In message 4865e3bf@qaanaaq, at 08:09:51 on Sat, 28 Jun 2008, Andy
Hall remarked:

- It isn't reasonable for anybody to expect the dentist to run his
business at a loss.

We have already agreed that very few dentists run their business at a
loss. That is, have to pay the rent and nurse's costs from their
savings.

- The NHS claims to provide for dental services funded in part by
taxation collected from across the population and for an individual
through thir lifetime. Despite the promise that this should be free at
the point of delivery it is not and additional charges are made to the
patient.

I agree. The NHS is failing to deliver on this promise.

--
Roland Perry

In message 4865e53c@qaanaaq, at 08:16:12 on Sat, 28 Jun 2008, Andy
Hall remarked:
Why would I want to do NHS work at all?
You wouldn't, but not everyone is like you.
Are NHS dentists easily and universally available?
How does that affect your decision to work in the NHS?

That's something that I would never do anyway.... However, the
point here is that clearly dentists are choosing not to work in the NHS
on a very broad scale, for reasons that have been explained.

We have doctors and consultants who do, so something is clearly broken
with the funding.

It would be rather unlikely for doctors and consultants to be woolly
thinking socialists and for dentists to be hard nosed, money grabbing
*******s.

One difference that I notice is that consultants (especially the private
ones) seem to be middle-aged or older, whereas most dentists I see are
quite young.
--
Roland Perry

On 2008-06-27 18:50:41 +0100, geoff said:

In message 48647258@qaanaaq, Andy Hall writes

Logically one would think that. I've found it to be rather
different. Certainly in large organisations in other countries it is
typical that the very top management will speak good English if the
company is a multinational as well. Otherwise they can often be of an
age where they didn't learn English earlier in life and haven't needed
to.

what, you mean even older than you and me ?

Some younger. Generally it's based around whether they have needed to.




People who have or have had a technical role typically do speak or at
least understand English, but those who have had a role mainly
communicating with their peers may well not

It's not uncommon to have a situation where someone at senior level
does speak some English but whose juniors speak it better. He may
then choose not to do so for fear of showing himself up.

These are situations where it is even more important to meet the people
face to face to make sure that misunderstandings don't happen before
they even start. It can otherwise take a lot of time to recover,
reset expectations and continue on track.


I think a lot of it is making excuses not to change

To some extent yes, but that's more generational, so the changes are
gradual unless specific actions are taken.

For example, at least one large networking company that I know made
spoken English courses available for his French salesforce. Normally
in their everyday work, they didn't need to speak English, so while
they were OK at reading it and listening, it was a one way street.
For right or for wrong, those who did make the effort , tended to rise
in the organisation. Whether they liked that when it happened, is
something else.

In message 4865eb5c@qaanaaq, at 08:42:20 on Sat, 28 Jun 2008, Andy
Hall remarked:
Choose the private hospital or private faciity at which they also
work after checking its credentials
Even when they have specifically said they would refuse to treat you
at any such establishment because the NHS hospital has better
facilities?

That would raise a red flag in respect to the rest of the information
from the consultant, because clearly he would be basing this on some
political ideology than any form of reality.

Of course not. Put bluntly, private hospitals are not very experienced
at intensive care.
--
Roland Perry

In message 4865ec3a@qaanaaq, at 08:46:02 on Sat, 28 Jun 2008, Andy
Hall remarked:
I was at CDG, and the most obvious "different airline" to choose is
Air France. And guess what, when I flew through CDG on their prime
carrier Air France (in business class) and used their lounge, six
months ago, the lounge wifi was inoperative as a result [apparently]
of some dispute between themselves and Orange - owned of course by
France Telecom.

There wouldn't have been a choice since BA uses the same lounge at CDG.

During that dispute, I used Eurostar.

I had to fly, because only that way did I save a thousand or so on the
ticket. Yes, they generally pay you to fly from UK to CDG, to catch an
onward longhaul flight.
--
Roland Perry

On 2008-06-28 08:46:02 +0100, Roland Perry said:

In message 4865dadc@qaanaaq, at 07:31:56 on Sat, 28 Jun 2008, Andy
Hall remarked:
The only whinging I hear, here, is that NHS dentists are underpaid.
So what would you propose?
- Pay them more
- Persuade them to work for less
- Get out of the business
Point out they can make a decent living at it, if they want to.
Except that they can't, or they would.
Only if their expectations are too high.

This makes no sense. Are you sure that you don't really mean that
you don't see why they should make more than you do?

Whether they make more or less than me isn't relevant.

Are you sure about that?


The problem is training up loads of practitioners (in any line of work)
on the promise of a lucrative job for life that can only be supported
by overcharging the public.

I don't suppose that that is in the training course and if loads really
are being trained up, one would expect the market dynamics to reduce
the price points. Unless, of course the reality is that the economic
rate is not overcharging the public.

On 2008-06-28 08:48:29 +0100, Roland Perry said:

In message 4865e3bf@qaanaaq, at 08:09:51 on Sat, 28 Jun 2008, Andy
Hall remarked:

- It isn't reasonable for anybody to expect the dentist to run his
business at a loss.

We have already agreed that very few dentists run their business at a
loss. That is, have to pay the rent and nurse's costs from their
savings.

Right, and they achieve that by not selling their services at NHS prices.



- The NHS claims to provide for dental services funded in part by
taxation collected from across the population and for an individual
through thir lifetime. Despite the promise that this should be free at
the point of delivery it is not and additional charges are made to the
patient.

I agree. The NHS is failing to deliver on this promise.

Right. So the logical conclusion is to fix that or to shut it down.
There have been attempts to fix it going back pretty much 60 years and
all have failed so far. It would therefore be surprising if it can
be fixed.

Taking an exit from dentistry could be a good first stage to its demise
and eventual close down, which would be a good thing.

On 2008-06-28 08:50:05 +0100, Roland Perry said:

In message 4865e53c@qaanaaq, at 08:16:12 on Sat, 28 Jun 2008, Andy
Hall remarked:
Why would I want to do NHS work at all?
You wouldn't, but not everyone is like you.
Are NHS dentists easily and universally available?
How does that affect your decision to work in the NHS?

That's something that I would never do anyway.... However, the
point here is that clearly dentists are choosing not to work in the NHS
on a very broad scale, for reasons that have been explained.

We have doctors and consultants who do, so something is clearly broken
with the funding.

