthcare governance and the costs associated with financing healthcare. This was below the median for Organisation for Economic Co-operation and Development (OECD) countries with comparable data (Figure 5).
...
The relatively low UK spending on governance and financing costs is partly down to the type of health system the UK operates. The NHS and other tax-based healthcare systems do not tend to have the financing costs typically incurred in health insurance schemes, such as revenues collection (the equivalent of which would be managed centrally in tax-based systems), risk-management, and profits in the case of mandatory private health insurance schemes.

The number of people in hospital has increased a larger proportion of the UK population age (a 40% increase in the number of over 80s). While the population has grown over the last 10 years, there is a higher growth percentage wise of people needing hospital. "Other factors that may also be driving up demand include patientsí rising expectations (for example, in relation to quality of care and speed of access), earlier referrals from GPs for suspected cases of cancer, and advances in technology that make it possible to treat more people." At the same time, since we had a Neo-Classical obsession with austerity, the growth in funding dropped dramatically in 2010, which means busier hospitals and a reduction in spending that had been previously keeping up with the demographic changes.

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Our analysis has shown that, over the 13 years of data we have reviewed, rising demand is resulting in increasing hospital activity Ė from A&E attendances and emergency admissions to referrals to outpatient services, diagnostic tests and elective admissions. There is also evidence that other parts of the health service are facing similar challenges, including general practice (Baird et al 2016) district nursing health services (Maybin et al 2016) and mental health (Gilburt 2015).

Since 2010, this increased activity has coincided with a prolonged funding squeeze. Between 2010/11 and 2014/15, funding slowed significantly, averaging 1.2 per cent per year, and is set to average 1.1 per cent from 2015/16 until 2020/21. The effects of this can be seen in deteriorating financial performance and growing waiting times across secondary care. There is compelling evidence of a health system buckling under the strain of trying to meet increasing demand within constrained resources.
3

So, the long and the short of it is that in real-terms we're cheap on spending, despite having a public system to minimise the actual governance costs, and pay less than other G12 countries. We then layer across both a pandemic over two years, and a real-term cut to staff income due to high inflation, and lead to poor work conditions which provokes a strike.

The long and the short of it, is that you get what you pay for, and the UK public chooses cheap and cheerful every single time they come to an election, despite looking at a demographic time-bomb.

1 https://www.health.org.uk/news-and-comment/charts-and-infographics/how-does-uk-health-spending-compare-across-europe-over-the-past-decade
2https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29
3https://www.kingsfund.org.uk/publications/hospital-activity-funding-changes

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singcobb
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« Reply #2 on: January 03, 2023, 15:36:59 pm »

It turns out we now live in a third world country with a health service to match, we collectively pay 12% of our GDP into this black hole of bureaucracy and mismanagement, which for balance is on par with what Germany spends on its healthcare.
It’s time for a complete overhaul and if this means privatisation then so be it, I for one don’t want to be waiting 10 hours plus for an ambulance.
This goes beyond politics and should be cross party.


All well and good bringing the Fatherland into it, but if you don't have medical insurance you are fúcked. I recently had a ride in an ambulance with the blues and twos going and one of the first thing they checked was my insurance card so they could decide which hospital to take me to.
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Manwork04
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« Reply #3 on: January 03, 2023, 15:47:38 pm »

At least you got an ambulance https://www.dailymail.co.uk/health/article-11594743/National-Hell-Service-Wife-dies-16-HOUR-ambulance-wait.html
Not quite what you expect for £160 billion per year.
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« Reply #4 on: January 03, 2023, 16:01:55 pm »

Years of under investment in all areas of health care, including prevention and after care has surprise, surprise lead to it creaking, fit to burst.

Poor decision making at the top end, demotivating the staff causing problems with recruitment and retention.

Take away a big chunk of staff in hospitals in all roles and decimating the numbers of staff in social care.

