7 years medical training.... Really??

[Mr Smokes Blunts.]

In such areas of the health service already privatised, notably Drug Treatment, the waste and cynical diversion of resources is ten times worse.

Sorry, but the NHS would fall apart without the private sector. They provide all the equipment used, they provide all the medicines, they build all the buildings, they run all of the GP surgeries. The only thing they don't currently do is administer all of the services. There are plenty of countries where they have tax payer funded private service administration that are million miles better than what we have - Singapore, France, Germany, Italy, Austria, Japan... No one goes without in these countries, they just get better services. Why can't we have that? My local hospital is NHS run and government funded, yet somehow it has gone totally bust and ended up selling loads of buildings off and moving everything to otherside of Leeds where property is cheaper. It being socialised isn't protecting anything any way.

 

[knock]

There are plenty of countries where they have tax payer funded private service administration that are million miles better than what we have - Singapore, France, Germany, Italy, Austria, Japan... No one goes without in these countries, they just get better services.

How do you know all this?

 

[Mr Smokes Blunts.]

How do you know all this?

By looking at the WHO health rankings - part of whether they offer universal coverage is factored into their rankings, hence America is rightly like 37th.

 

[knock]

By looking at the WHO health rankings - part of whether they offer universal coverage is factored into their rankings, hence America is rightly like 37th.

So you use the WHO statistics to measure quality of healthcare provision - OK, that's certainly reasonable at first glance.

But what about the analysis of private/"socialised" (I'd prefer the word here "state" over "socialised" myself, but whatever) administration?

 

[Mr Smokes Blunts.]

So you use the WHO statistics to measure quality of healthcare provision - OK, that's certainly reasonable at first glance.

But what about the analysis of private/"socialised" (I'd prefer the word here "state" over "socialised" myself, but whatever) administration?

Do you mean, how have I come to the conclusion of which types of healthcare are provided in these countries? By reading about on them, and how they provide the services. You also have to look at other ranking tables, because WHO hasn't reported in ages. Cancer survival rates and stuff like that.

 

[knock]

Do you mean, how have I come to the conclusion of which types of healthcare are provided in these countries? By reading about on them, and how they provide the services. You also have to look at other ranking tables, because WHO hasn't reported in ages. Cancer survival rates and stuff like that.

Can you direct us to your reading material? I'm genuinely interested. I'm not merely trying to bait you!

 

[Mr Smokes Blunts.]

Can you direct us to your reading material? I'm genuinely interested. I'm not merely trying to bait you!

There are dozens of articles (mostly from the economist). Just search for "X country healthcare system/model" and it will describe in several places per country how they run things. Is there a specific country you're interested in?

 

[knock]

There are dozens of articles (mostly from the economist). Just search for "X country healthcare system/model" and it will describe in several places per country how they run things. Is there a specific country you're interested in?

I'd like to know the mechanism by which private administration of healthcare provision results in improved healthcare provision, and I'd like to see examples of it, because my gut feeling is that it's wrong, based on anecdotal evidence like horror stories where care homes under private management treat patients inhumanely.

I can believe that wealthy people can buy themselves superior care privately. That goes without question. I'm more interested in how the private sector would treat ordinary people who can't afford private health care.

So I looked at France which you gave as one of your examples of private administration / superior provision, but I saw that 62% of "hospital capacity" there is public sector. (a further 18% is charitable and only 18% actually private) So I wondered where you were getting your data.

I've tried to find the Economist's articles on the French system but I've failed, can you give a link?

 

[Mr Smokes Blunts.]

I'd like to know the mechanism by which private administration of healthcare provision results in improved healthcare provision, and I'd like to see examples of it, because my gut feeling is that it's wrong, based on anecdotal evidence like horror stories where care homes under private management treat patients inhumanely.

I can believe that wealthy people can buy themselves superior care privately. That goes without question. I'm more interested in how the private sector would treat ordinary people who can't afford private health care.

So I looked at France which you gave as one of your examples of private administration / superior provision, but I saw that 62% of hospitals there are public sector. So I wondered where you were getting your data.

I've tried to find the Economist's articles on the French system but I've failed, can you give a link?