It would be rather unlikely for doctors and consultants to be woolly
thinking socialists and for dentists to be hard nosed, money grabbing
*******s.

One difference that I notice is that consultants (especially the
private ones) seem to be middle-aged or older, whereas most dentists I
see are quite young.

I see a mix in both cases when I shop around.

Andy Hall wrote:
On 2008-06-28 08:46:02 +0100, Roland Perry said:

In message 4865dadc@qaanaaq, at 07:31:56 on Sat, 28 Jun 2008, Andy
Hall remarked:
The only whinging I hear, here, is that NHS dentists are
underpaid.
So what would you propose?
- Pay them more
- Persuade them to work for less
- Get out of the business
Point out they can make a decent living at it, if they want to.
Except that they can't, or they would.
Only if their expectations are too high.

This makes no sense. Are you sure that you don't really mean that
you don't see why they should make more than you do?

Whether they make more or less than me isn't relevant.

Are you sure about that?


The problem is training up loads of practitioners (in any line of
work) on the promise of a lucrative job for life that can only be
supported by overcharging the public.

I don't suppose that that is in the training course and if loads really
are being trained up, one would expect the market dynamics to reduce the
price points. Unless, of course the reality is that the economic rate
is not overcharging the public.

But the first reaction might be for them to increase the amount of
work/number of services they provide - and push them hard.

And another problem is that it is extremely difficult to price compare
dentists. I really can't imagine them being willing to give a firm quote
for anything without doing their own examination - for which they will
naturally charge.

--
Rod

Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
www.thyromind.info www.thyroiduk.org www.altsupportthyroid.org

Andy Hall wrote:
On 2008-06-27 20:40:30 +0100, Roland Perry said:

In message 4863f829@qaanaaq, at 21:12:25 on Thu, 26 Jun 2008, Andy
Hall remarked:
The only whinging I hear, here, is that NHS dentists are underpaid.
So what would you propose?
- Pay them more
- Persuade them to work for less
- Get out of the business
Point out they can make a decent living at it, if they want to.

Except that they can't, or they would.

Only if their expectations are too high.

This makes no sense. Are you sure that you don't really mean that you
don't see why they should make more than you do?

So now you're presuming to know what people really meant to say. There
certainly seems to be no end to your talents.

On 2008-06-28 08:40:37 +0100, Rod said:

Andy Hall wrote:

Only a fool allows the doctor to be the decision maker without doing
further checking themselves.


And if your illness makes you a fool, you have to rely on them.

Well, touche, but this is then a case where other capable family
members can become involved.

I can certainly relate to your point about medicine on uncharted
territory and also to conditions that can affect judgment. There will
always be these situations.

However, I was really referring to the broader situation where people
are able to check for themselves to some degree and more important to
take responsibility for themselves rather than sitting back and letting
doctors do it all.

As time goes by, I realise more and more that especially GPs don't have
the depth of knowledge on some quite common ailments and are more and
more time constrained. After that, as one reads the clinical
studies, it's also apparent that there are often not hard and fast
decisions that can be made, but rather statistical probabilities, if
the subject has been properly studied at all.

On 2008-06-28 08:55:06 +0100, Roland Perry said:

In message 4865eb5c@qaanaaq, at 08:42:20 on Sat, 28 Jun 2008, Andy
Hall remarked:
Choose the private hospital or private faciity at which they also
work after checking its credentials
Even when they have specifically said they would refuse to treat you
at any such establishment because the NHS hospital has better
facilities?

That would raise a red flag in respect to the rest of the information
from the consultant, because clearly he would be basing this on some
political ideology than any form of reality.

Of course not. Put bluntly, private hospitals are not very experienced
at intensive care.

Put bluntly, that depends on where you go and should be part of the
decision making along with the consultant and team.

Andy Hall wrote:
On 2008-06-28 08:40:37 +0100, Rod said:

Andy Hall wrote:

Only a fool allows the doctor to be the decision maker without doing
further checking themselves.


And if your illness makes you a fool, you have to rely on them.

Well, touche, but this is then a case where other capable family members
can become involved.

I can certainly relate to your point about medicine on uncharted
territory and also to conditions that can affect judgment. There will
always be these situations.

However, I was really referring to the broader situation where people
are able to check for themselves to some degree and more important to
take responsibility for themselves rather than sitting back and letting
doctors do it all.

As time goes by, I realise more and more that especially GPs don't have
the depth of knowledge on some quite common ailments and are more and
more time constrained. After that, as one reads the clinical studies,
it's also apparent that there are often not hard and fast decisions that
can be made, but rather statistical probabilities, if the subject has
been properly studied at all.

Unfortunately whenever time is critical it will be difficult to follow
your prescription. In the past three years we have pulled ourselves up
by our bootstraps to become familiar with and understanding of the area.
But we have no medical training, no medical background (neither of us
had really suffered anything significant before now). So it has been
hard work.

However our areas interest/concern are incredibly complex - directly
affecting every cell of the body. There is immense confusion and
disagreement over the meanings of even the basic tests. It is hugely
exploited by snake oil salesmen - who have every reason to misinform.

I agree about GPs not having the knowledge. But what I would have liked
ot see simply does not exist. I want a specialist nurse-led unit which
encourages people to drop in (if they are able), chat, discuss,
research, help each other - but with someone who has knowledge and
experience in charge. And I really can't see a private version of that
ever being much good. For a start, the ones who could afford it would
not get the benefit of the experiences of those who cannot.

Common? Well something like 2.1% of adults in England diagnosed with one
form. (And permanent complaints obviously don't come and go so their
persistance pushes them well up the league of what people are suffering
on any one day.)

Research? Tons of it. Some very good and very interesting. But how does
it ever get passed on to GPs and thence to patients?

--
Rod

Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
www.thyromind.info www.thyroiduk.org www.altsupportthyroid.org

On 2008-06-28 09:13:46 +0100, Rod said:

Andy Hall wrote:


I don't suppose that that is in the training course and if loads really
are being trained up, one would expect the market dynamics to reduce
the price points. Unless, of course the reality is that the economic
rate is not overcharging the public.

But the first reaction might be for them to increase the amount of
work/number of services they provide - and push them hard.

I have never found that to happen in 30 years of using a variety of
different private dentists. Never once has unnecessary treatment
been offered or taken. I have asked for information and that has
been given. That is a sample size of four patients and four
dentists, but it would be surprising if they treated other patients
differently.



