Go Private for the Treatment You Need, NHS Tells Patients

Yves here. Even though the fate of the NHS is a UK story, Americans should pay close attention. Despite the mythology otherwise, about 60% of healthcare spending in the US is government-paid, between Medicare, Medicaid, the VA, and other programs. Yet Medicare has plenty of gaps, witness the need to buy Medigap insurance with traditional medicare, the many limits on Medicare drug plans, and the sneaky narrow networks in Medicare Advantage plans. And in many parts of the US (NYC, Connecticut, Dallas), many doctors don’t take Medicare. And as those on the VA beat know, it’s getting the Post Office treatment, being underfunded, so it can’t deliver at its former service level, and then is deemed to be failing (as opposed to have been made to “fail”) to justify privatization.

But the Government is engaging in a classic Big Lie: professing that nothing has changed as patients are being forced to seek private care (of course, assuming they can afford it).

By Caroline Molloy, editor of openDemocracy UK and OurNHS, a journalist and speaker. She has written extensively on politics, public services and the welfare state, and has a particular interest in public services and technology. Originally published at openDemocracy

One in five patients has been told by a doctor or another NHS professional that they would have to go private to get the treatment or test they need. That’s just one of the shocking results from a survey of nearly 7,000 openDemocracy readers – backed up by separate polling commissioned by openDemocracy.

NHS staff echoed the patients’ claims. Nine out of ten (87%) members of patient-facing staff said they had been simply unable to give a patient treatment or a procedure they would benefit from.

The survey, one of the largest of its kind of NHS patients and staff, provides a detailed – and worrying – breakdown of what happens to these patients.

The government has repeatedly reassured the public that the NHS will remain “free at the point of use”. But such language will bring little comfort to the many who told openDemocracy that the NHS had been scaling back what it offers even before the pandemic.

Both patients and NHS staff also reported an increasing reliance on the private sector to fill in the gaps – whether funded by the taxpayer or the patient themselves – despite successive prime ministerial promises that the NHS is “not for sale”.

Paying Privately

Forty per cent of patients who replied to our survey were told that the NHS simply can’t offer them the treatment they need. Half of these patients – one in five of all patients – said an NHS worker then told them they would instead have to pay privately for the treatment they needed:

‘There’s an increasing sense that if you can’t pay for private healthcare you are treated worse than before.’

‘My GP was always pushing me for private care and never took steps to refer me to the specialist.’

NHS staff themselves told us a similar story.

One GP said: “I now routinely ask people if they have private insurance before referring them as I know the system is so overwhelmed.”

Suggesting patients pay “alleviates patient and carer/family anxiety regarding delays for diagnostic tests,” added a nurse.

Many respondents noticed NHS staff were “apologetic” and “saddened” when they had to suggest people went private. NHS staff “were always honest and showed they didn’t like the situation any more than I did”, said one patient. Their doctor’s “hands were tied and they would have helped if they could”, added another. Their GP told them it was “due to funding issues”, said yet another.

Another told us: “The doctor apologised for not being able to offer me the operation. My condition is not considered bad enough. I am prescribed Tramadol for pain. I have a poor quality of life, so am not sure how bad I would have to be before an operation was offered. I am a widow, which means my quality of life is even poorer, as I can go days without a visitor, and rely on the internet for shopping and have to pay a gardener and cleaner. My savings are rapidly disappearing.”

NHS guidelines have become increasingly restrictive in recent years, with a large range of procedures, from ear syringing to hip operations, either no longer paid for in some areas, or funded only in exceptional circumstances or conditions of extreme pain.

What Else Are Patients Told To Do?

Other advice given to those who had been refused NHS treatment included recommendations of ‘self-care’ (one in five was given this advice), being directed to a cheaper option such as a voluntary service (one in ten), and being directed to an online service (one in 20). Some 84-90% of patients reported being dissatisfied with these options, with the highest dissatisfaction (90%) among those who were directed to an online service.

“I had to attend a pointless group education session on women’s urinary issues. I live in a small town, and it’s an embarrassing topic – I wondered if they did it to lower referrals due to embarrassment,” said one patient. “There was nothing in the education session that couldn’t have been provided in a leaflet.”