France pretty much has the system I believe the government is aiming for. (http://www.frenchentree.com/fe-health/DisplayArticle.asp?ID=197) You pay upfront and decide where you go with the help of your GP commissioner - you can go private or public, the public sector competes for your custom just like any private institution would. The government then reimburses you 70-100% of the cost of your initial consultation depending on how much money you have. Privatisation doesn't mean total privatisation at all, it means partial so that there is accountability and patients can choose to move their healthcare. People who can afford it contribute more both in terms of their taxes and the amount they pay when they use. This seems to me like the best mechanism to use to get people to contribute more to the healthcare system. There is no skipping the que in France because there is no que

And here is the link from The Economist which briefly details the French system:
"Moreover, France’s health system, a mix of private and public provision, manages both to guarantee universal coverage and produce a relatively healthy population for half the cost per person of America’s, and with shorter waiting lists than Britain’s somewhat cheaper version. The French have higher life expectancy than both the British and Americans. Through means-testing, the state covers those without the top-up private insurance needed to complement the public scheme."
http://www.economist.com/node/13610197

(There was also a program on the BBC ages ago about the French healthcare system, I can't remember it's name, I don't know if you saw it? Their hospitals are amazing! Didn't Michael Moore also go there for Sicko? http://www.businessweek.com/magazine/content/07_28/b4042070.htm)

If you look at cancer survival rates it is obvious that the UK has a terrible record compared to France:
http://news.bbc.co.uk/1/hi/health/7510121.stm

I don't think either of us can deny that this is preferable and worth aiming for to what we currently have?

 

[knock]

Sorry, I thought you were arguing for privatisation of healthcare administration, but maybe I've misinterpreted you. Are you in favour of a "mix" as the French have? One where less than 20% is private?

 

[Mr Smokes Blunts.]

Sorry, I thought you were arguing for privatisation of healthcare administration, but maybe I've misinterpreted you. Are you in favour of a "mix" as the French have? One where less than 20% is private?

What I want is a system where private companies can step in if they see an opportunity to offer what we currently have for less, or improve the services we currently have for the same price or slightly more. There needs to be some government provided health services to compete with the private ones to keep standards high. Sorry, I see why you thought I was talking about administration as in paperwork rather than administering health care, I could have been more direct there.

 

[knock]

So you think the introduction of a "market" will help? I can't personally see how it would, and is it not telling that you think government provision would need to be retained to keep standards high?!

I just think that focusing on modes of administration is a red herring. A bit ideological, in fact. I know it's not just down to how much money you spend either, there is no clear correlation globally.

Maybe I'm naïve but in my mind, what the DoH should do is ask people with experience of the system what the problems are, and then address the problems. Introducing a market is a bit like saying "that's too hard, let's just make it look like retail!"

 

[Mr Smokes Blunts.]

So you think the introduction of a "market" will help? I can't personally see how it would, and is it not telling that you think government provision would need to be retained to keep standards high?!

I just think that focusing on modes of administration is a red herring. A bit ideological, in fact. I know it's not just down to how much money you spend either, there is no clear correlation globally.

Maybe I'm naïve but in my mind, what the DoH should do is ask people with experience of the system what the problems are, and then address the problems. Introducing a market is a bit like saying "that's too hard, let's just make it look like retail!"

So you think the introduction of a "market" will help? I can't personally see how it would, and is it not telling that you think government provision would need to be retained to keep standards high?!

I just think that focusing on modes of administration is a red herring. A bit ideological, in fact. I know it's not just down to how much money you spend either, there is no clear correlation globally.

Maybe I'm naïve but in my mind, what the DoH should do is ask people with experience of the system what the problems are, and then address the problems. Introducing a market is a bit like saying "that's too hard, let's just make it look like retail!"

Yes I definitely think an introduction of the market would help. At the moment there is zero accountability for the quality of care hospitals give or the cost it comes in at. They can just spend and spend into oblivion knowing that the government i.e. us, will have to pick up the bill. So I think it will increase effeciency and quality. I also think it will cut down on the ridiculous levels of beaurocracy that innevitably form around anything that has been socialised (just thinking about the amount of fat lazy bitches in the back offices in hospitals up and down the country is enough to give me a heart attack). Furthermore having more than one provider of services in an area should cut down waiting lists, as patients disperse evenly. The main problem that keeping the NHS providing some health care solves is making sure that private companies don't get a monopoly, which is when you get problems like lower standards or higher costs.

Is it telling that I think government provision needs to be retained? No, i'm not ideologically wed to the idea that privatisation will be perfect and make everything amazing on it's own. I see the pros and cons of both systems, so I want a mixed system that retains all the pros whilst doing away with the cons. I think it is ideological that despite having worse services than most of Europe with their semi-privatised health care systems that provide universal coverage, people still cling to the NHS with such a brain dead zeal. If you listened to the Guardian you would think that the NHS was already perfect and partial privatisation was going to lead us to American style leave people behind healthcare, if you listened to the Daily Mail you'd think privitisation was going to lead to American healthcare quality for all... neither of them is totally right or totally wrong.