And another problem is that it is extremely difficult to price compare
dentists. I really can't imagine them being willing to give a firm
quote for anything without doing their own examination - for which they
will naturally charge.

I've never had a problem with that. It's certainly possible to
obtain a range of prices for common treatments.

Besides which, something as important as healthcare shouldn't be bought
on price.

On 2008-06-28 09:17:01 +0100, stuart noble said:

Andy Hall wrote:
On 2008-06-27 20:40:30 +0100, Roland Perry said:

In message 4863f829@qaanaaq, at 21:12:25 on Thu, 26 Jun 2008, Andy
Hall remarked:
The only whinging I hear, here, is that NHS dentists are underpaid.
So what would you propose?
- Pay them more
- Persuade them to work for less
- Get out of the business
Point out they can make a decent living at it, if they want to.

Except that they can't, or they would.

Only if their expectations are too high.

This makes no sense. Are you sure that you don't really mean that
you don't see why they should make more than you do?

So now you're presuming to know what people really meant to say. There
certainly seems to be no end to your talents.

No, I'm simply asking a question. So far there hasn't been a
rational explanation as to why dentists should run at a loss, only that
it's supposed not to be acceptable for them to have a reasonable house
and car.

I can understand it if people feel that someone with whom they do
business and has a better financial position than they do is ripping
them off. That's a natural human reaction, but let's at least be
open about it.

Andy Hall wrote:
On 2008-06-28 09:13:46 +0100, Rod said:

Andy Hall wrote:


I don't suppose that that is in the training course and if loads
really are being trained up, one would expect the market dynamics to
reduce the price points. Unless, of course the reality is that the
economic rate is not overcharging the public.

But the first reaction might be for them to increase the amount of
work/number of services they provide - and push them hard.

I have never found that to happen in 30 years of using a variety of
different private dentists. Never once has unnecessary treatment been
offered or taken. I have asked for information and that has been
given. That is a sample size of four patients and four dentists,
but it would be surprising if they treated other patients differently.



And another problem is that it is extremely difficult to price compare
dentists. I really can't imagine them being willing to give a firm
quote for anything without doing their own examination - for which
they will naturally charge.

I've never had a problem with that. It's certainly possible to
obtain a range of prices for common treatments.

Besides which, something as important as healthcare shouldn't be bought
on price.


Prices for a range of common treatments have a horrible habit of
becoming the prices on which comparisons are made. This puts downward
pressure onto those prices - but allows the other prices to drift
upward, sometimes (often?) unnoticed - and possible unknowably.

Not bought on price alone, I would agree.

But not taking it into account? That truly is giving carte blanche for
the dentist to charge what they like.

--
Rod

Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
www.thyromind.info www.thyroiduk.org www.altsupportthyroid.org

On 2008-06-28 09:50:24 +0100, Rod said:

Unfortunately whenever time is critical it will be difficult to follow
your prescription.

Yes I agree. Of course there are instances where this isn't possible,
for example in cases of sudden and serious illness.


In the past three years we have pulled ourselves up by our bootstraps
to become familiar with and understanding of the area. But we have no
medical training, no medical background (neither of us had really
suffered anything significant before now). So it has been hard work.

Yes I know. I've done it in relation to several ailments over the
last few years. The only crumb of comfort that I can give you is
that once you have done it for one, you do at least know the methods
and where to look.



However our areas interest/concern are incredibly complex - directly
affecting every cell of the body. There is immense confusion and
disagreement over the meanings of even the basic tests. It is hugely
exploited by snake oil salesmen - who have every reason to misinform.

Indeed. Also, one has to be careful about the clinical
meanings/interpretations of everyday terms. They are very much based
on context and stats. For example, I was recently reading about side
effects of anaesthetics. The RCOA defines "very common" as 1 in 10,
"common" as 1 in 100, "uncommon" as 1 in 1000 and so on.



I agree about GPs not having the knowledge. But what I would have liked
ot see simply does not exist. I want a specialist nurse-led unit which
encourages people to drop in (if they are able), chat, discuss,
research, help each other - but with someone who has knowledge and
experience in charge. And I really can't see a private version of that
ever being much good. For a start, the ones who could afford it would
not get the benefit of the experiences of those who cannot.

That would be good. It is difficult to see it being funded in either regime.



Common? Well something like 2.1% of adults in England diagnosed with
one form. (And permanent complaints obviously don't come and go so
their persistance pushes them well up the league of what people are
suffering on any one day.)

That actually is a lot.


Research? Tons of it. Some very good and very interesting. But how does
it ever get passed on to GPs and thence to patients?

Sadly, the GPs don't have the time, and the patients don't know where
to look and are not encouraged to go and look.

On 2008-06-28 10:23:01 +0100, Rod said:

Prices for a range of common treatments have a horrible habit of
becoming the prices on which comparisons are made. This puts downward
pressure onto those prices - but allows the other prices to drift
upward, sometimes (often?) unnoticed - and possible unknowably.

Not bought on price alone, I would agree.

But not taking it into account? That truly is giving carte blanche for
the dentist to charge what they like.

People do compare because in the private dental sector, there is
generally a fair amount of choice available. So recommendations, word
of mouth etc. become factors as well.

If somebody is good, they will get recommendations, if they massively
over-price, that soon gets around as well.

Andy Hall wrote:
On 2008-06-28 09:50:24 +0100, Rod said:

Unfortunately whenever time is critical it will be difficult to follow
your prescription.

Yes I agree. Of course there are instances where this isn't possible,
for example in cases of sudden and serious illness.


In the past three years we have pulled ourselves up by our bootstraps
to become familiar with and understanding of the area. But we have no
medical training, no medical background (neither of us had really
suffered anything significant before now). So it has been hard work.

Yes I know. I've done it in relation to several ailments over the last
few years. The only crumb of comfort that I can give you is that
once you have done it for one, you do at least know the methods and
where to look.


Crumbs don't help when wheat allergy pops up! :-)
(Though written to leaven the post - that possibility does exist.)



However our areas interest/concern are incredibly complex - directly
affecting every cell of the body. There is immense confusion and
disagreement over the meanings of even the basic tests. It is hugely
exploited by snake oil salesmen - who have every reason to misinform.