And there were real-world consequences, for many – 38% of those who’d been refused the ideal treatment or a test and been given this range of other options – said their health had worsened as a result, a similar number (38%) had suffered anxiety. Twelve per cent said a diagnosis had been missed.

Staff worries

Of the 500-odd NHS staff who responded to our survey, most (68%) said the problem had got worse in the past decade. Only 12% blamed the pandemic.

Nearly all frontline NHS staff – 98% – said they had felt worried that a patient’s health was going to deteriorate due to the length of time they would have to wait for an NHS treatment, with around three-quarters saying the wait times had got worse over the past ten years, and around a sixth (14%) saying it had got worse mostly since the pandemic.

Around 48% of current NHS staff were thinking about leaving the service, with only 37% saying they weren’t.

Public Money, Private Sector

Nearly two in five patients (38%) said that an NHS worker had told them they’d get seen more quickly if they accepted an NHS referral to a private hospital or clinic. Staff confirmed this – nearly three in five frontline NHS workers told us they’d had to refer patients to an NHS-funded private provider. Of those who did so, the majority (70%) had misgivings about this approach, but many said they felt they had little choice.

‘Patient [was] seen faster. NHS clinic [had] very long wait so we were told to refer.’
Nurse

‘In my field of ophthalmology (eye care) the only way to get the elderly population the treatment they need is to resort to NHS-funded private care. It’s still the thin end of the wedge!’
Ophthalmologist

‘I felt torn as every use of private provider means decline of the NHS funds.’
Midwife

‘Made me feel complicit in privatisation by stealth. By sending them patients I was driving their profit, eroding the platform I stand on.’
Hospital doctor

Around half of patients and nearly three-quarters (73%) of staff who’d experienced this issue said it had got worse over the past decade, with far smaller proportions saying it was mainly a COVID issue or had always been an issue. Not a single member of staff said it had got better over the past decade. Four in five (82%) of NHS staff said they’d seen evidence of privatisation.

And both patients and staff explained how the private firms doing NHS work wanted only the easy cases they could “cherry-pick” NHS cash for, and make a profit from – with one patient commenting their private referral was “usually a waste of time as I end up being referred back to the NHS”.

The government has recently set aside another £10bn for the private sector to deal with the backlog of cases that built up during COVID.

Getting In – and Being Pushed Out

While most people were positive about the physical healthcare, if and when they actually received it, difficulties in even getting through the door were highlighted as a concern for many.

One patient told us that getting an appointment at his local GP was “harder than joining the Masons”.

Mental health services were highlighted as a particular concern, with another patient saying: “Local primary mental health triage sends you away with a list of phone numbers for other services. Took eight months, two attempts and six assessments just to see the doctor.”

Once through the door of NHS services, there’s also the problem of being allowed to stay there long enough. Two out of five (41%) patients said that they or someone they cared for had been discharged from hospital or another NHS service too early, though some were better able to navigate the system than others.

One told us: “Mother yo-yo’d in and out of hospital with broken leg and infections. Repeatedly released while still ill.”

Another said, “I was going to be discharged from hospital far too early. but my wife who was a senior social worker intervened, and I was kept for another seven days until care provision at home was organised.”

Again, NHS workers agreed. Fifty-six per cent of patient-facing staff told openDemocracy they’d had to discharge a patient too early.

Currently, hospitals and local authorities are required to assess a patient’s care needs before they are discharged from hospital – a requirement many cash-strapped organisations have struggled to do promptly. This requirement was suspended during COVID and the Health and Care Bill currently before Parliament scraps it altogether.

Not a Pandemic Problem

Most concerns were identified as long predating the pandemic. Over half (56%) of patients who were refused treatment on the NHS, and a similar proportion of those who’d been discharged to early (55%) said the problem had got worse over the past decade, compared with around a quarter who felt these issues had been caused mostly by COVID. Only 1% said things had got better over the past decade.

Perhaps unsurprisingly, the single most common problem reported was having to use a telephone or online service to access the NHS, which most patients affected identified as something that had happened primarily since the pandemic (86%). But of more concern is that 64% of all respondents said they’d had to use remote access to use the NHS when they didn’t feel it was suitable for their needs.

