On Tue, 17 Feb 2004 10:51:15 +0000, Mike Mitchell
wrote:

On Mon, 16 Feb 2004 20:54:44 -0000, Sausage King
wrote:

In article ,
says...
However, tonight the Trevor McDonald programme on ITV had a piece
about the dreadful lack of midwives in the UK and the effect this is
having on births all over the country. Apparently we are 10,000 (ten
thousand!) midwives short. The midwives that there are are having to
work long hours to cope with the pressure.

For which they get more money than other people in similar professions.

Obviously not enough to entice more into the profession.

So, if anything, both Labour and the Tories should be ploughing in
*more* taxpayers' money into the NHS, not less.

Why not just introduce better tax breaks for people wishing to take
private medical care...?

Private medical care is a misnomer.

Only in your mind

The correct term is: Let us balls
up the simplest operation because we know the NHS will bail us out as
the hozzie of last resort.

That's a strange idea and is a long way from the truth.

Over the past five years I've had occasion to need to use secondary
healthcare with respect to four different issues. None of them would
have been regarded as immediately life threatening in the acute sense,
although one would be if untreated in the long term and two required
surgery. None would be regarded as elective or cosmetic conditions
either, all resulting in some impact on quality of life.

I would not have been able to obtain a consultation for any of them,
let alone treatment in under a year by using the NHS, for two of them
almost two years. Appointments couldn't even be scheduled until 3
months ahead of the available dates.

I was able to obtain private consultation and treatment and follow up
in 4 weeks for three of the cases and 8 weeks for the other two - that
was simply because time needed to elapse before the follow up.
Appointments were scheduled when the physican was available of course,
but there was a lot of flexibility. I was able to make changes on two
occasions and only slip a week before the next available appointment.
The facilities, equipment, staff and treatment were beyond reproach -
all of the latest medical equipment etc.

In all of the cases, the consultants carry out both private and NHS
work, so it is not correct to say that one sector is robbing the
other. All of them said that the main limiting factor is
availability of supporting services, not consultant time.

I checked out the credentials of all of the consultants and surgeons
that I saw. It is reasonably easy to do so from the GMC web site and
then a search for the individual in terms of research papers and
clinical work that they have done. Each had published at least two
peer reviewed papers.

When one considered the hurdles to achieve accreditation to work at
this level, it is frankly amazing that people stay the course, but
they do. I talked to every single consultant and surgeon that I met
about this. All of them felt that it was important to make their
skills available to the public health service but they were too
frustrated by its limitations and bureaucracy to allow it to be their
sole source of work and income. In effect, most viewed the private
sector as a means to bring their income to an acceptable level and to
maintain their sanity. Sad but true.

If we look at the economics, again taking a personal example. I
don't mind commenting that I am reasonably well remunerated as
represented by what I can contribute to my company's business. As a
result, I contribute a lot into the state system by virtue of my
taxes, NI contributions and my employer NI contributions. These are
certainly a great deal more than I would take from the system, even if
I were using it. To a point I don't have a problem with that. In a
civilised society, I think it's reasonable to contribute for the needs
of others and perhaps for one's own needs in later life.

In order to achieve an acceptable level of service for healthcare I
turn to the private sector to provide it. The public sector could do
something but not in a timescale that is acceptable or useful.
To address that, my employer pays for health insurance. This is
hardly cheap at several £k per annum. From the financial
perspective, this is treated as further income and so the full gamut
of tax, employee and employer NI are addeed to it. In effect I have
to pay for about half of the cost out of net income. On top of this
there is insurance tax of another 5% IIRC.

So adding this all up, I am unburdening NHS facilities, I am providing
funding to a source of income for highly skilled clinicians who are
not able to derive an acceptable income from the NHS. Yet I get
penalised either deliberately or accidentally by the tax system.

I have no problem with contributing "over the odds" for the benefit of
others. However, I would like to see a return to me that is equal to
the value of a treatment under the NHS. In other words, if a
particular piece of treatment costs £3000 through the NHS, then I
should receive a voucher for that, or a substantial part of it which I
can either "spend" at an NHS facility or at a private one,
supplemented by insurance or cash..

For people who can't or don't wish to supplement their healthcare, the
state sector would then have more resources to provide treatment
because more of the population would be able to afford to seek
treatment part funded by themselves if they need it.
In terms of prioritisation of public sector services, those with life
threatening or seriously debilitating conditions would have more
resource available.

The problem comes in the present outdated notion of free treatment at
the point of delivery and trying to create a one size fits all
service. It doesn't work. The best that can be achieved is
mediochre treatment. Those who want healthcare faster and on a more
convenient basis are penalised, and those who are unable or don't wish
to pay for it draw a short straw as well.

It would be far more effecitve if a more open market were created and
people could choose what they want to spend on healthcare vs. other
things. The current notion of over management of the available
resources to make sure that nobody gets more of the state pie than the
next man misses the point completely.

Resource should not go into the equipment for the groundsman to create
a level playing field but into the quality of the players and the
involvement in the game for the supporters.

The current NHS system is rotten to the core in terms of what is meant
to be a service for all. You can always tell how an organisation
wants to be viewed by its PR and marketing.

With respect to the NHS, two things spring immediately to mind.

- A series of radio commercials to entice nursing staff back to work
for them. The premise was that the person was grateful to the NHS
for providing care for her ageing mother. What a crock. For
something that is meant to be a public sector service, it is audacity
in the extreme to suggest that people should be grateful for what they
get

- Illuninated signs on the sides of cranes on construction sites.
What do they think they are doing spending money on that type of
nonsense? The only explanation is political humbug and correctness.
It certainly doesn't benefit any patients.

That is why I have no problem in making the proposition that the
current system and notion of it should be shut down and replaced with
something that addresses patient requirements rather than outmoded
dogma














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