Indeed. Also, one has to be careful about the clinical
meanings/interpretations of everyday terms. They are very much based
on context and stats. For example, I was recently reading about side
effects of anaesthetics. The RCOA defines "very common" as 1 in 10,
"common" as 1 in 100, "uncommon" as 1 in 1000 and so on.


I have been heartened by the apparent increasing use of qualification
such as "rare ( 1 in 100,0000)" in many medical documents (including
Patient Information Leaflets). Without the numbers it is obscure what is
really meant.


I agree about GPs not having the knowledge. But what I would have
liked ot see simply does not exist. I want a specialist nurse-led unit
which encourages people to drop in (if they are able), chat, discuss,
research, help each other - but with someone who has knowledge and
experience in charge. And I really can't see a private version of that
ever being much good. For a start, the ones who could afford it would
not get the benefit of the experiences of those who cannot.

That would be good. It is difficult to see it being funded in either
regime.

It is. I think that the major charities have managed something vaguely
along those lines - but thyroid is not currently viewed as being as
importnat as cancer. (That is NOT a dig at cancer - those involved have
done a huge amount to help themsleves.)

Common? Well something like 2.1% of adults in England diagnosed with
one form. (And permanent complaints obviously don't come and go so
their persistance pushes them well up the league of what people are
suffering on any one day.)

That actually is a lot.


And do bear in mind, that is pretty much the ones who a) have symptoms
that caused a doctor to do a TSH test; b) had a TSH level outside the
normal range - sorry, reference range on the day tested; c) have got
past the "we'll do anothe rtest in six months and see how it is going"
barrier. That figure came from Department of Health analysis of GP
statistics from one of the recent years (somewhere 2003 to 2006 IIRC).

It necessarily excludes those whose symptoms have been misattributed to
some other cause - e.g. idiopathic forms of early/premature menopause,
dislipidaemia, heart problems, etc.

From immediate family contacts alone, I can say that some have had
their thyroid issues ignored for years - maybe decades.

I would not be at all surprised if you could double that to around 4 to
5 % with significant levels of hypothyroidism.


Research? Tons of it. Some very good and very interesting. But how
does it ever get passed on to GPs and thence to patients?

Sadly, the GPs don't have the time, and the patients don't know where to
look and are not encouraged to go and look.


It could be expected that the relevant consultants would do something to
get the messages passed on to GPs. But it actually appears that even
they do not (cannot?) keep up with the flood of research.

I always carry some business cards for my favourite thyroid organisation
- and have given out quite a number. Some feedback has been very
grateful. (Not that I do it to achieve that - I can't live with myself
if I don't do what I can.)

--
Rod

Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
www.thyromind.info www.thyroiduk.org www.altsupportthyroid.org

On 2008-06-28 10:57:40 +0100, Rod said:


I have been heartened by the apparent increasing use of qualification
such as "rare ( 1 in 100,0000)" in many medical documents (including
Patient Information Leaflets). Without the numbers it is obscure what
is really meant.

Yes that is useful and the increase in the ratios is as well.




I agree about GPs not having the knowledge. But what I would have liked
ot see simply does not exist. I want a specialist nurse-led unit which
encourages people to drop in (if they are able), chat, discuss,
research, help each other - but with someone who has knowledge and
experience in charge. And I really can't see a private version of that
ever being much good. For a start, the ones who could afford it would
not get the benefit of the experiences of those who cannot.

That would be good. It is difficult to see it being funded in either regime.

It is. I think that the major charities have managed something vaguely
along those lines - but thyroid is not currently viewed as being as
importnat as cancer.
(That is NOT a dig at cancer - those involved have done a huge amount
to help themsleves.)

It's all about politics and money, unfortunately. Given that there
is a finite limit to what an individual can do in regad to those, it
becomes more important to look for oneself and also to find others in
the same predicament, if nothing more at least as a sanity check.



Common? Well something like 2.1% of adults in England diagnosed with
one form. (And permanent complaints obviously don't come and go so
their persistance pushes them well up the league of what people are
suffering on any one day.)

That actually is a lot.


And do bear in mind, that is pretty much the ones who a) have symptoms
that caused a doctor to do a TSH test; b) had a TSH level outside the
normal range - sorry, reference range on the day tested; c) have got
past the "we'll do anothe rtest in six months and see how it is going"
barrier. That figure came from Department of Health analysis of GP
statistics from one of the recent years (somewhere 2003 to 2006 IIRC).

That is very concerning. I certainly had to push for repeat tests
quite hard.



It necessarily excludes those whose symptoms have been misattributed to
some other cause - e.g. idiopathic forms of early/premature menopause,
dislipidaemia, heart problems, etc.

From immediate family contacts alone, I can say that some have had
their thyroid issues ignored for years - maybe decades.

I would not be at all surprised if you could double that to around 4 to
5 % with significant levels of hypothyroidism.

If it's not getting the attention, that wouldn't be surprising.





Research? Tons of it. Some very good and very interesting. But how does
it ever get passed on to GPs and thence to patients?

Sadly, the GPs don't have the time, and the patients don't know where
to look and are not encouraged to go and look.


It could be expected that the relevant consultants would do something
to get the messages passed on to GPs. But it actually appears that even
they do not (cannot?) keep up with the flood of research.

Really it is cannot. There is an information overload. My GP is said
to me on a couple of occasions that I know more about conditions X and
Y than he does. That's not a compliment but a reality. Flattering
that he would say it I suppose, but indicative that he can only really
deal in headlines and NICE guidelines.


I always carry some business cards for my favourite thyroid
organisation - and have given out quite a number. Some feedback has
been very grateful. (Not that I do it to achieve that - I can't live
with myself if I don't do what I can.)

Especially when it's a condition that can be responsible for idiopathic
symptoms as you say

The message 4865f42e@qaanaaq
from Andy Hall contains these words:

Of course not. Put bluntly, private hospitals are not very experienced
at intensive care.

Put bluntly, that depends on where you go and should be part of the
decision making along with the consultant and team.

Not forgetting the bottomless money pit.

--
Roger Chapman

"Roger" wrote in message
k...
The message 4865f42e@qaanaaq
from Andy Hall contains these words:

Of course not. Put bluntly, private hospitals are not very experienced
at intensive care.

Put bluntly, that depends on where you go and should be part of the
decision making along with the consultant and team.

Not forgetting the bottomless money pit.

No need to worry.. if anything goes wrong they will transfer you to NHS
where you can actually be treated.
It happens all the time.
Just make sure you choose a private hospital near an ambulance station.