The government has recently responded to a backlash against online and telephone GP appointments by pledging support for more face-to-face appointments. But the move has left many doctors infuriated, coming as it does after years of the government heavily promoting online and remotely delivered health services in both primary and hospital care.

“My wife and I are over 80 and not comfortable with triage by unknown person over [the] phone, etc,” said one patient. “We’d like to see our GP to assess our health issues which, though minor, may worsen over time if not treated. Too often we rely on brief and inconclusive chats with pharmacist.”

Patient Anger

However, respondents to the openDemocracy survey were deeply unhappy about the prospect of more private involvement in healthcare, with the most common responses being “angry”, “disgusted”, “worried”, horrified”, “appalled”, or “concerned”.

The 40 most common words used by openDemocracy readers to describe what is happening to the NHS. The more frequent a word’s use, the larger it appears | openDemocracy. All rights reserved

Many highlighted that they felt the attacks on the NHS were deliberate and political, and some pointed to funding issues:

“There is no discussion anymore. Was told [the NHS] won’t pay for lots of things any more. Because I can largely self-manage and have been successful, I am on the virtual ‘to be ignored list’, it seems.”

The NHS was hugely important to our readers – 95% gave the NHS five out of five for importance – the average score being 4.92 out of five.

But some expressed despair, saying they had “lost trust in the NHS” and felt “abandoned”.

“Since COVID, it no longer feels there is a health service for all,” said one.

“I feel there is no longer any adequate health care in this country. I must take care of myself,” added another.


Note: The figures in our survey refer primarily to the English NHS, but early indications suggest a significant difference in the experience of users in Scotland, Wales and Northern Ireland, which we will report on further.

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33 comments

  1. PlutoniumKun

    Referring back to yesterdays discussion about medical incentives, here in Ireland we have a pernicious mix of public and private insurance which often incentivises consultants to push patients into private treatment.

    In simple terms, Ireland has a reasonably comprehensive public system – nearly all hospital doctors are salaried by the govenment (even if in a non State owned hospital), but are permitted their own private practices, often on the same hospital grounds. Health insurance here is heavily tax deductable and very cheap by US standards. I pay the equivalent of less than $200 a month for mine.

    The misincentive is of course obvious. My local doctor says I need to go to the hospital for tests.
    The consultant there says that I need X treatment, but I have to wait 6 months for it. However, if I have insurance I can be treated that evening. So I return in the evening and see the same consultant in his private clinic…. On the way out I notice a line of Mercedes and Jaguar cars in the staff parking lot. Guess who they belong to.

    This is the key reason why mixing private insurance treatment with even a very good public system is so pernicious. It layers up misincentives at all levels of the system. Needless to say, this is why so many want to introduce it to the NHS. When I lived in the UK 2 decades ago, I didn’t know anyone with private health insurance (at least, nobody who would admit to it). Now it seems very common with anyone above the average income.

    Reply
    1. liam

      This is really sad. As you have no doubt experienced PK, Irish people look admiringly at the NHS, and only wish.

      Also, an interesting aspect of this is the Northern Ireland situation. If the NHS is being converted into an Irish style system, then one of the key unionist arguments about health care in the south becomes kind of moot. Mary Lou recently identified an All Ireland NHS as a strategic priority for her party in their last Ard Fheis! Smart politics that.

      Reply
      1. PlutoniumKun

        I’ve a few family members who have hopped from the UK to Ireland and vice versa in their careers. 20 years ago there would have been a vast gulf in difference in quality of care, but they say that now its not really all that different for most conditions. In some areas, such rural clinics, its probably better in the Republic. But the Irish system is significantly more expensive in GNP terms, mostly I think because of arbitrage for certain internal players, as described above. I should state that a good friend of mine is a hospital consultant. And he drives a Porsche. And his wife regularly complains to me about high taxes.

        There is already quite a lot of co-operation between north and south in health care. So far as I know ,most transplant patients in Ireland are sent to NI or England for treatment, while NI sends pediatric cardiology cases to Dublin for any operations. This is independent of (former) EU agreements on healthcare sharing. But yes, if there was a unified Ireland, there would be justified calls to extend the NI NHS system down south. But I know a few Porsche drivers who would be less than happy with that.

