The NHS is one of the World’s largest organisations, with 1,163,568 staff in England and a health budget here that last year was £110 thousand million.  There are also the separately managed NHS organisations in Wales, Scotland and Northern Ireland. They are all run, very inefficiently, on Marxist lines.  No other country has chosen to copy the idea. We are not the envy of the world. Its core principle is that care is free at the point of use. Obviously it is not really free. It costs about £2,000 each year for every man, woman and child.
The first, proven, way to improve matters is to bring in competition and private management. This was done by Labour’s Andy Burnham at Hinchingbrooke Hospital, which has been a fantastic success, going from one of the worst in Britain to one of the best very quickly indeed. Every hospital should be run this way. And remember every GP practice always has been. (Now, disgustingly, sabotaged by lefty activists.)
The second, also well proven method, it to take the government out of the loop, whist still keeping care free at the point of use. So instead of paying your £2,000 (average) a year to the government you pay it to an insurance company, as a % of income, with the government covering those who can’t pay. Health services in countries like Holland and New Zealand are vastly superior to the NHS.
The third immense saving is to stop NHS services being available to anyone who turns up. People travel in droves from all over the world to get their free healthcare here, paid for by us. The NHS should be a membership service with qualification of, say, being a British citizen who has resided here for more than half their life OR having an NI number with a record of four full years of contribution out of the last five. Every NHS service must have a robust charging system for everyone who isn’t a member. There need to be a huge fine for patients impersonating to defraud. Say £100,000.
The fourth immense saving is to stop people putting themselves in hospital. Most modern Western illnesses are self inflicted: obesity, bad diet, alcohol abuse, tobacco smoking and other drugs. Here is some of what can be done about these:
- Introduce a new tax on all food with added sugar or any other natural or artificial sweetener. (Artificial sweeteners fool the body into putting down fat then eating more). Start this tax at, say, 5% then ramp it up at 5% every year.
- Bring back domestic science as a school subject, so pupils know what the constituents of food are and how to cook from basic ingredients. Most of their parents don’t know this.
- Introduce gastric band production lines for everyone with a BMI over, say, 35. All other treatment withheld till this is done.
- Use social measures to further reduce tobacco addiction. Ban it within 100 metres of all public buildings. Only sell tobacco products to registered addicts. Only sell tobacco in off licenses from which everyone under 18 is banned. etc
- Use alcohol taxes to stop people abusing it. This drug is far too cheap.
Fifth make people pay themselves for all over the counter (OTC) drugs. Then make many more drugs OTC. If Paracetamol is allowed to be OTC then many more drugs should be. Also reduce the scope of free prescription enormously, the current qualifications for these are excessive and stupid. Sixty year old’s are just as capable of paying as 59 year olds. Massively reduce unnecessary prescriptions, for instance most anti-depressants are not needed, these should only be prescribed by a consultant, not a GP.
Sixth, stop the NHS doing many silly things that have nothing to do with health, for example:
- Cosmetic surgery, other than for very strict clinical necessity.
- Tattoo removal.
- Artificial insemination.
- Homeopathy and all other scientifically unproven “alternative” medicines.
- Gender reassignment.
Seventh, where the NHS is used but the liability is someone else’s then that someone should always pay, not the British taxpayer. This applies to car accidents, industrial injuries etc
Eighth make the NHS immune from being sued. About 20% of all NHS spending is on lawyers and payouts. This is utterly outrageous, medicine is inherently dangerous. The people who make these claims, many of which are bogus, the result of no win, no fee lawyers, should be ashamed.
With all the money these measures would save, easily, more than half of what we are now spending, Â the NHS could start looking after its patients better. Improving diagnosis would be a good start.
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Also see:
Why the NHS is only safe with the Conservatives.
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None of that is an answer to my Question.
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Some excellent points – good to know there is someone else who knows the GPs have always been private contractors!
The really bad thing about GPs is they say they can’t be expected with checking eligibility for free treatment so they can charge those not entitled to free treatment. Why not? They have never had a problem charging for holiday jabs or signing ID documents! Yet rather than ask if someone is entitled to free treatment they happily sign referrals to hospital consultants.
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http://www.nhs.uk/chq/pages/1086.aspx?categoryid=68 where are your facts on all these people getting free NHS treatment who are not entitled?
http://blogs.channel4.com/factcheck/foreign-visitors-owe-nhs-2bn-factcheck/16194
The biggest cost to the NHS is the elderly, take a trip to any A&E into the ambulance arrival area and you will see this.
I do however agree with your proposals about taxing certain foods, that is a good suggestion.
But none of your suggestions address the every growing need for Care for the Elderly in or out of hospital which is the biggest cost to the NHS.
Making a profit out of Health & the NHS or Care does not work well, because it means profit comes before care.
Try finding yourself a good private care home, the money goes to line the owners pockets not to the person needing the care. Have a tour around a few care homes in your area, saying you are looking for an elderly relative and see if that’s how you want to end up? Being fed slops everyday and poor staffing levels, all the staff on NMW, despite the demanding and stressful jobs they do. That’s privatization and the free market for you 🙂
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Glad to see you contributing your immense knowledge and experience of health economics to this important question. Fuckwit.
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Steve Reeve,
See how you failed on the pyramid of intellect:
You also lost. To Margaret Thatcher: