I am generally pro-markets and pro bringing competition into public services but these NHS reforms are not a good idea, they will make healthcare in the UK worse not better.



There are basically two problems:



1. Co-ordination failures. When there are multiple providers delivering different bits of healthcare, you run in to problems when a patient has treatment provided by two different providers. There will be co-ordination difficulties and extra administration costs - this is one of the problems that makes healthcare in the US so expensive. Healthcare is a natural monopoly and when it is delivered by a single body (the NHS) it is easier to co-ordinate the treatment of a complicated case.



2. Separating out opportunities to profit in a taxpayer funded system. Private healthcare providers are motivated by maximising profits. The way to profit in healthcare is to provide treatment at lower cost than the fee charged for it. This would be good if it provided the motive for investing in how to deliver treatments more efficiently, but the way they have set up these NHS reforms, the motive instead will be on selecting which cases to treat and which not to treat. The way to make profits is to bid for the simple relatively easy cases, deliver these below cost and make a margin between what the NHS (taxpayer) pays and what it costs the provider. Serious illnesses like cancer, chronic conditions, complicated cases etc are not profitable because they are so expensive to treat - as medical technology improves, it makes previously untreatable cases treatable albeit at very high cost: there is no incentive for this to a profit making provider as they want to minimise costs.



So you will get private companies bidding for the cheaper relatively simple cases - and charging the NHS over and above what they are spending on providing them to make their profits, whilst leaving the complicated cases to the NHS.



Now the complicated cases were in the hands of the NHS, so whats different? The fact that there is less resource available to treat it because part of the NHS budget has been creamed off in profit margins to the private providers. The profits come out of the NHS budget, it is a transfer of resources from the taxpayer to the owners and shareholders of private health providers, rather than from the taxpayer to patients. The NHS has a big budget so there are good opportunities for making profits and no doubt these reforms will be successful for private health providers but they are not going to improve health outcomes.



The cunning part of the plan, from a right wing perspective, though is that it will still have the name of the NHS. So when patients start complaining in 5 -10 years time about declining health outcomes, this will be a failure of the NHS, and will provide the basis of an argument to dismantle some more of the principles of the NHS like free at the point of delivery, to move towards a fully privatised system, because people will then be told that "the NHS is failing, what was right in 1945 is simply not right for 2020".

I suggest you:



a) Attempt to understand the "swedish model" of which you speak



b) Make an effort at comprehending what I have written in the past



At no point have I indicated approval of the Swedish healthcare system

The NHS was a difficult concept from day 1. People were going to live longer and treatments were going to become more expensive as medicine advanced. Still, there is no excuse for spending money on treatments like this: www.dailymail.co.uk/news/article ... lants.html

The NHS was a difficult concept from day 1. People were going to live longer and treatments were going to become more expensive as medicine advanced. Still, there is no excuse for spending money on treatments like this: www.dailymail.co.uk/news/article ... lants.html

The starting point was probably as low as you can get to start from with health care consisting of only the very wealthy being able to afford to consult a doctor for debilitating illness, the rest, including I'd guess most readers of these forums, having to depend on charitable hospitals, cheap insurance policies, or just hope that they didn't get ill - a bit of a long shot in times of heavy manual labour and no controls over air pollution or factory safety.



The reality now is that very few people earn enough to be safe in the knowledge that whatever ailments come their way they can afford a private team to put them right again and for anyone who has ever checked recently even if all encompassing and unlimited private health care existed (it doesn't), it would be beyond most of our wallets, particularly those with families and ironically its those with children who are most likely to need a health care plan and ironically again its childrens ailments that often have the highest success rates, albeit often with cost expensive requirements.



Anyone who thinks that they are ok and won't need an NHS in a socially funded framework and not dependent on markets or accountants is probably deluded enough to need help from that very health service.

Quote The Video Ref="The Video Ref"The NHS was a difficult concept from day 1. People were going to live longer and treatments were going to become more expensive as medicine advanced. Still, there is no excuse for spending money on treatments like this: www.dailymail.co.uk/news/article ... lants.html'" What an ugly looking women

Quote The Video Ref="The Video Ref"The NHS was a difficult concept from day 1. People were going to live longer and treatments were going to become more expensive as medicine advanced. Still, there is no excuse for spending money on treatments like this: www.dailymail.co.uk/news/article ... lants.html'" What an ugly looking women

There are a lot of misconceptions amongst the supporters of private healthcare, about what it will mean for them in practice. I expect most of its supporters are relatively rich, and expect that in a private healthcare system, they will either get better healthcare for similar cost to their current tax contributions or get the same level of healthcare for lower insurance premiums than their current tax contributions. They expect that the people that will lose out are those lower down the income chain who were being subsidised by the tax contributions of the rich.



