I would like to believe this will do something, but the cynic in me says that it’s either going to fail or the condems will come back a week later with other subtle ways to privatise the NHS. I wonder what the NHS will be like once I finish my graduate entry medicine course? Probably a mess…

Obviously the ‘altar boy’ has now had some sort of ,road to Damascus moment’. As the architect of many of the past ‘privatisation’ moves under labour including the dire ‘out of hours’ system which is virtually all private, he has displayed massive hypocrisy.
He was also the Health Secretary who opposed outright the concept of a ‘duty of candour’ for Doctors and Clinicians which he now embraces. Such a massive political volte-face does not bode well for any future tenure of his place in a Labour Goverment.

Good luck to them, it appears the penny has finally dropped. Can we expect them to publicise this?

Too little, to late. Typical New labour.bHowever it will be good to get the lie dems on the record of being for privatisation of the NHS. Then no one will be in any doubt they have betrayed their voters again.

The reason why the media hasn’t been agitating about privatisation is because what matters is the quality of healthcare delivered to patients, not whether the state has a near-monopoly in the provision of healthcare.

Why should it matter to patients if they get the healthcare they need at private hospitals if the NHS pays?

5 that is such shit. You obviously hate democracy if you think politicians should ignore what they told voters they are going to do, and then do the opposite. Cameron parading his dying son as a prop to claim he loved the NHS

Thatcher had the balls to say honestly she was going to privatise gas and water and electric. Cameron and clegg are liars and con men.

The reason the media has been silent is because most of it is corporate and want the sell off to go ahead. Murdoch is a master in keeping information out of his papers (like the poll the sunday times commissioned on media regulation, which showed the public approved. Funny the paper did not print it.)

They have had to lie in their manifestos, have a full media blackout, and claim that it was all about giving doctors the power. Which is in fact bullshit. The private companies who wrote the legislation don’t want doctors running their cash cow. It is quite amazing to see how this giant con has bee, pushed through. Democracy is now finished. It is over. We have had a silent invasion and we are now run by corporations.

Sally: “that is such shit. You obviously hate democracy if you think politicians should ignore what they told voters they are going to do, and then do the opposite. Cameron parading his dying son as a prop to claim he loved the NHS”

You are stark raving bonkers if you think that comment goes anywhere near justifying why we have to have a near state monopoly in Britain to provide healthcare. What matters to patients is the quality of healthcare they get and whether it is free at the point of delivery.

Other W European countries have pretty good healthcare systems without having state monopolies. By the findings of independent international surveys, the NHS rates as rather mediocre in terms of patient satisfaction as compared with other W European countries so I’m saying it is time to look around Europe to see if there are lessons to be learned.

Btw by a web search I’ve just learned that the local NHS hospital I go to has a projected deficit for 2012/13 of nearly £20m and has just been fined £4.8m for failing to meet NHS targets to control C Difficile infection rates. How the hell is the hospital trust going to pay down that deficit and pay that fine without degrading the quality of healthcare services to patients? I can easily provide links to support those figures

In 2001, that same hospital was declared to be ‘the worst hospital in Britain’ by the healthcare watchdog at the time – I can post the link to the report in the Guardian. Both the chief exec and medical director left and were were replaced. Yet another new chief exec was appointed in mid 2007. In August 2007, I received a letter from the Pathology Dept to request that I return so they could take another blood sample to complete the recent blood test.

On inquiring, it turned out that the ‘recent’ blood test they were referring to had been in April. It took the Pathology Dept from April to August to discover that they didn’t have enough blood to do the tests requested by my GP. Fortunately for me, the test wasn’t critical.

What we desperately need in Britain is dependable services of the quality they have in other W European countries.

Cameron and his baby son is just a side issue. I’m interested in the fundamentals, not the propaganda stuff.

@Bob B
You should watch this video.

http://www.youtube.com/watch?v=a6k5ZisRV8Y

It explains quite well why privatisation, particularly the way the NHS reforms are being introduced, will actually reduce service quality and just compete on price. The standards of care in Western Europe are decreasing much like our own and becoming more expensive to individuals. Furthermore many international comparison studies are multifactorial and are really hard to evaluate. It is the reason WHO refuses to compare healthcare systems due to the massive quantity of variables that are involved in healthcare and also the restricted data you get from private companies.

@Bob B

I apologise for the missing words in that last post, it is late and I have been working/revising since 9am my brain is half dead at the moment.

5

In theory the private sector should be no different to the NHS provision as all medical, nursing and other professionals are trained by the NHS. The difference is that the private sector do not contribute to the training of said professionals. It’s easy to be competative when the majority of costs (training) is paid for by the taxpayer. Perhaps if those private health-care companies paid for the training, there would be fewer Trusts with deficits.

Mediastinum

The exposition in that video linked @8 is far from from clear and I’m not persuaded.

Respondents keep dodging the fundamental questions I’m putting: What I need are good quality, dependable healthcare services, free at the point of delivery.

Why does it matter if the provider is a private hospital, rather than a state-owned NHS hospital, if the NHS is paying? Why do I have to have my healthcare services from a verging-on state monopoly provider with little choice?

Why do we have to stick with the NHS model? Why can’t we look to see if there are lessons to be learned from other W European countries which evidently have pretty good healthcare systems going to judge by the findings of independent international surveys? After all, a national social insurance system to cover personal healthcare costs was pioneered in Germany by Bismarck in the 1880s long before Britain got around to creating the NHS in 1948:

“Germany had a tradition of welfare programs in Prussia and Saxony that began as early as the 1840s. In the 1880s his social insurance programs were the first in the world and became the model for other countries and the basis of the modern welfare state. Bismarck introduced old age pensions, accident insurance, medical care and unemployment insurance. He won conservative support by promising to undercut the appeal of Socialists—the Socialists always voted against his proposals, fearing they would reduce the grievances of the industrial workers. His paternalistic programs won the support of German industry because its goals were to win the support of the working classes for the Empire and reduce the outflow of emigrants to America, where wages were higher but welfare did not exist. Politically, he did win over the Centre Party which represented Catholic workers, but Socialists remained hostile.”
http://en.wikipedia.org/wiki/Otto_von_Bismarck

On the evidence and personal experience, NHS healthcare services in my locality haven’t been consistently of the best quality. I don’t have private medical insurance but friends who do and who have experience of private and NHS care say they get better quality healthcare in the private sector.