        Reply
      2. vlade

        There’s plenty of NHS consultants who drive expensive cars. Although the ones really milking the system are GPs who own (not just work in) a private practice.

        The UK GP system is antiquated, to say the least, and even many GPs privately admit it. But it serves them well, so they don’t want to change it.

        Basically, when the NHS was being created, GPs were bribed to go along, and they are still being bribed, 70+ years on.

        Reply
  2. vlade

    I’d like to hear from David or someone else who lives in France, as my understanding of their system is that the system there is a mix of private/public, and works very well – mostly, to my understanding, because the government controls and regulates it very closely.

    Reply
    1. Jackiebass63

      I think what makes the French system work is the short time limit insurance companies have to pay a claim. If they violate this time limit the have to pay a hearty fine.

      Reply
    2. PlutoniumKun

      My understanding is that the French system is primarily based on a government owned insurance system. Additional private insurance is optional, but since the Government system is so highly subsidised and controlled there is very little incentive for people to take out private insurance except for gold plated coverage.

      In practice, the hospitals seem to just ignore all requirements for checking and charging. A few years ago the husband fo a friend of mine fell very ill with cancer while travelling in France. He is an Australian citizen and didn’t have travel insurance. My friend is a nurse and knew a little about how to navigate the system. She simply gave a french friends address as their ‘home’ address and he was immediately put into emergency treatment. Three months later he was cancer free and left without having to pay a cent. She said the medical staff probably knew there would be complications in payment, so just ignored the bureacracy and charged things through the system as if he was a fully covered French citizen.

      My friend, incidentally, worked in oncology wards in Sydney and Dallas previously and said that although it was a provincial hospital in France, the care her husband got matched the very best anyone would have recieved in the top hospitals there, and far superior to the care he would have got in his native Oz town, or a smaller city in the US.

      The Dutch system is famously high quality and also uses a mix of insurance systems. I once met someone who was sent to study it to see if it could be applied to Ireland. He said that the joke in the Netherlands system was that there was only three people in the country who actually understood how the system worked, and two of them were retired. But thanks to very strict overlapping controls and a generally very functional governmental system, it worked very well. He concluded that if they tried to copy it in Ireland, the result would have been utter chaos.

      Reply
  3. Sailor Bud

    After two decades of hearing Brits say, “oh, I don’t know how you Americans can stand your health care,” I now get to watch them do nothing as it happens to them.

    Schadenfreude? Nope. It’s so nasty and trashy, all I can do is pray for them to be better than us, and they won’t be.

    Desire to rub it back in their faces? Well, maybe the English, a bit.

    Reply
  4. Anonymous2

    I am told that, perhaps unsurprisingly, it is becoming increasingly difficult to book private medical appointments in the UK, such is the increased demand.

    Reply
    1. vlade

      I know that for many routine/elective things, medical tourism was starting to take off in the UK few years back. Covid put paid to that, who knows whether temporarily or not.

      Reply
      1. PlutoniumKun

        I wonder if the number of older retired people who would previously have been wintering on the Costa del Sol but are now in the UK is having a significant impact.

        Reply
        1. vlade

          It was one of the points I was making on Brexit, all those years back. Not just those wintering, but all those that had to return back to the UK.

          I’d really like to see the numbers.

          Reply
  5. Jackiebass63

    The people you elect determine the services you get. Like in the US, the UK keeps electing people that don’t represent their important needs like good health care. If I remember correctly Boris promised big improvements in the NHS. Just like in the US, campaign promises are soon forgotten. Covid has provided the perfect cover for neglecting this promise.

    Reply
    1. Count Zero

      No, and I get weary of repeating this: the nature of the electoral system means that the government is always elected by a minority of the electorate. It’s usually around 40%, but sometimes less. Thatcher never received more than 43% of the vote. We would need to check the data on % of the electorate and % of those who actually voted in a series of elections. The latter is usually around 65-70% of the former.

      So it gets complicated. But the general point stands. Governments represent a minority of the people in the UK. And I think that’s the case in other Western “democracies”. Electoral systems have been manipulated to ensure that there is no risk to the interests of big capital. As the old anarchists used to say: “It doesn’t matter who you vote for the government always gets in.”