I just choose a good NHS hospital instead.

On 2008-06-28 14:29:41 +0100, Roger said:

The message 4865f42e@qaanaaq
from Andy Hall contains these words:

Of course not. Put bluntly, private hospitals are not very experienced
at intensive care.

Put bluntly, that depends on where you go and should be part of the
decision making along with the consultant and team.

Not forgetting the bottomless money pit.

Not forgetting that private health insurance will pay for these, but
remembering that it is taxed four times over.

In message 48666769@qaanaaq, Andy Hall writes
On 2008-06-28 14:29:41 +0100, Roger said:

The message 4865f42e@qaanaaq
from Andy Hall contains these words:

Of course not. Put bluntly, private hospitals are not very
experienced
at intensive care.

Put bluntly, that depends on where you go and should be part of the
decision making along with the consultant and team.
Not forgetting the bottomless money pit.

Not forgetting that private health insurance will pay for these, but
remembering that it is taxed four times over.

does your private health insurance pay for immediate treatment for e.g.
a broken bone or cut requiring stitches - A&E type injuries

or for what the NHS can't treat in 6 weeks ?


--
geoff

On 2008-06-28 16:19:21 +0100, "dennis@home"
said:



"Roger" wrote in message
k...
The message 4865f42e@qaanaaq
from Andy Hall contains these words:

Of course not. Put bluntly, private hospitals are not very experienced
at intensive care.

Put bluntly, that depends on where you go and should be part of the
decision making along with the consultant and team.

Not forgetting the bottomless money pit.

No need to worry.. if anything goes wrong they will transfer you to NHS
where you can actually be treated.
It happens all the time.

Citations? Independent statistical evidence?


Just make sure you choose a private hospital near an ambulance station.

I just choose a good NHS hospital instead.



That must be a challenge.

On 2008-06-28 17:52:05 +0100, geoff said:

does your private health insurance pay for immediate treatment for e.g.
a broken bone or cut requiring stitches - A&E type injuries

No, because it isn't designed to do so. It's worth pointing out that
in addition to the tax distortion of the market, the other components
of immediate treatment such as the 112 call centres and ambulance
services do not operate on a competitive basis for A&E purposes but
feed NHS facilities.

I do think that even with the current taxation and healthcare delivery
muddle, there is a market opportunity for privately run and insurable
immediate treatment centres for walk in cases.



or for what the NHS can't treat in 6 weeks ?

Most private insurers offer several products. One type does have
the scenario of providing cover at a private facility when the NHS
fails to deliver in 6 weeks. These are less expensive than products
that provide for first choice at a private facility.

Personally, I prefer the latter because I don't want to mess about with
the uncertainty but rather to choose consultant, location and dates to
fit with other commitments.

In message 48667d0a@qaanaaq, Andy Hall writes
On 2008-06-28 17:52:05 +0100, geoff said:

does your private health insurance pay for immediate treatment for
e.g. a broken bone or cut requiring stitches - A&E type injuries

No, because it isn't designed to do so. It's worth pointing out that
in addition to the tax distortion of the market, the other components
of immediate treatment such as the 112 call centres and ambulance
services do not operate on a competitive basis for A&E purposes but
feed NHS facilities.

So your shiny ins policy doesn't give you a point of sale facility

YOU have to rely on the NHS for that

When you are lying bleeding at the roadside, you depend on the NHS

is that the case ?



I do think that even with the current taxation and healthcare delivery
muddle, there is a market opportunity for privately run and insurable
immediate treatment centres for walk in cases.

I think that the word you are looking for is cherry picking



or for what the NHS can't treat in 6 weeks ?

Most private insurers offer several products. One type does have
the scenario of providing cover at a private facility when the NHS
fails to deliver in 6 weeks. These are less expensive than products
that provide for first choice at a private facility.

Personally, I prefer the latter because I don't want to mess about with
the uncertainty but rather to choose consultant, location and dates to
fit with other commitments.


So, how much are you paying a year for the first choice policy you have
?


--
geoff

Andy Hall wrote:
On 2008-06-27 12:00:24 +0100, magwitch said:

Chris Shore wrote:
"magwitch" wrote in message
...

Sorry to burst your balloon.

Sad, inexcusable and awful though those stories are, I am certain
that we could rehearse
just as many from within the NHS. I am aware of several myself.

Chris

Oh I'm sure they can and do happen to NHS patients, but these happened
entirely because of private treatment... in my mother's friend's case
because she had the cash to pay for what had already been ruled an
inappropriate (in her case) operation, and in mum's cousin's case
because he was in a private room, if he'd been on a NHS general
post-op ward, someone would have heard him fall over and he'd have
been noticed and treated almost immediately.

It's very easy to come up with anecdotes like this. Nothing is
without risk. What actually counts is outcome and that is a
statistical analysis, not an emotional one.


Inge wasn't an 'anecdote', and if you want to know about *really* taking
risks, she was in the Resistance in Denmark during the war... what a
limited outlook you display.

Andy Hall wrote:
On 2008-06-27 10:44:36 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-26 22:27:31 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-26 18:32:05 +0100, Roland Perry said:

In message 486177d1@qaanaaq, at 23:40:17 on Tue, 24 Jun 2008,
Andy Hall remarked:
One can consult with virtually any consultant doing NHS work on a
private basis. The important thing is to check the
credentials and track record of the individual.

And when the track record is exemplary, and they recommend
treatment in an NHS hospital, who do you do then?

Choose the private hospital or private faciity at which they also
work after checking its credentials

A consultant friend of mine says that with private care you just get
the consultant (however skilled or distuingished) what you don't get
is the team of various professionals who work closely with him in
the NHS.

On the contrary. In respect of a particular exercise, I checked
that precise point with all of the individuals concerned, especially
how often they had worked together. My findings were quite the
opposite.



With a private hospital's operating theatre and rooms (however
plush) the visiting medical staff more or less rent the facilities
and then go their separate ways leaving the patient's progress to fate.

I found that not to be true either as have many friends and relatives
who have eschewed the high infection rates and poor standards of the
NHS.

Two case histories:

The first was an old friend of my mother who, like my mother, had
arthritis in her knees and went to her NHS orthopaedic consultant. He
said that a knee joint replacement would not be advisable for her (on
weight and general health grounds).