@5 Because, strange as it may seem, some people object to profit being made from their illness, or think that the entire principles the NHS was founded on are betrayed by the introduction of free market principles. Or even that assets and skills built up over decades with taxpayers money shouldn’t be handed on a plate to profiteers. Tony Blair started this “The public don’t care who delivers the service” bollocks. Maybe not in his middle class metropolitan focus groups, but many people do care who delivers it and think it should be people whose primary motivation is care.

“@5 Because, strange as it may seem, some people object to profit being made from their illness, or think that the entire principles the NHS was founded on are betrayed by the introduction of free market principles. ”

So it’s OK if we have rotten quality healthcare services from a state-owned, verging on monopoly provider if no one is making a return on capital employed? Thanks. I’d rather go for quality healthcare and to see if we have something to learn from healthcare systems in other W European countries.

“More than 5,700 patients in England died or suffered serious harm due to errors latest figures for a six-month period show. The National Patient Safety Agency said there were 459,500 safety incidents from October 2008 to March 2009 – the highest rate since records began. Patient accidents were the most common problem, followed by mistakes made during treatment and with medication.” [BBC website 2009]
http://news.bbc.co.uk/1/hi/8295417.stm

@ Bob B

‘The exposition in that video linked @8 is far from from clear and I’m not persuaded.’

I’m sorry to hear that, but it’s probably the simplest explanation that you will find at present. What are the difficulties you are having? maybe I could attempt clear it up for you?

‘Respondents keep dodging the fundamental questions I’m putting: What I need are good quality, dependable healthcare services, free at the point of delivery.’

The NHS has all the capability to do that and has been doing that for 65 years. It is definitely not perfect, but it would be disingenuous to suggest any system could be. The great thing about the NHS is that the foundations to provide good quality, dependable healthcare services, free at the point of delivery is already there, and unfortunately from what I have read in the Health and Social Care Bill, there is nothing that will improve that. Monitor for example is a regulator of price competition not quality of service. There can only be an inevitable reduction in quality due to that. One recent example of a recent reduction of dependable healthcare services is that the H&SC bill has made it so that GP surgeries (like the one I train at) are no longer paid for minor surgeries if they are performed in the GP surgery. The surgery therefore has a difficult choice: to make a financial loss by treating the patient at their convenience in the surgery or use a private company, which they do get funding for, but the patient will then have to travel at great personal disadvantage. Some of our older patients are already experiencing difficulty getting to these appointments but the surgery can’t afford to take minor surgeries anymore. I don’t think I have dodged the question, but I am happy to elaborate any points I’ve made.

‘Why does it matter if the provider is a private hospital, rather than a state-owned NHS hospital, if the NHS is paying? Why do I have to have my healthcare services from a verging-on state monopoly provider with little choice?’
The video answered these points quite effectively. I believe it was talked about in the first ten to twenty minutes. Choice in a free market is only successful if the customers have enough education to make an informed choice. The market quickly becomes rigged if the customer has to rely on the advice and guidance of the provider to know what they need to buy. For example as a doctor who is also a provider (i.e. owner of a private company as well as a GP; or a GP from a surgery with a contract to private company) I might be able to determine a health problem from your history thereby not needing to send you for any tests. That wouldn’t however be in my financial self interest so I will send you for that test anyway. I have therefore increased my own profit at your expense and that of the public purse. The sick thing is that you had no idea that I ripped you off as you did not have the information needed to understand that the test wasn’t necessary.
‘Why do we have to stick with the NHS model? Why can’t we look to see if there are lessons to be learned from other W European countries which evidently have pretty good healthcare systems going to judge by the findings of independent international surveys?’

Well the H&SC Bill is changing that so it will not be the NHS model come April 1st. I believe I mentioned the unreliability of international studies in my previous post so I will direct you to that. If you have any questions on it I can explain in greater detail.

‘On the evidence and personal experience, NHS healthcare services in my locality haven’t been consistently of the best quality.
Unfortunately personal experience is anecdotal so not a reliable indicator to grade a system, my own personal experience of the NHS is very positive but I wouldn’t use that as a reliable indicator. If you have other evidence however I would like to see it, I am happy to alter my opinion in light of new data.

‘I don’t have private medical insurance but friends who do and who have experience of private and NHS care say they get better quality healthcare in the private sector.’
This was answered in the video as well the private sector in this country is very different to other as it functions as a ‘bolt-on’ it takes very simple and profitable operations and therefore can add far more creature comforts. It really cannot translate to a dedicated private sector healthcare provider as they would not have the public sector to absorb the vast majority or most difficult cases.

From your response I feel it might be worth having another quick look through the video as it does provide a good answer to many of your questions. As I have said before I would be happy to clear up any points. In the end we want the same thing from the NHS so if you could provide evidence to alter my perceptions I would be happy to read it (I’m stuck at home learning anatomy over the next few days so happy for a distraction!).

Mediastinum

Please check my post @7.

On the reported evidence and from personal experience, local NHS hospital services are not satisfactory. The hospital is running a projected deficit of nearly £20m in 2012/13 and it has just been fined £4.8m for failing NHS targets for controlling C Diff infection rates.

How do you suppose the hospital is going to pay down that deficit and pay off the fine except by further degrading the quality of healthcare services to patients. And there is plenty of evidence that services have been and are being degraded.

There are many other examples of hospitals in deep financial trouble. 20 something hospitals are teetering on the verge of bankruptcy because of ambitious PFI contracts:

PFI hospital crisis: 20 more NHS trusts ‘at risk’
NHS trusts running more than 60 hospitals are in serious financial trouble and face being taken over by government administrators without urgent improvements.
http://www.telegraph.co.uk/health/healthnews/9357679/PFI-hospital-crisis-20-more-NHS-trusts-at-risk.html

It’s really no use pretending these are rather minor problems which will conveniently go away.

I’ve really no objection to being treated in a private hospital on an NHS contract. What matters is the quality of care and who pays, not whether the provider is part of a verging-on state monopoly provider of heathcare.

I believe that there are lessons to be learned from other W European countries on how their healthcare systems function.

Does it matter who runs the NHS, as long as it delivers good health care? They said something similar about Italian railways once upon a time.

“Does it matter who runs the NHS, as long as it delivers good health care? They said something similar about Italian railways once upon a time.”

What a pathetic comment to make. Try instead this entry in Wikipedia for: Healthcare in Italy:

“Health care spending in Italy accounted for 9.0% of GDP in 2006 (about $2,600 per capita) of which about 75% is public, slightly more than the average of 8.9% in OECD countries. In the WHO’s last health care ranking in 2000, Italy’s healthcare system was regarded as the 2nd best in the world after France, and according to the CIA World factbook, Italy has the world’s 10th highest life expectancy. Thanks to its good healthcare system, the life expectancy at birth in Italy was 80.9 years in 2004, which is two years above the OECD average.”
http://en.wikipedia.org/wiki/Healthcare_in_Italy

Ignorance is strength. It rather looks as though we could learn something from seeing how they manage healthcare in other W European countries.