      All you are doing by saying the English are getting what they voted for is legitimising unrepresentative electoral politics and taking pleasure in regressive social policies. I don’t blame ordinary working Americans for the shitfest they have to endure at the hands of their unrepresentative governments. We are all in the same sinking boat.

      God knows why anybody who isn’t wealthy ever voted Tory in the UK. But that raises a different set of questions.

      Reply
  6. orlbucfan

    The United Kingdom is a country over a thousand years old. The United States is barely half that age. What baffles me as a Yank is why are the British allowing the same/similar mindset that is wrecking havoc on U.S. healthcare do the same to them? Haven’t they learned anything over all those centuries? I’ll admit that I really don’t understand it.

    Reply
    1. Anonymous2

      England is a thousand years old. The UK is much younger. Act of Union between England and Scotland was 1707. With Ireland IIRC the Union was 1801. I don’t recall when Wales was absorbed by the English.

      Brexit means that US influence over the UK will probably grow even greater. After all, an American, Murdoch, owns much of the media.

      Reply
      1. drumlin woodchuckles

        Murdoch is an Australian. He was given American citizenship so he could legally buy some media properties he could not have bought as an alien. Somebody decided to grant him citizenship in return for . . . what?

        Anyway, he proceeded to Murdochify much of the American media. Fox News is an expression of Murdoch’s inner self.

        Reply
      2. ChrisB

        Murdoch is the number one threat to English speaking democracy. As an Australian, shame on you Americans for inflicting him on the world.

        Lalalala can’t hear you.

        Our Torys (Liberal Party of Australia, established by Kieth Murdoch father of Rupert) are undermining our version of the NHS (Medicare) at exactly the same time that the NHS is being trashed. Not enough people give a shit, the billionaire owned media oligopoly seems not to be covering it.

        Reply
    2. orlbucfan

      I meant Great Britain/England. :-) I always think of that group of islands as the British Islands even though there are plenty of Irish, Scots, and Welsh who would raise eyebrows. Murdoch is not a native Yank; he’s Aussie by birth. He infests the U.S. cos of the tax breaks.

      Reply
  7. Terry Flynn

    I wonder what the “officially it doesn’t exist but unofficially it was estimated by simply observing what NICE approved for everyone” cost-per-QALY ceiling is these days?

    In my day it was originally £30,000 per QALY gained. Then it went up. Then, though admittedly I’ve been out of the loop somewhat, it stopped being mentioned altogether.

    Reply
  8. garden breads

    How have you experienced “in many parts of the US (NYC, Connecticut, Dallas), most doctors don’t take Medicare”? According to the analysis “How Many Physicians Have Opted-Out of the Medicare Program?” by the Kaiser Family Foundation “In all states except for 3 [Alaska, Colorado, Wyoming], less than 2% of physicians in each state have opted-out of the Medicare program” (this excludes pediatrics). Many of the 2% are “non-participating providers” who actually do accept some Medicare payments. These figures are consistent with my experience and the CMS “Medicare Provider Utilization and Payment Data: Physician and Other Supplier” reports which list total payments to each individual physician in the US.

    Of course there are few specialists in Medicare Advantage networks, but that is entirely different. Medicare Advantage is an abomination.

    Reply
    1. Yves Smith Post author

      Everyone I know who is about my age with whom I discuss medical stuff (about a dozen people in NYC) have GPs who do not take Medicare. My GP does not, every NYC specialist I use does not. So tell me the odds of that?

      I have had friends (multiple) in Connecticut and Dallas report the same thing. I have a friend turning 65 who is leaving Manhattan for a city with a major teaching hospital and her big reason is none of her doctors (and she sees a GP plus I believe three specialists) take Medicare and she’s going to a city where her medical care will be covered.

      Reply
  9. Hayek's Heelbiter

    This article talks about the symptoms in the slow destruction of the NHS patient experience but not the root causes.

    In the interest of objectivity, I must say the Covid vaccination program was rolled out with tremendous efficiency, even though I was in the midst of switching NHS practices. Flu shots and Covid booster jabs are frequently available at a chemists [pharmacy], often as a walk-in.

    There are multiple studies claiming that NHS adminisflation (and manager salary inflation) is beneficial. But friend, a former NHS employee, quit due to the increasing amount of CYA box-ticking paperwork.

