http://www.numberwatch.co.uk/2007%20January.htm

Buster, have you seen any policy or manifesto that would sort this out?

The daily mail has a paice on an Italian doctor paid over three thousand pounds for five days cover over the holiday period.
Surely there was a cheaper option available to the NHS.

There is also the fact that the r4eason there was no coverage is down to the new contracts issued to GP’s by the Labour government.

Labour have systematicaly ground dowen the core services of the NHS with red tape and paper hungry middle management. A real case of to many chiefs and not enough indians. Though wit all the hostpital closures we seem to be running out of wig-wams too.

The French Health system is phonenomenal when it works and you need healthcare. And draconian when you don’t – or even do! On one level, the level of care is superb – immediate attention and access to the best in healthcare. However, on the other hand, if you don’t pay your social charges, they take over your bank account, take you to court, take over your assets, ban you from earning or selling, make you homeless…it’s a bit harsh, isn’t it! They give it with one hand and take it away with another!

And the NHS (as an organisation – not the individuals in it) is like most organisations – firstly interested in persisting the organisation rather than meeting the needs of the customer in whatever way is best for them.

It’s only relatively recently they’ve started finding out what works! Most companies ask their clients ‘how satisfied are you with our product or service?’ and then (sometimes) seek to improve it. The NHS largely works on the basis that ‘if they don’t comeback, then what we did worked’. And because they’re at capacity then they really don;t want patients to come back. And that’s understandable – they couldn’t cope if they did! A bit like pricing rail fares because the network is at capacity.

I was told some years ago by a Doctor and then the subsequent Consultant I saw that the NHS isn’t there to cure, it’s to get people to a position of coping: So that would be a ‘Pain Management Clinic’? – you still have to have pain. ‘Asthma Clinic’? – you’ll still struggle to breathe. Cognitive Behavioural Therapy? We’ll give you just 8 sessions when actually it’s been shown you need 10-12 sessions to get results.

My only interest is ‘does it work?’ and go with that. And in finding the simplest and easiest way possible to do that, and sometimes occasionally that doesn’t involve popping a pill! (there’s some more suggestions on this at: http://anthonydavis.wordpress.com/2006/08/08/e-tip-25-men-in-white-coat-syndrome/)

Nobody has the monopoly on health. Not even the monopoly that is the NHS.

Anthony

We can’t operate a system like this. Healthcare is a huge and growing aspect of modern society and we can spend limitless funds trying to keep alive if we so wish.

Should the state be the agent to do this? I think not or else an ever increasing part of GDP/National spending will be expended on healthcare. There is a point of diminishing returns at which I think the NHS is long past.

Most of the huge extra spending by labour has gone on wages and pensions. This has reuslted in little productvity growth but has ratchedted up the cost base to its current unsustainable level.

The answer is less government interference and to stop promising everyone free cost healthcare that is actually unaffordable to all.

Despite what the pathetic dupes at the BBC tell us about Cuba, Governments don’t run medical services successfully anywhere in the world. They never have and they never will. The best we can hope for is to keep it so simple as to be within their pathetically limited abilities.

The most Governments manage successfully anywhere (albeit with their usual levels of inefficiency) is to administer a compulsory insurance scheme, as in France. All the bureaucrats have to do is collect the compulsory payments, pay medical expense claims against invoices signed off by doctors and investigate the inevitable frauds.

The doctors’ surgeries, the hospitals, clinics and laboratories would all be independent businesses (most of them quite small), run by qualified people acting in the interests of their patients for the sake of their own business reputation. Doctors would set up surgeries and hospitals where they (and their financial backers) thought they could find patients – so they wouldn’t be opened and closed to reward Government voters and punish those of the Opposition, for example.

We could also then end the “free at point of use” nonsense which turns doctors’ surgeries into social centres for the old and unemployed and builds vast stockpiles of outdated drugs in pensioners’ bathroom cabinets. In France, you pay your own costs, but reclaim 70% of them promptly from the Caisse Primaire Assurance Maladie. You get your money within a short period (usually less than a week!) by direct payment to your bank account.

Private insurances are available to cover the missing 30%, if you wish. The compulsory social insurance is based on income (so it’s a sort of tax). The private element is competitive, so income-independent (and costs proportionately less than the average cost of the 70%). The discipline of having to find the money yourself and go to the trouble of making one or two claims ensures no-one wastes doctors’ time or medicines. It makes it all real, rather than “silly money.”

My late grandfather had a garage full of wheelchairs when he died because every time he complained, the NHS sent a new one – but had no mechanism to take back the others. That kind of insanity takes a Government to generate. He would never have wasted his own money in that way – even if he only had to part with it for a week or so each time to achieve the same bizarre result. He was perfectly smart about buying and selling cars, for example. It took Soviet healthcare to make a wastrel of him.

Under such a system, you would have your own business relationship with your doctor, just like with your plumber or your lawyer. He would get to be an independent professional again, and win back the respect he has lost as a bossed-about worker in a State Enterprise. He would serve- and be answerable to – you, not the Government. If you didn’t like him, you would choose another doctor – and he would lose the fees. Every Conservative knows that’s the best way to motivate the efficient and punish the useless. Why on Earth would we lose sight of that when it comes to something as important as health?

The French are also trusted to keep a folder with their own medical notes to present to their doctor when they visit. Self-interest (do you really believe politicians and bureaucrats care more about your health than you do?) ensures they keep it safe. No need for an insecure, multi-billion pound database or a bureaucracy (literally) the size of the Chinese Army.

How the hell the Conservatives have painted themselves into the corner of endorsing the last Soviet healthcare system on the planet is a major mystery to me.

Can anyone persuade me that another party has a better policy? This seems to me to be one of those topics that are screamed about accross the floor, generating more heat than light. I think the NHS will always be a hot and difficult issue, whichever party is in power. If you give more money to that, you have to take it from something else. Or tax more.

Did the present Govt ever purport to prioritise health? I seem to remember it was education, education, education, but may be times have moved on.