As Emmanuel Goldstein put it: “Even the humblest Party member is expected to be competent, industrious, and even intelligent within narrow limits, but it is also necessary that he should be a credulous and ignorant fanatic whose prevailing moods are fear, hatred, adulation, and orgiastic triumph.”

BobB – “Why does it matter if the provider is a private hospital, rather than a state-owned NHS hospital, if the NHS is paying? Why do I have to have my healthcare services from a verging-on state monopoly provider with little choice?”

Gotta love this argument, which I’ve heard near verbatim from the mouths of Tories and other free market zealots repeatedly over the last 3 decades. I know that the counterargument has been aired, but I want to have a shot.

Bob, there is an instrinsic difference between the NHS and a commercial healthcare entity: the core function of the NHS is to look after the health of the nation; the core function of a commercial private health company is to maximise profit and minimise loss. In market-based commerce all elements of the company can be altered, shrunk, expanded, discarded, replaced or retasked in order to satisfy the bottom line. It has to or it runs the risk of going out of business. Straight away, any reasonable person can spot the risks inherent in placing one’s health in the hands of a commercial enterprise.

As for the financial problems that bedevil a number of hospitals up and down the country, well, what else is to be expected after 30 years of pro-market policies, and a succession of governments that have worked tirelessly to set up the NHS to fail? The fact that its taken this long for the NHS to sink to such a degraded state is a tribute to the nurses and doctors who have worked within it all these years.

And up until recently the NHS compared very favourably with other western healthcare systems; check out the report of the Commonwealth Fund for 2010 which showed that the NHS was the most cost-effective of all health systems analysed. With the arrival of the Coalition I doubt that this remains the case, not while the NHS budget is being using to channel revenue streams to the private sector.

Mike Cobley: “there is an instrinsic difference between the NHS and a commercial healthcare entity: the core function of the NHS is to look after the health of the nation; the core function of a commercial private health company is to maximise profit and minimise loss.”

On the evidence, they manage healthcare in other W European countries better than we do so it makes good sense to look to see how they manage to do that. It’s just demonstrably untrue to claim that clinical priorities take precedence over costs and profits in the NHS.

No profiteering in all those dozens of PFI projects in NHS hospitals – at least 20 of which are going bankrupt as a result? C’mon.

The hospital I go to has a projected deficit of almost £20m this year and has just been fined £4.8m for failing to meet NHS targets on the control of C Diff infection rates. It’s patently clear from experience that the quality of patient care is being downgraded to help pay down the deficit. In 2001, this hospital was declared to be the ‘the worst in Britain’ by the healthcare watchdog. It has improved a great deal since then but it has the huge deficit overhang.

We don’t have a uniform system of healthcare in Britain. We have a postcode lottery:

“An atlas published by the Government that maps variations in health spending and outcomes across England has highlighted some significant regional differences including amputation rates among diabetics. . . .

“Amputation rates among diabetics showed one of the most striking variations. Data revealed that the amputation rate for patients with Type 2 diabetes in the South West (3 in 1000 patients) is almost TWICE the rate in the South East. The Charity Diabetes UK was also concerned that the data showed less than half those with the disease (Types 1 and 2) had received nine key healthcare checks.”
http://www.mddus.com/mddus/news-and-media/news/november-2010/nhs-variation-atlas.aspx

We can’t afford to be smug about the NHS any longer. Try this report in the Indy last year on 12 July:

Almost 12,000 patients are dying needlessly in NHS hospitals every year because of basic errors by medical staff, according to the largest and most detailed study into hospital deaths ever performed in the UK.

The researchers from the London School of Hygiene and Tropical Medicine and colleagues found something went wrong with the care of 13 per cent of the patients who died in hospitals. An error only caused death in 5.2 per cent of these – equivalent to 11,859 preventable deaths in hospitals in England.

Helen Hogan, who led the study, said: “We found medical staff were not doing the basics well enough – monitoring blood pressure and kidney function, for example. They were also not assessing patients holistically early enough in their admission so they didn’t miss any underlying condition. And they were not checking side-effects… before prescribing drugs.”

@Bob B

Gosh I didn’t expect you to reply so quickly! I will have to be quick with this response as I am a bit busy.

‘On the reported evidence and from personal experience, local NHS hospital services are not satisfactory.’

Ok I am going to have to verbally slap your wrist every time you talk about personal experience, as I have mentioned previously personal experience is anecdotal and any experienced debater will rip you apart if you use it. Just for sake of your own arguments don’t say it as it gives the impression you do not know how to adequately use evidence to highlight a point.

‘The hospital is running a projected deficit of nearly £20m in 2012/13 and it has just been fined £4.8m for failing NHS targets for controlling…….hospitals are in serious financial trouble and face being taken over by government administrators without urgent improvements.’

I cant help but think you are a bit confused with the evidence that you are supplying, you seemed to have changed the question we are discussing a started a different point.

These are the topics that we were discussing in your own words, I think it is important to highlight this so no one is accused of dodging your questions:

‘Respondents keep dodging the fundamental questions I’m putting: What I need are good quality, dependable healthcare services, free at the point of delivery.

Why does it matter if the provider is a private hospital, rather than a state-owned NHS hospital, if the NHS is paying? Why do I have to have my healthcare services from a verging-on state monopoly provider with little choice?’

The financial difficulty of one local hospital and the PFI schemes that have been (stupidly) put in place in several trusts are a whole different topic to the questions we were discussing. I feel it would be wise to have a have closer look at your evidence as it does not support a the position that we should have smaller private run hospitals, in fact I could use the evidence provided to suggest that only a monopoly state provider (which we don’t have btw due to the foundation trust initiative) could use the surpluses from one part of the country to rescue the failing hospitals of another. Therefore I believe a good start would be for you to make doubly sure what question you want to debate as you seem to have moved the conversation on to other topics without analyzing my counter arguments @14. I am happy to change subject however if you have no direct responses to my counter arguments @14.

‘I’ve really no objection to being treated in a private hospital on an NHS contract. What matters is the quality of care and who pays, not whether the provider is part of a verging-on state monopoly provider of heathcare.’