The private orthopaedic surgeon had no such qualms, so after paying
him the £30,000 fee, she had the op. After 3 weeks, an infection set
in (this was treated on the NHS as the private consultant/hospital
didn't want to know) and 6 weeks later she had her leg amputated above
the knee, this was so traumatic to her that she literally lost the
will to live and died a few days later.

Both examples are ridiculous.

The correct course of action is for the patient or their family to take
responsibility for themselves and to seek second opinions in both cases
as well as researching the risks involved.

The fact that there was such an obviously wide variance of opinion
should have rung a very large warning bell. Whether one was an NHS
consultant and the other not, can have the opposite connotation to the
private consultant being on the make as you are implying. It can
equally be the NHS not being willing to fund this procedurefor someone
of these QALYs.



Thank god you (obviously) aren't anything to do with the medical profession.

Andy Hall wrote:
On 2008-06-27 10:44:36 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-26 22:27:31 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-26 18:32:05 +0100, Roland Perry said:

In message 486177d1@qaanaaq, at 23:40:17 on Tue, 24 Jun 2008,
Andy Hall remarked:
One can consult with virtually any consultant doing NHS work on a
private basis. The important thing is to check the
credentials and track record of the individual.

And when the track record is exemplary, and they recommend
treatment in an NHS hospital, who do you do then?

Choose the private hospital or private faciity at which they also
work after checking its credentials

A consultant friend of mine says that with private care you just get
the consultant (however skilled or distuingished) what you don't get
is the team of various professionals who work closely with him in
the NHS.

On the contrary. In respect of a particular exercise, I checked
that precise point with all of the individuals concerned, especially
how often they had worked together. My findings were quite the
opposite.



With a private hospital's operating theatre and rooms (however
plush) the visiting medical staff more or less rent the facilities
and then go their separate ways leaving the patient's progress to fate.

I found that not to be true either as have many friends and relatives
who have eschewed the high infection rates and poor standards of the
NHS.

Two case histories:

The first was an old friend of my mother who, like my mother, had
arthritis in her knees and went to her NHS orthopaedic consultant. He
said that a knee joint replacement would not be advisable for her (on
weight and general health grounds).

The private orthopaedic surgeon had no such qualms, so after paying
him the £30,000 fee, she had the op. After 3 weeks, an infection set
in (this was treated on the NHS as the private consultant/hospital
didn't want to know) and 6 weeks later she had her leg amputated above
the knee, this was so traumatic to her that she literally lost the
will to live and died a few days later.

Both examples are ridiculous.

The correct course of action is for the patient or their family to take
responsibility for themselves and to seek second opinions in both cases
as well as researching the risks involved.

The fact that there was such an obviously wide variance of opinion
should have rung a very large warning bell. Whether one was an NHS
consultant and the other not, can have the opposite connotation to the
private consultant being on the make as you are implying. It can
equally be the NHS not being willing to fund this procedurefor someone
of these QALYs.



The second was my mother's cousin, who'd had a routine hernia
operation privately with the usual post-op overnight stay. He got up
in the middle of the night and fell over and knocked himself out on
the way to the ensuite bathroom. As nobody checked on him during the
night (private room) he lay there for 7 hours. He spent 6 weeks on a
NHS intensive care ward, as he'd sustained some brain damage (due to
being left unconscious on the floor, not his head wound) and wasn't
able to live independently again.

I know of a similar story in a local NHS facility. The difference was
that the individual contracted an infection and is no longer with us.





Well losing a mother and providing 24/7 care for one's father
certainly burst my friend Jenny's and second-cousin Michael's for them.

Anecdotal information isn't very useful.

Before undertaking a clinical procedure, it's the responsibility of the
individual to check out the facility and the personnel involved and to
cross check that in the profession to determine track record. That
is more indicative of likely outcome.




Reading through your first callous reply was bad enough, but here it is
again!

Andy Hall wrote:
On 2008-06-27 10:56:53 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-26 23:22:11 +0100, geoff said:

Logically one would think that. I've found it to be rather
different. Certainly in large organisations in other countries it
is typical that the very top management will speak good English if
the company is a multinational as well. Otherwise they can often be
of an age where they didn't learn English earlier in life and haven't
needed to.

People who have or have had a technical role typically do speak or at
least understand English, but those who have had a role mainly
communicating with their peers may well not

It's not uncommon to have a situation where someone at senior level
does speak some English but whose juniors speak it better. He may
then choose not to do so for fear of showing himself up.

These are situations where it is even more important to meet the
people face to face to make sure that misunderstandings don't happen
before they even start. It can otherwise take a lot of time to
recover, reset expectations and continue on track.

My Dad was export sales manager for ICI Caribbean and South America
for 20 years, and err... learned to speak Spanish and Portuguese (self
taught).

Purely because, when closing a deal, he could understand what they
were saying privately amongst themselves and they knew he could
understand them so they didn't try it on.

This is a good point and is the ideal. It will work for a few countries
but becomes less practical if one works in a large number of countries,
cultures and languages.


I forgot to say... he had a smattering of Thai, Japanese and Malay.
Learned them all when he was a POW in Burma building the railway.

He used them too... during the 60's he was unique in that he'd closed an
export deal worth £1 million with the Japanese, it was all the other
way at that time.

On 2008-06-28 19:51:24 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-27 12:00:24 +0100, magwitch said:

Chris Shore wrote:
"magwitch" wrote in message
...

Sorry to burst your balloon.

Sad, inexcusable and awful though those stories are, I am certain that
we could rehearse
just as many from within the NHS. I am aware of several myself.

Chris

Oh I'm sure they can and do happen to NHS patients, but these happened
entirely because of private treatment... in my mother's friend's case
because she had the cash to pay for what had already been ruled an
inappropriate (in her case) operation, and in mum's cousin's case
because he was in a private room, if he'd been on a NHS general post-op
ward, someone would have heard him fall over and he'd have been noticed
and treated almost immediately.

It's very easy to come up with anecdotes like this. Nothing is
without risk. What actually counts is outcome and that is a
statistical analysis, not an emotional one.


Inge wasn't an 'anecdote', and if you want to know about *really*
taking risks, she was in the Resistance in Denmark during the war...
what a limited outlook you display.

On the contrary. My outlook is very broad in this regard. Consider
the issues.

I am sure that Inge did a great job in the Danish resistance during the
war and that that was fraught with risk and dangers.

However, it has zero relevance to choices about healthcare, other than
to determine, perhaps, the individual's attitude to risk when presented
with the figures.