There we have it - austerity, poor leadership and Brexit. Whose bright ideas over the past 12 years in charge of this shÓt show? Yes, that's right, the Tories. Not so long now before they will be out on their arsęs, but still long enough to alienate a few more of their supporters - see the OP.

Happy New Year to you all!
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« Reply #5 on: January 03, 2023, 16:13:12 pm »

Manny, it's all well and good saying that it goes beyond politics, but it is politics. It is the political decisions made by representatives of political parties voted for depending upon the political views of the electorate.

Basically, you get what you (the country) voted for. I (as an individual) didn't get what I wanted either in the general election or Brexit, but I believe you probably did. This is the consequence. If you don't like it, vote differently next time you have the chance to.

 I don't know why it is a surprise to you, it is like when Sunak told Truss that her economic policies would be a disaster, well as predicted, they were. And all the "Project Fear" stuff - guess what it is happening? But at least our fish are happy and our passports are the "right" colour.
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« Reply #6 on: January 03, 2023, 19:16:34 pm »

I'm passionate in my belief that the NHS is a fantastic concept and that it should remain free for all at point of delivery. Look at things in other countries; the position you'd find yourself in if you were ill and couldn't afford health insurance in the US is terrifying and turns your stomach when you look at the country's overall wealth.

While I'm all for the concept though, I think the institution needs a damn good shake up. It's a wasteful behemoth that in its current form would plough through whatever funding it was given.

To give an example, my wife has worked in the NHS all her life. Last year she decided enough was enough and left for a new job in the private sector. They begged her to stay as they are incredibly short-staffed and she was very well thought of but she'd made her mind up.

6 months later she felt she'd made a mistake, missed her old role and started to think about moving back to the NHS. She found there were no jobs being advertised in her area so reached out to friends to ask if there was anything. It turns out there were numerous roles going, they just weren't bothering to advertise them because no one wanted them. When they found out she was interested in returning they put an advert out specifically for her. She then had to go through the whole, formal recruitment process. Bear in mind they knew her, trusted her, were desperate to keep her and then equally desperate to get her back and she'd only been gone 6 months; in my world we'd just say "When can you start?" but such is the bureaucracy in the NHS she had to jump through all these hoops, culminating in a highly formal interview. I was in the next room when she had the interview via Teams. The two people interviewing her had both worked with her in the past and they started by"doing introductions"; who they were, what their roles involved, what the team structure was.. all because every interview has to follow an exact script to ensure no one gets an advantage.

All well and good, but there were no other applicants.

 In the past a woman took on a secondment into the role that was effectively my wife's boss. She took on a failing team that was effectively in special measures and in the space of 12 months turned it around, created a strong team and earned the respect and friendship of everyone working for her. When they came to interview for the job she had to interview for it along with everyone else and they "weren't allowed" to take her past handling of the role into account. She didn't get it. They gave it to someone else who was widely regarded to be useless but who'd answered the questions better on the day. She felt betrayed and left, and the NHS had lost another good employee.

Someone else I know was seconded into a senior nursing role. They did it successfully for over two years until they were told that they couldn't do it as a secondment anymore without it being classed as a permanent role, but despite competently doing the job for all that time they weren't allowed to apply for it because they had entered nursing before a degree was required. Had they had a degree- any degree, media studies, sociology, whatever - they would have been fine but rules is rules in the NHS.

And the training they have to do! My wife had to do mandatory training on what to do in the event of a terrorist attack. Fair enough if she worked in a hospital or somewhere but she works from home!!!

All pretty minor I guess but you multiply these type of things up across the entire organisation and there's an appalling level of inefficiency and waste going on.