You bring up your original question again but have yet to answer my counterpoints. If you wish to just repeat this and not debate please tell me as it will be a waste of my time if this keeps getting repeated without a sufficient response. I also implore you look at the video I provided, I understand you found it confusing but again I am happy to explain it.

‘I believe that there are lessons to be learned from other W European countries on how their healthcare systems function.’

One question of my own in response to this statement is, what lesson do we need to learn? what differences would be worth bringing over and why? a further point could the changes be implemented into a public service and if not why not?

@Bob B

Again please forgive the occasional spelling and grammar errors in my post, particularly the ‘One question of my own’ should read three questions lol. I wrote very fast and did not have much time to proof read

Mediatinum

“Ok I am going to have to verbally slap your wrist every time you talk about personal experience, as I have mentioned previously personal experience is anecdotal and any experienced debater will rip you apart if you use it.”

A nice one, that. My personal experience doesn’t count. I can easily post links about the the deficit of the hospital I attend and the recent NHS fine of £4.8m imposed for it failing to meet NHS targets for the control of C Difficile infection rates. How comfortable should I feel when I have a medical appointment at the hospital knowing that? What of the personal experience of all those who died early and unnecessary deaths at the Mid Staff Hospital Trust? Are we to take it that doesn’t count either?

The truth of the matter is that those claims about the NHS dispensing wonderful healthcare according to clinical priorities is, at best, pure fantasy, or more likely, mendacious propaganda. The fact is that the NHS is sinking under the extent negligence claims:

The head of Britain’s largest medical defence organisation is calling for a change in the law to curb the soaring cost of negligence claims which threatens to bankrupt the NHS.

Christine Tomkins, chief executive of the Medical Defence Union, which insures 200,000 doctors mostly in the UK, said the bill facing the NHS was now £18bn and rising – enough to pay the annual running costs of a dozen large teaching hospitals. But her proposals could mean victims of medical negligence would see their damages claims halved. [Independent Decmber 2012]

Botched care in pregnancy and childbirth has led to more than 5,000 successful negligence claims against the maternity services over the last decade – costing the NHS £3.1bn.

The sums paid out would be enough to build a dozen new obstetric units and hire thousands of extra consultants and midwives which could make childbirth safer. [Independent October 2012]

There is a percentage of relatively highly paid NHS professionals who don’t give an eff about the quality of what they do so long as they can keep trousering the big cash. Why should they care when taxpayers fork out for the compensation?

In the case of private hospitals the management has to care because the compensation payments impact on the insurance cover and hence the bottom line.

No wonder friends who have medical insurance say they get better quality care in private hospitals. Those hospitals want repeat customers to come back and good recommendations passed on to friends of their patients. Believe me, folk of around my age talk about healthcare issues.

We surely have lessons to learn from healthcare in other W European countries – where they don’t have state-monopoly providers of healthcare – because of the statistics showing better patient outcomes, longer average life expectancy rates, and more physicians per head of population as well as lower pay rates for clinicians. And we have the findings of independent, international surveys in which the NHS rates as rather mediocre by comparison with its European peers.

22

The providers of health-care in all health care settings are the professionals and support staff. In most EU countries, the state has the monopoly of provision because it determines the content of training courses and also the licensing of who can practise and where. In most EU countries, the state collects insurance premiums from the citizens who work, and this is compulsory.

The worst thing that the Tories did to the NHS was to attempt to ‘introduce’ a market within the existing framework, government bureacracies and free-markets are an oxymoron.

Why don’t you go private if you don’t want to be treated by the NHS, although, you will receive your treatment from professionals who were either trained in the NHS or the government will have determined that their qualifications are suitable for practice, and further, the government will have licensed those professionals. The private healthcare you receive will probably include a cup of tea, staff who may call you ‘sir’ and a better quality of upholstery on the sofas. You have a choice, which is better than most people had before the NHS.

23

“Why don’t you go private if you don’t want to be treated by the NHS”

Because the premiums for limited insurance starting at my age, with my medical history, are prohibitive. The sensible decision is to start healthcare insurance young, which is what young, mobile professionals do but I swallowed all the beguiling propaganda about wicked private medicine. The hip operations I had were in a self-funding unit, specialising in elective orthopaedic surgery, which has to pay its way from the income it attracts from treating patients, charging for NHS patients at set tariffs. The official NHS cost of hip operations is: £5,280 – £6,032. If the unit can’t attract enough patients then it has to shrink its staffing and scale of operations. It tries to limit the medical risks and costs by careful pre-op vetting: I was very carefully checked out with pre- and post-op ECGs because of a prior cardiac history. A lady in her 80s I know was refused for about a year until her blood pressure was better controlled. The reason is that post-op complications affect the unit’s bottom line so the risk is contained pre- and post-op. Post op patients get periodic monitoring questionnaires in following years to complete about unwelcome potential downstream complications – heart attacks, strokes, embulism, thrombosis.

All sorts of general hospitals across the south of England are doing hip ops – without the experience of the specialised unit I went to. In convalescence, I met with some patients who had been treated elsewhere and ended up with complications. Hip operations involve risk. After my first operation, I needed two blood transfusions but none after the second. That impacts on the bottom line.

It is a complete delusion to suppose healthcare decisions are determined just by clinical considerations with a bottomless source of money from taxpayers. If that were the case, we wouldn’t have the postcode lottery, the negligence cases, the scandals like the high mortality rates from cardiac operations at the Bristol Children’s Hospital etc.

The evidence from independent sources shows that there are better standards of healthcare in other W European countries. How do they manage it? Bismarck, as first chancellor of the Germany empire, deserves the credit for launching social insurance for healthcare back in the 1880s, long before the NHS started in 1948.

The real problem is that the British public has been fooled for more than 50 years into believing the propaganda that the only alternative to the NHS was the horrors of the American healthcare market. As better healthcare systems in other W European countries show, that isn’t so.

@Bob B

‘A nice one, that. My personal experience doesn’t count.’

It is a shame you feel the need to put words in my mouth, one can only think you haven’t got good arguments if you have to resort to lying about what I am saying. However I am a generous soul and I will assume you just don’t know what anecdotal evidence means so I will give you a good definition(extracted directly from Wikipedia):

The expression anecdotal evidence refers to evidence from anecdotes. Because of the small sample, there is a larger chance that it may be unreliable due to cherry-picked or otherwise non-representative samples of typical cases. Anecdotal evidence is considered dubious support of a claim; it is accepted only in lieu of more solid evidence. This is true regardless of the veracity of individual claims.
The term is often used in contrast to scientific evidence, such as evidence-based medicine, which are types of formal accounts. Some anecdotal evidence does not qualify as scientific evidence because its nature prevents it from being investigated using the scientific method. Misuse of anecdotal evidence is an informal fallacy and is sometimes referred to as the “person who” fallacy (“I know a person who…”; “I know of a case where…” etc. Compare with hasty generalization). Anecdotal evidence is not necessarily representative of a “typical” experience; in fact, human cognitive biases such as confirmation bias mean that exceptional or confirmatory anecdotes are much more likely to be remembered. Accurate determination of whether an anecdote is “typical” requires statistical evidence.