However, in a private healthcare system you are only better off if you are relatively healthy. In that case, insurers compete for your custom, because the way they make their money is by having relatively healthy people that do not claim much. If you have a simple condition that needs straightforward treatment like a one off operation (eg a hernia) then a private insurance system is likely to work better for you than the NHS, you will get seen quickly at a time to suit you and there will be no waiting lists like there are in the NHS. Also if you want general appointments or scans again you can get these quickly.



The problem comes when you have complicated or expensive treatment or something chronic, or something that is likely to compromise your health going forwards (eg a heart attack, stroke, cancer etc). From this point on, you are a likely loss maker for any health insurer as you are a risk of being a heavy claimer in the future. So from now on they do not care about having your custom, they want you off their books. Their goal from now on is providing the minimum treatment they and their legal teams can get away with providing (and they will have made sure their policies are tightly written to minimise their obligations). The idea that you now have great 'patient choice' goes out of the window, the insurer chooses what and how much treatment you can have. If they don't cover it then either sell your house, find the money elsewhere or tough.



The NHS, for all its faults, does not give up on you. No matter who you are and how much of a burden you will be on it in the future, it does its best to treat you, it does not thrust its legal teams in your face when you are sick to show you the small print so that it can get out of obligation to treat you. The NHS is not there to profit, a private insurer is, so sadly at the point you become no longer profitable for it, the insurer will drop you like a stone.

The TV program "24 hours in the NHS" (or something like that) was an illustrator of that last week, following various consultants and doctors in their jobs on a given day last year in lots of different hospitals, the camera/editors all concluded each piece when a patient was referred to a different department or successfully treated and sent home with the question "Have you ever stopped to think how much your treatment of that person has cost today ?" and to their credit each of them didn't know, and nor should they ever be in a position to have to stop and think about it either.



Thats not to say that they go on treating for ever, there was an example of an old lady who was in for palliative treatment and who died several weeks later, she still deserved their full attention even though they had all agreed to stop fighting her cancer and no-one knew how much she was costed out at.



Only an accountant with a heart of stone and a head full of idiocy would try and cost out each individual consultation anyway - its the same with all of the emergency services, they are there for their twelve hour shifts anyway whether they sit on their backsides or rescue forty cats from forty trees, we've already paid for them !

When a Telegraph columnist and an NHS doctor (the same person) concludes that [url=http://www.telegraph.co.uk/health/healthnews/9962195/NHS-reforms-From-today-the-Coalition-has-put-the-NHS-up-for-grabs.htmlThe NHS is up for grabs[/url, you just know the job's fooked

An interesting article. Although I don't believe for one moment that a patient would be refused revision surgery on a botched knee replacement.



Today also saw legal aid go for pretty much everything but criminal law.

She sounds like she has smoked 50 a day for the last 20 years. Which she probably has.

Then let the scales fall from your eyes because each and every change that comes into being today is linked. The common link has little, if anything to do with saving money. No ones taxes will reduce, apart from those earning more than £150k per year. The state will continue to spend, the only difference being that somewhere someone, or more than one, will be taking a profit.



The poor will end up poorer, the sick will end up even more sick. This bunch of evil bastads are going further than even Thatcher would have dreamed possible and the frightening thing is: it is happening by creep. There will be no big bang, just a relentless chipping away at the social compact that we've enjoyed since 1947. I cannot even begin to explain how deep my hatred of the Conservative party and their supporters is but I do know that the hatred grows as each day of this government continues.

Not unexpectedly, there could be worse to come: [url=http://www.telegraph.co.uk/news/9965039/Minimum-wage-could-be-frozen-or-cut-if-it-starts-to-cost-jobs-or-damage-economy-Government-suggests.htmlMinimum wage could be frozen or even cut[/url



Is there really no end to what this bunch can dream up?