And don't even get me started on their procurement processes....
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« Reply #7 on: January 03, 2023, 22:02:53 pm »

Public office has always been a nightmare, public procurement all but extinguishes innovation and the length of time taken to procure things is a joke, the EU OJEU process added 6 month to a year to any project.
The NHS is a basket case and needs root and branch change, the trouble is you canít say anything bad about it because itís taken on a biblical saintly persona since COVID.
God help the country if Labour get in, anyone earning more than a few bob will be taxed to the hilt and guess what they will all fcuk off.
Socialism a great idea until you run out of other peoples money.
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TPFKA Marvo
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« Reply #8 on: January 06, 2023, 09:49:00 am »


God help the country if Labour get in,

I know what you mean, the last 12 years has been all sunshine and lollipops.
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« Reply #9 on: January 06, 2023, 15:26:29 pm »

I know what you mean, the last 12 years has been all sunshine and lollipops.
TBF Marvo, the Tory baśtards have got Brexit done, had a once in 100year pandemic to deal with and then for good measure a war in Europe.
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« Reply #10 on: January 06, 2023, 16:21:53 pm »

And do please tell what they are doing about the "war in Europe" which has so greatly impacted the people of Britain?
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« Reply #11 on: January 06, 2023, 18:39:07 pm »

TBF Marvo, the Tory baśtards have got Brexit done, had a once in 100year pandemic to deal with and then for good measure a war in Europe.


Brexit has caused an absolute nightmare for any companies working cross border. The pandemic was handled atrociously, only saving a bit of face with the vaccine. The war in Ukraine was a welcome distraction for them. Numerous u-turns, tax threshold freezes and people on £40k a year relying on food banks. Mass support for lower income earners/the benefits mob, whilst hammering middle earners. Multiple PMís and plenty of scandal. However clueless labour would be any party/group of professionals would have struggled to make a bigger mess.
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TPFKA Marvo
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« Reply #12 on: January 06, 2023, 22:12:03 pm »

Brexit has caused an absolute nightmare for any companies working cross border. The pandemic was handled atrociously, only saving a bit of face with the vaccine. The war in Ukraine was a welcome distraction for them. Numerous u-turns, tax threshold freezes and people on £40k a year relying on food banks. Mass support for lower income earners/the benefits mob, whilst hammering middle earners. Multiple PMís and plenty of scandal. However clueless labour would be any party/group of professionals would have struggled to make a bigger mess.

There's no point in trying to convince Manny with facts, he's brainwashed. He's like a survivor of a nuclear war, outside a barren wasteland, eating a dead rat and ranting it would be much worse under Labour.
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« Reply #13 on: January 07, 2023, 08:06:41 am »

With this 'war in europe'...if only there was a EU army. because why would we be afraid of an army we are part of.

anyway manwork drinking the cool aid again. I hope he has people around him that will help him go cold turkey on the daily mail and rid him of all his hate filled bigoted opinions. nobody is born that way.
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« Reply #14 on: January 07, 2023, 18:44:06 pm »


 I hope he has people around him that will help him go cold turkey on the daily mail and rid him of all his hate filled bigoted opinions. nobody is born that way.
But educated from the point of birth by their parents. Never been to Glasgow or Belfast then?
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« Reply #15 on: January 07, 2023, 18:46:50 pm »

TBF Marvo, the Tory baśtards have got Brexit done,

Are you suggesting that it was a good thing?  Shocked
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« Reply #16 on: January 08, 2023, 13:36:40 pm »

Are you suggesting that it was a good thing?  Shocked
There was always going to be short term pain for long term gain with Brexit.
We are all looking at the success of Brexit through a very narrow lens, give it 10 years and things may be a lot different.
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« Reply #17 on: January 08, 2023, 13:37:33 pm »

And do please tell what they are doing about the "war in Europe" which has so greatly impacted the people of Britain?
About 2.3 billion reasons.
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« Reply #18 on: January 08, 2023, 13:43:47 pm »

About 2.3 billion reasons.

Fúcking peanuts compared to what you beloved Brexit has cost.
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« Reply #19 on: January 08, 2023, 14:17:36 pm »

Fķcking peanuts compared to what you beloved Brexit has cost.
Brexit will have a return on investment, unlike spending money on a war.

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