I hope this explains why people should be suspicious and not take stock of a singular account.

‘I can easily post links about the the deficit of the hospital I attend and the recent NHS fine of £4.8m imposed for it failing to meet NHS targets for the control of C Difficile infection rates. How comfortable should I feel when I have a medical appointment at the hospital knowing that?’

Again with bringing up the problems of your local hospital when we are discussing a different topic and with no explanation to why it is relevant. You have given me no data and explanation about how this isn’t just a financial issue caused by the break up of a centralized healthcare system.

‘What of the personal experience of all those who died early and unnecessary deaths at the Mid Staff Hospital Trust? Are we to take it that doesn’t count either?’

I can only assume from this pretty insensitive statement that you haven’t read the full Mid Staffs report. The report isn’t anecdotal evidence, I apologize if this is difficult for you to grasp as I have only just shown you what it means. It would be a great idea if you have the time if you read the full report as it explains in great detail what the actual failings were.

http://www.midstaffsinquiry.com/pressrelease.html

It highlights why cutting 10 million out of a budget in it’s desperation to become a foundation trust lead to low staffing levels etc etc. In trying trying to become that non-state monopoly independent organisation that you want it caused all of those horrible events. It’s pretty disgusting that people want that to happen more by fragmenting the service totally. People who are against a centralized state healthcare should be ashamed of this event, and it should be a warning to others about fragmenting care. However most don’t understand the details so are just turkeys voting for Christmas. Its a shame really.

‘the fact is that the NHS is sinking under the extent negligence claims’

Are you suggesting that we don’t pay these individuals compensation? that’s pretty barbaric. Or are you saying we should legislate to remove human error from the NHS? which would of course be very difficult as everyone makes mistakes. Have you recently searched for the deaths that are caused in private hospital recently? do you think they don’t have to pay compensation?

‘There is a percentage of relatively highly paid NHS professionals who don’t give an eff about the quality of what they do so long as they can keep trousering the big cash.’

Wow gosh if you have this information you should tell someone. I expect however that is just your frustration coming through. Sad really as it is hard to respect your conversation partners when they say things like that.

‘Why should they care when taxpayers fork out for the compensation?’
‘In the case of private hospitals the management has to care because the compensation payments impact on the insurance cover and hence the bottom line.’

You do understand that doctors pay into an insurance scheme with a premium function. If they get sued they are actually hurt financially. It does not benefit a doctor to mess up or provide poor care. The foundation trust also loses money and therefore it is damaged by compensation claims. It would be better I think if you looked into things a bit more deeply before you use that argument again, it makes you sound really disconnected from the actual events that take place in our healthcare system.

‘No wonder friends who have medical insurance say they get better quality care in private hospitals. Those hospitals want repeat customers to come back and good recommendations passed on to friends of their patients. Believe me, folk of around my age talk about healthcare issues.’

tut tut again anecdotal evidence *wrist slap* and this has been tackled in the previous posts in my ‘bolt-on’ counter point. I still await an explanation why you don’t directly challenge many of my counter-points, it’s quite rude and it’s a shame since you have previously blamed others for dodging the question. It’s a bit hypocritical.

‘We surely have lessons to learn from healthcare in other W European countries – where they don’t have state-monopoly providers of healthcare – because of the statistics showing better patient outcomes, longer average life expectancy rates, and more physicians per head of population as well as lower pay rates for clinicians. And we have the findings of independent, international surveys in which the NHS rates as rather mediocre by comparison with its European peers.’

So you have not answered my questions. I asked nicely for specifics and also justification why they cannot be done with centralized state healthcare, you have just talked about general themes and just insisted that state healthcare can not for some reason. Opinions are nice however I cannot take your word for these points as so far you have yet to display the ability to critical evaluate evidence. It is important that we stick to a standard.

Specifics: In this Wednesday’s news from the BBC:

Care regulator ‘ignored hospital concerns’

“Model of regulation is not fit for purpose”

A senior figure at a health regulator has accused it of ignoring concerns about some hospitals in England.
http://www.bbc.co.uk/news/health-21951227

More specifics: try the quotes from press reports @13 – about the numbers of NHS patients dying through medical errors – and @17 about the NHS sinking under the increasing cost burden of meeting negligence claims.

I’ve also posted links to independeent surveys (by WHO and for the Euro Health Consumer Index 2009) where the NHS is shown up as rather mediocre in comparison with its peers in W Europe.

As for the relevance of personal experience, antibiotics were discovered because Alexander Fleming in 1928 noticed something peculiar about a specimen of bacteria in a petrie dish that had been left out in the laboratory and gone mouldy. He started to think about what could have caused the death of the bacteria on the dish.

The moral of that insight is that we can learn from personal experience if we take note of it and analyse it.

Mediastinum, stop being so patronising.

As you surely know, the Mid-Staffs situation was NOT caused by under-funding.

There may well have been difficulties caused by cuts made in the wrong place, etc etc. This could even lead to unnecessary deaths in the very short-term.

However, given the number of deaths, shouldn’t someone have said something?? Maybe some of the complaints could have been investigated.

“However, given the number of deaths, shouldn’t someone have said something?? Maybe some of the complaints could have been investigated.”

More specifics: try this news report on 24 March 2013 following an official review of the response by NHS central to incoming complaints about the quality of care at the Mid Staff Hospital Trust:

More than 60 Mid Staffordshire hospital complaints to Government ignored

Dozens of complaints were made to the Department of Health about Mid Staffordshire hospitals after Sir David Nicholson began overseeing the trust, ministers have revealed.
http://www.telegraph.co.uk/news/politics/9951218/More-than-60-Mid-Staffordshire-hospital-complaints-to-Government-ignored.html

@Bob B

‘As for the relevance of personal experience, antibiotics were discovered because Alexander Fleming in 1928 noticed something peculiar about a specimen of bacteria in a petrie dish that had been left out in the laboratory and gone mouldy. He started to think about what could have caused the death of the bacteria on the dish.

The moral of that insight is that we can learn from personal experience if we take note of it and analyse it.’