If anything at least it will get people in our country to part with a bit more of their cash, which is necessary for better healthcare too.

 

[charlie clean]

Can't quite see how the introduction by a socialist government in Italy of free prescriptions and healthcare to citizens on a low income was an advertisement for privatisation, MSB.

Sure, nationalised industries have a tendency to excessive bureaucracy and waste but costs aren't cut at the expense of poor, which is what invariably happens when private companies look to make a profit. To provide a better service for less, costs have to be cut somewhere and it's rarely administrative salaries. There's something quite obscene about patients denied vital operations for want of a lousy buck. In the USA, it's a regular feature of life. When it happens here, it's news and that's the way I'd like to keep it.

Drug Treatment is admittedly one of the lesser areas of the health service, which is possibly why it was chosen for a little-publicised privatisation. The 'voluntary service' corporations paid less to coalface workers and paid out for glossy 'presentations' to underbid the NHS and win contracts. The number of middle managers and PR men increased considerably. Ill attended classes of a standard far below what's available in adult education and unnecessary 'counsellors' - often friends or relatives of the managers - added to the bill. Drug tests cost more when outsourced to other private companies and here, after speculating their reserves in Icelandic banks, they even had the gall to claim they couldn't afford to pay the price of patient prescriptions. What, in effect, we saw was a service that went from serving patients to existing for the benefit of the people running it. Now other areas of the health service are to be privatised, I fear the same phenomenon will occur.

 

[Mr Smokes Blunts.]

Can't quite see how the introduction by a socialist government in Italy of free prescriptions and healthcare to citizens on a low income was an advertisement for privatisation, MSB.

Sure, nationalised industries have a tendency to excessive bureaucracy and waste but costs aren't cut at the expense of poor, which is what invariably happens when private companies look to make a profit. To provide a better service for less, costs have to be cut somewhere and it's rarely administrative salaries. There's something quite obscene about patients denied vital operations for want of a lousy buck. In the USA, it's a regular feature of life. When it happens here, it's news and that's the way I'd like to keep it.

Drug Treatment is admittedly one of the lesser areas of the health service, which is possibly why it was chosen for a little-publicised privatisation. The 'voluntary service' corporations paid less to coalface workers and paid out for glossy 'presentations' to underbid the NHS and win contracts. The number of middle managers and PR men increased considerably. Ill attended classes of a standard far below what's available in adult education and unnecessary 'counsellors' - often friends or relatives of the managers - added to the bill. Drug tests cost more when outsourced to other private companies and here, after speculating their reserves in Icelandic banks, they even had the gall to claim they couldn't afford to pay the price of patient prescriptions. What, in effect, we saw was a service that went from serving patients to existing for the benefit of the people running it. Now other areas of the health service are to be privatised, I fear the same phenomenon will occur.

You can still be provided prescriptions and healthcare paid for by the government but carried out by private institutions - that is what Italy does. All our pharmacies are private for instance. You referencing America to prove your point proves nothing, because I have already shown you half a dozen countries where they mix their provision of healthcare between private and nationalised where and still provide universal coverage. The poor don't miss out. This doesn't seem like something we will ever give up in this country, so what we are talking about is universal coverage paid for by the tax payer but administered by private and nationalised companies.

Do you have a source for what you are claiming about drug services? I believe they might be worse, but I don't think I accept your reasoning for why they are worse. I think the services for drugs suck because funding has been so low for so long. There are plenty of stories of successful private healthcare that is paid for by the government for us, such as actual medicine which has come on leaps and bounds over the years. GPs have also been private for ages too. There are also many operations that are carried out by private institutions because the NHS can't cope or meet acceptable waiting time deadlines. My main worry is that we fail to fix our healthcare system in time for when the number of 65s+ booms even more, because at the moment it is all built on a pyramid scheme whereby they are reliant on more people paying taxes to cover the shortfall they have left behind with their payments.

 

[knock]

GPs have also been private for ages too.

And here we are, in a thread about how poor the GP service is! :D

 

[Mr Smokes Blunts.]

And here we are, in a thread about how poor the GP service is! :D

Move GP's then, thankfully you can do that because they're private

 

[knock]

Have you any idea how long it takes just to see a fucking GP let alone get to know them well enough to decide you should move? And then get on the waiting list for the one you're not registered at?

No, I think the solution is not move GPs but more GPs, better trained GPs, or perhaps more, better trained non-medical staff with increased responsibilities. Or both.

 

[Mr Smokes Blunts.]

It's not very hard where I live, the wait can be a while if there are loads of students booking around winter time... It's probably harder with smaller patient populations. Most surgeries have a good doctor or two though.

 

[knock]

Oh aye, fucking students eh!