Purveyors of healthcare, medicines, equipment and all the rest, love to
do their marketing with case studies talking about Fred, the taxi
driver from Nottingham who did this or that and all was well. Support
groups do the same, except that Fred might be taking part and one gets
to hear whether Fred was OK or not OK. This is all very
interesting, but has almost no relevance to another patient's outcome
or even the decision making processes that they should take.

The correct action is not to look at what happened to Fred, Mabel or
even Inge, because that was what happened to them; but rather to look
at consultants, facilities and clinical research. It is with these
that correct decisions are made. The individual should have all of
the risk and complication data and then make an informed decision based
on that, not on stories and emotions.

On 2008-06-28 19:54:17 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-27 10:44:36 +0100, magwitch said:

Andy Hall wrote:
On 2008-06-26 22:27:31 +0100, magwitch said:

Two case histories:

The first was an old friend of my mother who, like my mother, had
arthritis in her knees and went to her NHS orthopaedic consultant. He
said that a knee joint replacement would not be advisable for her (on
weight and general health grounds).

The private orthopaedic surgeon had no such qualms, so after paying him
the £30,000 fee, she had the op. After 3 weeks, an infection set in
(this was treated on the NHS as the private consultant/hospital didn't
want to know) and 6 weeks later she had her leg amputated above the
knee, this was so traumatic to her that she literally lost the will to
live and died a few days later.

Both examples are ridiculous.

The correct course of action is for the patient or their family to take
responsibility for themselves and to seek second opinions in both cases
as well as researching the risks involved.

The fact that there was such an obviously wide variance of opinion
should have rung a very large warning bell. Whether one was an NHS
consultant and the other not, can have the opposite connotation to the
private consultant being on the make as you are implying. It can
equally be the NHS not being willing to fund this procedurefor someone
of these QALYs.



Thank god you (obviously) aren't anything to do with the medical profession.

Do you imagine that the NHS doesn't make funding and availability of
treatment decisions based on such criteria?

Type QALY and NHS as search terms into Google and prepare to be disgusted.

Since you seem to like anecdotes, I'll provide you with one. A
ninety five year old lady, otherwise in good health and with excellent
mental faculties, was refused a hip replacement operation on this
basis. Of course, it was packaged up as risk etc. but never clearly
explained. She was persistent and had the surgery done in a
private hospital with full backup and ICU facilities (which actually
she didn't need).

Her quality of life improved as she was able to move around more than
she had done for many years. She lived to be 103 and continued to
have good health right until the end. Clearly she and her family
thought that it was worth the investment, even though the faceless
bureaucrats of the NHS, playing God, saw it differently.

On 2008-06-28 19:24:35 +0100, geoff said:

In message 48667d0a@qaanaaq, Andy Hall writes
On 2008-06-28 17:52:05 +0100, geoff said:

does your private health insurance pay for immediate treatment for e.g.
a broken bone or cut requiring stitches - A&E type injuries

No, because it isn't designed to do so. It's worth pointing out that
in addition to the tax distortion of the market, the other components
of immediate treatment such as the 112 call centres and ambulance
services do not operate on a competitive basis for A&E purposes but
feed NHS facilities.

So your shiny ins policy doesn't give you a point of sale facility

It provides exactly what it is designed to do which is cover for
diagnosis and acute care. I know exactly what I can get, when and
where. I can't get that from the NHS.

In terms of A&E, there is, in effect, a closed NHS market for most aspects.

However, for the cases that you described of a broken bone or cut
requiring stitches - i.e. a walk-in issue; if faced with sitting for 4
hours in a filthy NHS hospital surrounded by drunks and going and being
seen immediately for one or two hundred quid, I'm very clear on what I
would do.



YOU have to rely on the NHS for that

When you are lying bleeding at the roadside, you depend on the NHS

is that the case ?

Of course it is, because there is no choice, and that is fundamentally wrong.





I do think that even with the current taxation and healthcare delivery
muddle, there is a market opportunity for privately run and insurable
immediate treatment centres for walk in cases.

I think that the word you are looking for is cherry picking

It's providing patient choice.




or for what the NHS can't treat in 6 weeks ?

Most private insurers offer several products. One type does have
the scenario of providing cover at a private facility when the NHS
fails to deliver in 6 weeks. These are less expensive than products
that provide for first choice at a private facility.

Personally, I prefer the latter because I don't want to mess about with
the uncertainty but rather to choose consultant, location and dates to
fit with other commitments.


So, how much are you paying a year for the first choice policy you have ?

A small fraction of what I pay to the NHS.

On 2008-06-28 19:55:48 +0100, magwitch said:

Andy Hall wrote:

Anecdotal information isn't very useful.

Before undertaking a clinical procedure, it's the responsibility of the
individual to check out the facility and the personnel involved and to
cross check that in the profession to determine track record. That
is more indicative of likely outcome.




Reading through your first callous reply was bad enough, but here it is again!

It isn't callous at all, but the right way to make medical choices.

If you want to make decisions about your healthcare based on what
happened to friends and acquaintances then go ahead, but it won't
result in the best outcome available.

In message 486694eb@qaanaaq, Andy Hall writes
On 2008-06-28 19:24:35 +0100, geoff said:

In message 48667d0a@qaanaaq, Andy Hall writes
On 2008-06-28 17:52:05 +0100, geoff said:

does your private health insurance pay for immediate treatment for
e.g. a broken bone or cut requiring stitches - A&E type injuries
No, because it isn't designed to do so. It's worth pointing out
that in addition to the tax distortion of the market, the other
components of immediate treatment such as the 112 call centres and
ambulance services do not operate on a competitive basis for A&E
purposes but feed NHS facilities.
So your shiny ins policy doesn't give you a point of sale facility

It provides exactly what it is designed to do which is cover for
diagnosis and acute care. I know exactly what I can get, when and
where. I can't get that from the NHS.

In terms of A&E, there is, in effect, a closed NHS market for most aspects.

However, for the cases that you described of a broken bone or cut
requiring stitches - i.e. a walk-in issue; if faced with sitting for 4
hours in a filthy NHS hospital surrounded by drunks and going and being
seen immediately for one or two hundred quid, I'm very clear on what I
would do.


YOU have to rely on the NHS for that
When you are lying bleeding at the roadside, you depend on the NHS
is that the case ?