Seriously? You really need to read up into flemming’s work with penicillin before you say stuff like that, it is embarrassing to read. Flemming discovered penicillin whilst performing scientific experiments on mold, you know, experiments where you collect concrete data and not anecdotal evidence. Flemming had to do a huge battery of scientific tests to prove that what he saw wasn’t an anomaly, followed up by several decades of research to make antibiotics fit for human consumption. He had to PROVE his observation wasn’t a fluke or an error. You have massively not understood what anecdotal evidence means and why you should be embarrassed in ascribing ‘what my friends say’ as data that is as reliable as scientific research. There is not much more I can say about this as I don’t have the time to teach you basic critical evaluation and scientific theory. Just please study about it when you have time.

‘More specifics: try the quotes from press reports @13 – about the numbers of NHS patients dying through medical errors – and @17 about the NHS sinking under the increasing cost burden of meeting negligence claims.’

I’ve already countered these points and you are still refusing to answer them directly, furthermore these are errors that have occurred in our system not procedural differences between our system and another therefore you haven’t even begun to address my question.

‘I’ve also posted links to independeent surveys (by WHO and for the Euro Health Consumer Index 2009) where the NHS is shown up as rather mediocre in comparison with its peers in W Europe.’

I have also countered this point before and I saw the link to the WHO report, tbh I thought it must have been a joke as you were using Data collected in 1997 to prove a point about healthcare in 2013. Do you know WHY the study is dated in 2000 because WHO DOES NOT DO INTERNATIONAL HEALTH SYSTEM SURVEYS ANYMORE as they have said they are inherently unreliable as there are too many factors and any comparative study on such a grand scale is unreliable. However this conversation has shown that you either refuse to or can’t directly answer my counterpoints so I expect you to keep throwing these links that you do not understand at me as some sort of magic answer.

Not going to lie Bob B, I feel like you don’t grasp how to apply evidence. It is very depressing as all you have shown is that your fear of healthcare has made you into a useful idiot for people to damage your healthcare. Unfortunately for you the NHS changes are only going to shorten your life, me on the other hand thanks to the corruption of the system will be able to make huge amounts of money as a GP or consultant. We really should be on different sides of the argument however I don’t want Mid Staffs to become a regular thing and you seem to be desperately trying to drive the NHS toward with you lack of critical evaluation skills. The hilarious thing is that it will very hard to spot another Mid Staffs as private companies do not follow freedom of information laws and can issue gagging clauses so people are going to die and no one will really care because they won’t have the newspapers telling them. In the end I feel sorry for you, however I am glad that science education has obviously improved between our two generations.

If you wish to continue going round in circles please do, however I won’t be wasting much time giving you long responses until you actually respond to my questions. So before you throw links at me please think and look at the information first and explain how it is relevant to answering mine and your own questions. On a side note I can also recommend some good science books that I use when I tutor, they help with the basics of critical evaluation, would you like me to link you to them?

‘to be desperately trying to drive the NHS toward with you lack of critical evaluation skills’

should read

‘to be desperately trying to drive the NHS toward that with your lack of critical evaluation skills’

@Jack C

I am just explaining why Bob is incorrect, it is up to him to learn how to apply evidence better. I am not going to be soft on someone when they do something wrong. We are all adults here talking about important issues, surely we do not need our hands held.

As a side note I do not resort to putting words in peoples mouths or using dead people to make a uninformed point. Poor show of character in my opinion.

By the sound of it you have not read the full mid staffs report either. Please look into it.

http://www.midstaffsinquiry.com/pressrelease.html

you also are both trying to switch the focus of the original question which I assume is because you cannot argue against it. I will remind people again, these were the original questions were were discussing.

‘Why does it matter if the provider is a private hospital, rather than a state-owned NHS hospital, if the NHS is paying? Why do I have to have my healthcare services from a verging-on state monopoly provider with little choice?’

My counter arguments have been rudely ignored, however I do not expect them ever to be answered as Bob seems to be more for heat than light.

So are we going to argue the actual debate topic or are you both going to avoid it?

Also Jack C you seem to be easily offended, I advise that internet comments sections are probably not for you.

‘which I assume is because you cannot argue against it’

should read

‘which I assume is because you cannot argue against my counterpoints.’

Mediatinum

Frankly speaking, you are incapable of rational discussion. For you, any evidence, personal or documented, critical of the NHS is to be brushed aside.

I would suggest that is one very likely reason for such press reports quoted @13 – about the numbers of NHS patients dying through medical errors – and @17 about the NHS sinking under the increasing cost burden of meeting negligence claims.

For the sake of patients, that is why we need to learn from healthcare systems in other W European countries where they don’t have state-owned, near monopoly providers and where, by independent, international surveys, the NHS is rated as rather mediocre compared with its peers. Details of other healthcare systems can often be found on the web – this is but one, selected at random from among many:
http://healthcare-economist.com/2008/04/14/health-care-around-the-world-an-introduction/

It is not worth my time discussing further with you.

@ Bob B

‘Frankly speaking, you are incapable of rational discussion. For you, any evidence, personal or documented, critical of the NHS is to be brushed aside’

You have still yet to counter my points and understand about how to rate and apply evidence so a discussion has been halted by you. I have provided clear explanation why you are wrong in your assumptions and again using anecdotes is highly irrational in a scientific debate.

‘I would suggest that is one very likely reason for such press reports quoted @13 – about the numbers of NHS patients dying through medical errors – and @17 about the NHS sinking under the increasing cost burden of meeting negligence claims.’

Again you have yet to answer my counter points so your mention of @13 and @17 is irrelevant if you wont defend yourself against another person’s critical evaluation. That is how science progresses.

‘For the sake of patients, that is why we need to learn from healthcare systems in other W European countries where they don’t have state-owned, near monopoly providers and where, by independent, international surveys, the NHS is rated as rather mediocre compared with its peers. Details of other healthcare systems can often be found on the web – this is but one, selected at random from among many:
http://healthcare-economist.com/2008/04/14/health-care-around-the-world-an-introduction/‘

Sorry Bob B I am going to trust WHO over you as you seem to lack the skills that they possess.

‘It is not worth my time discussing further with you.’

Translation: I have nothing to say of substance and cannot argue against any of your counter arguments, therefore I am going to run away to another comment section where I will hopefully not be picked up for my lack of knowledge or evaluative skill.

However all in all I have had an enjoyable time, I would have enjoyed it more if you understood the basics of scientific evidence though.