    And administration salaries? “Nurses were offered a 1% pay rise by Health Secretary Matt Hancock but top [NHS] bosses are on up to nine times their salary and raking in £300,000-a-year plus bonuses.”

    More administration is outsourced at ludicrous remuneration to IT consultants (frequently to friends of government ministers). The utterly useless Test-and-Trace program cost £13.5bn its first year. It’s harder and harder to actually book an appointment with a doctor over the phone. You have to use your internet or often a phone app.

    This tremendous burden on the elderly was brought to me last night when I was in a chemists getting my booster jab. A, woman, whom I estimate was in her 80s, had come in for something, , I’m not sure what. Once the clerks helped her get her walker over the threshold, they told her that she should have booked her appointment online.

    “How?” she responded. “I don’t have a computer.”

    “We’ll book you an appointment in two days,” which they did.

    They helped her out the door, and as she was unsteady on her feet, I offered to walk her home.

    Which was a mile-and-a-half away! She had walked to the chemists, with the assistance of her, walker, and then I walked her back!

    Multiply her experience by the millions of elderly people in the UK,

    Reply
  10. Jesper

    The privatisations appear to follow the same trajectory everywhere….

    Sweden has done the same as UK. The gist of the argument for privatisation appears to be that unless doctors are financially rewarded for providing good care to their patients then they won’t.
    The words and phrases are of course not those, the actual words and phrases are more along the lines of: “Public sector is inefficient and doesn’t innovate, lets release the innovation by privatising the healthcare. If we privatise then we’ll get doctor owned practices were they can do what they do best, treat their patients and then as a bonus they’ll get financial rewards for their treatments and innovation.”

    What then happens is that a can-opener is assumed. In this case the can-opener is the tome of rules relating to how the financial incentives for the doctor is perfectly aligned with the interests of the patient. That tome is either impossible or possible. What determines the possibility/impossibility of that tome is how good the rules need to be:
    -is it ok if patients interests and owner of the clinic interests are aligned 50% of the time?
    -it it ok if patients intereres and owner of the clinic interests are aligned as per Six Sigma?

    The tome is a Work In Progress (WIP), once written then constantly evolving due to either something not properly thought out when first written or evolving medical science etc etc.
    The evolution of the tome makes it grow thicker and thicker, more and more complex leading to costs of inefficiency in trying to follow and also trying to enforce the rules in the tome. The cost of the inefficency is then dealt with by efficiency of scale. The one doctor practice merges with another one doctor practice and so on until the practice is huge, close to the scale of the replaced public sector and has the same inefficiencies and worse than the replaced public sector.

    For doctors it is about the exit – they’ll make their serious money if and when bought up by venture-capitalists or multi-nationals.

    All the above might be easily predicted, so why wasn’t/isn’t it?
    The explanation might be either incompetence or conspiracy. One indication of conspiracy might be if the decision-makers or their close relatives are making more money after their decision. As it happens then it is not too uncommon that people switch from the public sector to a better paying job in the private sector so who knows…
    The reason why it happened does not matter that much to me, I’d rather just stop it from happening would be priority one. The second priority might be some corruption-charges but those would be almost impossible to get to stick.

    I am guessing that the WIP tome for healthcare in UK currently makes it possible for owners of private practices (doctors in early days, later it might well be multi-nationals based in tax-paradises) to make money on treating patients. Maybe the WIP of the tome will reduce the risk of profiteering in the healthcare, anything is possible, my personal belief is that profiteering will grow.

    Reply
  11. antidlc

    “And in many parts of the US (NYC, Connecticut, Dallas), most doctors don’t take Medicare.:

    fwiw,

    I have relatives in the Dallas area on Medicare supplemental plans (not MA). No problems with doctors taking Medicare (yet). But they don’t have a lot of health problems and don’t have a lot of doctor visits.