Of course it is, because there is no choice, and that is fundamentally wrong.



I do think that even with the current taxation and healthcare
delivery muddle, there is a market opportunity for privately run and
insurable immediate treatment centres for walk in cases.
I think that the word you are looking for is cherry picking

It's providing patient choice.



or for what the NHS can't treat in 6 weeks ?
Most private insurers offer several products. One type does
have the scenario of providing cover at a private facility when the
NHS fails to deliver in 6 weeks. These are less expensive than
products that provide for first choice at a private facility.
Personally, I prefer the latter because I don't want to mess about
with the uncertainty but rather to choose consultant, location and
dates to fit with other commitments.
So, how much are you paying a year for the first choice policy you
have ?

A small fraction of what I pay to the NHS.

How much are you paying for your policy?


--
geoff

In message 486694eb@qaanaaq, Andy Hall writes
On 2008-06-28 19:24:35 +0100, geoff said:

In message 48667d0a@qaanaaq, Andy Hall writes
On 2008-06-28 17:52:05 +0100, geoff said:

does your private health insurance pay for immediate treatment for
e.g. a broken bone or cut requiring stitches - A&E type injuries
No, because it isn't designed to do so. It's worth pointing out
that in addition to the tax distortion of the market, the other
components of immediate treatment such as the 112 call centres and
ambulance services do not operate on a competitive basis for A&E
purposes but feed NHS facilities.
So your shiny ins policy doesn't give you a point of sale facility

It provides exactly what it is designed to do which is cover for
diagnosis and acute care. I know exactly what I can get, when and
where. I can't get that from the NHS.

So it provides a cherry picked subset of a health service

it doesn't provide the open ended comprehensive care that the NHS is
attempting to do

like the courier companies who have taken on the profitable parts of the
royal mail and left the unprofitable bits so that we end up with a
strapped for cash service which can't operate effectively


--
geoff

On 2008-06-28 21:10:34 +0100, geoff said:

In message 486694eb@qaanaaq, Andy Hall writes
On 2008-06-28 19:24:35 +0100, geoff said:

In message 48667d0a@qaanaaq, Andy Hall writes
On 2008-06-28 17:52:05 +0100, geoff said:

does your private health insurance pay for immediate treatment for e.g.
a broken bone or cut requiring stitches - A&E type injuries
No, because it isn't designed to do so. It's worth pointing out that
in addition to the tax distortion of the market, the other components
of immediate treatment such as the 112 call centres and ambulance
services do not operate on a competitive basis for A&E purposes but
feed NHS facilities.
So your shiny ins policy doesn't give you a point of sale facility

It provides exactly what it is designed to do which is cover for
diagnosis and acute care. I know exactly what I can get, when and
where. I can't get that from the NHS.

So it provides a cherry picked subset of a health service

It provides what its customers want to buy, and there is a choice of
whether or what to buy. The NHS doesn't provide the choice. There
is no means of opt-out on a part or whole basis and little patient
control in terms of selection of treatment. Worse yet, the system
stifles competition and penalises those who wish to use independent
healthcare.



it doesn't provide the open ended comprehensive care that the NHS is
attempting to do

*Attempting* is the very operative word. The NHS has been attempting
for 60 years and has continually failed to deliver on its promises.




like the courier companies who have taken on the profitable parts of
the royal mail and left the unprofitable bits so that we end up with a
strapped for cash service which can't operate effectively

It never could operate effectively. What has changed is that
customer expectations have increased and Royal Mail remains stuck in a
bygone era - like the NHS.

geoff wrote:
In message 486694eb@qaanaaq, Andy Hall writes
On 2008-06-28 19:24:35 +0100, geoff said:

In message 48667d0a@qaanaaq, Andy Hall writes
On 2008-06-28 17:52:05 +0100, geoff said:

does your private health insurance pay for immediate treatment for
e.g. a broken bone or cut requiring stitches - A&E type injuries
No, because it isn't designed to do so. It's worth pointing out
that in addition to the tax distortion of the market, the other
components of immediate treatment such as the 112 call centres and
ambulance services do not operate on a competitive basis for A&E
purposes but feed NHS facilities.
So your shiny ins policy doesn't give you a point of sale facility

It provides exactly what it is designed to do which is cover for
diagnosis and acute care. I know exactly what I can get, when and
where. I can't get that from the NHS.

So it provides a cherry picked subset of a health service

it doesn't provide the open ended comprehensive care that the NHS is
attempting to do

like the courier companies who have taken on the profitable parts of the
royal mail and left the unprofitable bits so that we end up with a
strapped for cash service which can't operate effectively



The bit I really don't like is the obvious (and I suggest, unavoidable)
end point. Allow private emergency services. And have the paramedics
look for the insurance before saving their lives or taking them to hosptial.

I suppose it could end up working both ways. NHS paramedics happen to
find insurance and dump the patient?

--
Rod

Hypothyroidism is a seriously debilitating condition with an insidious
onset.
Although common it frequently goes undiagnosed.
www.thyromind.info www.thyroiduk.org www.altsupportthyroid.org

In message 4866a1e6@qaanaaq, Andy Hall writes
On 2008-06-28 21:10:34 +0100, geoff said:

In message 486694eb@qaanaaq, Andy Hall writes
On 2008-06-28 19:24:35 +0100, geoff said:

In message 48667d0a@qaanaaq, Andy Hall writes
On 2008-06-28 17:52:05 +0100, geoff said:

does your private health insurance pay for immediate treatment
for e.g. a broken bone or cut requiring stitches - A&E type injuries
No, because it isn't designed to do so. It's worth pointing out
that in addition to the tax distortion of the market, the other
components of immediate treatment such as the 112 call centres and
ambulance services do not operate on a competitive basis for A&E
purposes but feed NHS facilities.
So your shiny ins policy doesn't give you a point of sale facility
It provides exactly what it is designed to do which is cover for
diagnosis and acute care. I know exactly what I can get, when and
where. I can't get that from the NHS.

So it provides a cherry picked subset of a health service

It provides what its customers want to buy,

No it doesn't , you said so yourself it can't provide A&E

Now If I was injured on a Saturday night and bleeding, that's one point
of sale I would want to give me immediate attention rather than waiting
for 4 hours or whatever

YOu are still being very coy and avoiding answering my question as to
how much you are paying for the insurance you are getting

Could it be that you are in training to be a politician ?

we should be told

--
geoff