‘Details of other healthcare systems can often be found on the web – this is but one, selected at random from among many:
http://healthcare-economist.com/2008/04/14/health-care-around-the-world-an-introduction/‘

Oh and referencing a website which only uses the CATO institutes press releases. Btw CATO is a libertarian think tank, and is not ‘independent’, they have an inherent bias. I did not insult your intelligence by giving you studies from left-wing think tanks so don’t insult mine. If you decide to return please use more reliable information such as unbiased scientific journals.

Mediastinum

“You have still yet to counter my points and understand about how to rate and apply evidence so a discussion has been halted by you.”

That is blatantly untrue

In previous posts, I have quoted from many relevant press reports and independent surveys.

Even if you are manifestly incapable of absorbing their content, other passing readers will have been enabled to gain information and information sources.

For the sake of patients it harms, the NHS has to change.

@ Bob B

I thought you were leaving Bob and I still see you are dodging my counter points.

‘That is blatantly untrue’

Well luckily anyone with half a brain can see that this statement is incorrect. They probably would be people who understand that Flemming’s research on penicillin wasn’t anecdotal evidence tho.

‘In previous posts, I have quoted from many relevant press reports and independent surveys.’

And you haven’t understood them or countered my critizm. You have just continued to use the same articles again and again without any appreciation for there validity or actually what they indicate.

You have still yet to answer these questions:
what lesson do we need to learn? what differences would be worth bringing over and why? a further point could the changes be implemented into a public service and if not why not?

you seem to think a news article includes a procedure that a European country uses that we don’t and why it could not be integrated into the NHS. Your evidence is terrible and in most cases backs up my position that you have not explained why the simplistic idea of ‘public’ owned or ‘private’ owned being the main cause for problems in a healthcare system.

‘Even if you are manifestly incapable of absorbing their content, other passing readers will have been enabled to gain information and information sources.’

Say remind me again who is finding difficulty understanding the validity or anecdotes to scientific discussion.

‘For the sake of patients it harms, the NHS has to change.’

Well what a pointless throw away statement. Systems change all the time it is whether they are changing for the better is the important point and you have yet to provide anything close to reliable evidence to show why privatization is a good thing.

Mediastinum,
I’m aware of the report, and no I’m not easily offended. All I’m saying is that your bedside manner needs improvement.

Regarding the report, under-staffing is a root cause, but doesn’t cover the following:

1) Several of the specific points raised are NOT directly associated with under-staffing. For example, the failure to react to staff concerns.

2) There is also clear waste through inefficiency, such as sending people home who then had to be re-admitted. How did funding at Mid-Staffs compare to other hospitals, and how do relative results compare?

Let me ask you a question. Say you’re in charge of 10 patients in a ward, but only have staff to care for 9 adequately. As a result, lives are at risk. What would you do?

a) In the very short-term, make up through unpaid overtime, whilst alerting the hospital management (and your union, etc etc if you get no answer). You might also make it clear that unpaid overtime would end on a very near date.

b) As above, but with no unpaid overtime.

c) Ignore the situation (for years) and allow both very poor care, and unnecessary deaths.

Note: As regards your Big Question, we shouldn’t ignore what other countries do. You may feel that the NHS is the only and best way of delivering healthcare, but our peers do not. They can’t all be entirely wrong.

@ mediastinum

I admire your tenacity at trying to hold a debate with Bob B. you’re wasting your time. At least you didn’t get him onto Catholics or Muslims.

He’s moved on from his Roger Irrelevant act of yore, and now just drones on and on, trying to browbeat everyone into submission with his sheer persistence.

@ Jack C

Finally a proper answer, that has taken a while. So just to confirm before we go any further are we discussing the problems that occurred at mid staffs or do you want to go further into Bob B’s and my discussion. It is frustrating dealing with two topics at once especially since I was not the person who mentioned Mid Staffs. So we have question one which is related to Bob’s first topic:

‘Note: As regards your Big Question, we shouldn’t ignore what other countries do. You may feel that the NHS is the only and best way of delivering healthcare, but our peers do not. They can’t all be entirely wrong.’

Who said ignore? people have this nasty habit of attributing me to things I have not said. From the start I have been asking for specifics about what those countries do and evaluate them. Provide them and we can talk about it.

And two which is:

‘Regarding the report, under-staffing is a root cause, but doesn’t cover the following:

1) Several of the specific points raised are NOT directly associated with under-staffing. For example, the failure to react to staff concerns.

2) There is also clear waste through inefficiency, such as sending people home who then had to be re-admitted. How did funding at Mid-Staffs compare to other hospitals, and how do relative results compare?’

Thank you for being honest and concede that staffing was a root cause.

1) You are not going to here me supporting managers who don’t listen to their staff. It did make mention in the report that managers were more focused on cutting costs costs and bullied staff. If the hospital had not have to make 10 mil in cuts, would the managers be more inclined to listen. I doubt we will even know. I of course disagree with poor managers and want that to improve too be through procedural change or firing problem makers.

2)Your last two questions are important and I agree and would be interesting to know. I do not have that information on hand however. Sending patients home could be due to trying to hit targets or believing it will be better for the patient to return home. It is a bit counter intuitive but home can be a much better place for recovery than a high risk ward. It would be very hard to completely eliminate re admissions due to the variability of individuals. Waste and inefficiency in these circumstances are really difficult to eliminate because people don’t always respond the way you expect in medicine.

So it seems that we agree on the basics so I see very little friction points in this topic.

‘Let me ask you a question. Say you’re in charge of 10 patients in a ward, but only have staff to care for 9 adequately. As a result, lives are at risk. What would you do?

a) In the very short-term, make up through unpaid overtime, whilst alerting the hospital management (and your union, etc etc if you get no answer). You might also make it clear that unpaid overtime would end on a very near date.

b) As above, but with no unpaid overtime.

c) Ignore the situation (for years) and allow both very poor care, and unnecessary deaths.’

This is a difficult question to ask as it limits me to three options and has not given me the full information about my actual role, the patients I am observing and the staff. All I can really say is that I would report it if I noticed it and if my managers did nothing I hope I would have to strength of character to whistle blow. In reference to Mid staffs the workers did this and were ignored because of bad managers and were bullied into silence. Sounds like a case of firing and prosecuting the managers to me. I really cannot see the difference in our opinion, I disagree when it is used as a public vs private issue as it does not account for any of the individual variables. It would be like me using the deaths that happen in the private sector to make a counter argument. It does not answer anything.

‘I’m aware of the report, and no I’m not easily offended. All I’m saying is that your bedside manner needs improvement.’