    Reply
  12. Keith Newman

    For those interested, the Canadian public health system that covers doctors, hospitals and in-hospital pharmaceuticals strongly discourages private doctors in a rather simple way. A doctor either has patients covered by the public system or has no such patients at all. None. So when out of the system, the doctor is all the way out – s/he cannot claim any public payment for patients. Since public doctor services are usually high quality few patients want to go private.
    There are some specialties where private is significant, mostly in services to the well-off such as non-essential cosmetic surgery. Unfortunately some degree of under-funding, poor management and doctor shortages has led to delays in treatment in some areas – dermatology comes to mind. Hospitals also tend to be understaffed so this too takes a toll.
    An interesting phenomenon is that since public healthcare is beneficial to Big Business because it lowers its costs (see Michael Hudson on this) there is no business pressure to privatize the public system. However there are other pressures to privatize: anti-public sector ideologues especially in various conservative parties and think-tanks, as well as doctors who look South and want to get very rich via a US-style system.
    So far, those of us on the other side, (the labour movement, public advocacy groups, progressive doctors, etc.) have been able to protect the integrity of our system and are trying to expand it into additional areas such as pharmaceuticals and dentistry. Needless to say, opposition from those quarters is ferocious.

    Reply
    1. Kouros

      The Chaillou decision didn’t help either. The Supreme Court was a total Ass there. I have read their decision and the majority’s arguments where threadbare and did not consider at all the arguments of the public.

      The thing is continuing with a wannabe rich doctor (Day) in Vancouver that was charged by the government for double dipping and to avoid those charges he went on attack by accusing that patients’ rights are infringed due to the wait times. The thing is still ongoing.

      I had at some time a chat with the government lawyers and there is quite a lot of incompetence there. I am really concerned that the courts (because they are corrupt) might open the can of worms…

      Reply
  13. Sound of the Suburbs

    This is what it’s supposed to be like.
    There is a standard road map to privatisation.
    It requires running down the public option until the majority will be glad to see the back of it and privatisation looks like a good option.
    The NHS didn’t get into the mess it is today by accident.
    The desired destination for healthcare is the US version that comes near last in all international league tables for the developed world.
    Two whistle blowers from the NHS speak out:
    https://www.youtube.com/watch?v=BZL3Wt17w8g&t=54s
    Until I watched this video I didn’t realise neoliberal, New Labour, were also working against the NHS.

    The NHS is continually maligned in the papers.
    I was amazed when I saw the data, which actually shows the NHS is doing very well against international competitors. We are told its terrible.
    Angus Deaton, has been having a look at the data (27.30 mins. – 33.30 mins)
    https://www.youtube.com/watch?v=IX9k4s_UWiU
    He is showing how bad the US system is, and this also shows how good our NHS is/was.

    Reply
  14. Basil Pesto

    In 2012 I uncharacteristically misrecorded an NHS dermatologist appointment I had at Guy’s hospital in London, which I had waited about 4 months for. When I realised I had missed the appointment (totally my fault), I was told it would be another 4-6 month wait. As I was desperate for treatment (it was severe acne, which I know is trivialised but it shouldn’t be as it’s not always transient and can be a deeply unpleasant and distressing disease. I suspect there was some other skin infection at play as well; at one point in the preceding months I had a golf-ball sized cyst protruding from my jawline area), I went to a private hospital having been told there would be little/no wait, which there wasn’t.

    The building was on the bank of the Thames (also Southwark area iirc) and was lavishly appointed, with floor to seating windows and luxurious fixtures. I’d never seen anything like that in the category of something that could be described as a hospital. It was certainly an eye-opener.

    It was absolutely the worst single experience I’ve had as a patient with the doctor. The doctor was completely disinterested in treating me and obnoxious in his attitude. I was early 20s and by myself, and even now am not assertive by temperament, so I suspect he thought he could get away with treating me dismissively, which indeed he could. His consult amounted to “whatever, and by the way that’ll be [several hundred pounds]. He didn’t accept card payment so I had to go down the street to an ATM to withdraw cash to pay for the appointment. I could be misremembering but he may have taken collateral in the form of my ID while I did this (if he did, I probably volunteered it in the first place).

    The NHS is undoubtedly slow to an extent that the Australian public system uuuuusually isn’t. the solution to that, of course, is more government money, and more resources. But if my personal experience of private health in the UK is indicative, more private medicine in the UK is almost certainly not going to pan out well for patients, broadly speaking. There’s a reason the NHS is so highly regarded by so much of the public, and part of it is because they don’t treat you like that.

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