This made me chuckle, but I did not realize you were sick, being treated by me or lying in bed. However if you were and were spouting falsehoods I am expected even as a med student to correct you even if it upsets the patient. So if it is ok with you I will stick to my training.

@ Cherub

lol thanks Cherub very nice of you to say.

I don’t mind I am just bored as I am writing up a literature review.

It is fun to test my skills on immovable opinions. I will have to deal with them allot when I qualify so it is all good practice.

Argh ‘hear’ not ‘here’ self wrist slap!

@ Jack C

Oh I give up correcting myself there are loads more errors, if you don’t understand anything because of my typos just say.

Does Andy say why Lab have performed such a volte face with regard to their decade long infatuation with market solutions?

Is it because they now think markets are crap or is it mere contrarianism?

It really is hard not to loathe these amoral opportunists

“Sounds like a case of firing and prosecuting the managers to me”.

But also there were many cases of shocking bad care by many members of staff. It’s not just about under-staffing by any means. Basic H&S standards simply weren’t applied.

I think most people would agree that this would not have happened in a private hospital, or if it did, criminal charges, fines, etc would have resulted.

This does NOT mean that the NHS concept is wrong. But I think it DOES mean that the NHS needs to be more open and transparent when it fails. Brushing Mid-Staffs under the carpet will not help. Cover-ups never do.

@ A&E

I have not heard their reasons, I would like to think they have actually realized their errors and come to a reasonable conclusion…. I am probably wrong though and this is just another strategy to win votes. I am sure they will march on with similar ‘reforms’ if they get back in. I am not hopeful about the future, I think public healthcare is doomed to die through stealth, the people who want it to happen control the message and the money. all we can do as medical professionals is attempt to reduce the damage. Well at least A&E and Elderly care will be publicly funded, no way private companies will ever take them.

Indeed, mediastinum (@45) – I wonder if any of the NHS nay-sayers saw this?
http://www.bbc.co.uk/iplayer/episode/b01rk2d0/Keeping_Britain_Alive_The_NHS_in_a_Day_Episode_1/

That BBC video is just a piece of beguiling propaganda as though other W European countries have no healthcare systems, systems which lead to better patient outcomes according to independent surveys.

Try this other BBC report in 2010 about the NHS:

Fifty-seven patients underwent operations on the wrong part of their body last year due to NHS errors, figures show. The National Patient Safety Agency says these were some of the 111 so-called “never events” in 2009-2010. These are very serious, preventable patient safety incidents which the government says should not occur.
http://www.bbc.co.uk/news/health-11504808

That nearly happened to me. After a pre-op injection prior to a hip operation in 2010, the surgeon presented me with a consent form which specified the wrong hip. I refused to sign until the form was amended in manuscript so that is now part of my medical records.

The NHS sends me periodic questionnaires about patient outcomes for that and a second hip operation I had about 18 months later – which I regard as very sensible monitoring.

You can be sure I carefully checked the consent form for my second op but the illuminating insight is that the questionaires started to confuse the order of the two operations so I rang up the unit where I had had the operations. There was no point getting cross with the helpful young woman at the inquiry point. She checked the computer record of my two ops and found that was wrong.

[47] is your argument that a medical error invalidates an entire health system because if we take this position it invalidates the system ranked numero uno by the WHO
http://qualitysafety.bmj.com/content/early/2012/01/02/bmjqs-2011-000359.abstract

Anyway, why is the film ‘propaganda’ – I assume by this you are implying that the film makers captured all manner of dreadful mistakes yet refused to incorporate them in the final edit?

On the other hand it could be that the NHS has many dedicated and competent staff who are providing (in the main) a pretty decent service?

48

There is an endless stream of promotional propaganda about the NHS – like the opening show at the London Olympics – without corresponding investigative journalism to assess whether healthcare systems in other W European countries provide better patient outcomes, which is what healthcare is really all about or should be.

For about 50 years, we were fed a line that the only alternative to the NHS was the terrible American market system. The American healthcare market provides a very bad deal for Americans but it is only since about 2000 that information has surfaced about healthcare in other W European countries and it turns out that that they have pretty good systems going from which we could perhaps learn something.

From long experience, posting anything like that is evidently regarded as dire heresy by some whereas we should be having a sensible adult discussion about healthcare reform.

Why is it that other W European countries have avoided Britain’s model of a state-owned, verging-on monoply provider of healthcare services thereby creating the largest employer in W Europe?

It was only a few years back when I learned that Bismarck, the first chancellor of the German empire, deserves the credit for introducing a national social insurance scheme to cover healthcare costs back in the 1880s. That and a pension scheme introduced about the same time have been a template for the European Social Market Economy. In fact, Britain was very backward in introducing a welfare state.

The impression generated by all the NHS promotional stuff is that other W European countries must therefore have awful healthcare. Independent survey findings by WHO and the Euro Health Consumer Index show that isn’t so. I believe a wider public in Britain is entitled to know about that.

I’m not asking you about the olympics opening ceremony, I am asking you why you regard ‘Keeping Britain Alive’ as propaganda.

Discussing alternatives to the NHS is not heresy but none of the systems you frequently allude to are any cheaper, and given the tories are insistent on more cut backs (as well as enriching their corporate mates) it is a factor we cannot ignore, can we?

Maybe you think there is a parallel workforce of doctors and nurses that can be introduced to replace the incompetent NHS staff you have so many problems with?

50

“Discussing alternatives to the NHS is not heresy but none of the systems you frequently allude to are any cheaper”

When I last checked, only a small minority of W European healthcare are cheaper, as measured by healthcare costs as a percentage of national GDP. But I’m not trying to cover-up anything. I believe the British public is entitled to be told that the NHS is rated as rather mediocre compared with most other W European healthcare systems and to know that we have fewer – but relatively highly paid – physicians per head of population than many other W European countries, except for Ireland.

Everyone seems to evade this obvious question as to why other W European countries have avoided the British model of a state-owned, near monopoly provider of healthcare services.

The Answer to the NHS

I hope to explain my theory and the possible answer to NHS which has always in my opinion been a complete shambles from day one. If my system works we will have the best free health care in the world with a huge amount of financial relief on the tax budget.

? First put a value on every hospital in the UK property/land etc
? Yes they are all going to be sold but do not dismiss this letter please read on.
? Once a hospital becomes private owned they will be run in the manner they should be run
? All properties have a lease on them from the government and can never be changed with the planning departments into any other type of business.
? This has now taken the stress off the government other than visits to grade the hospitals as we do hotels
? Once the hospital is private owned we do not have to worry about running costs and management taking back hander’s which we know does happen from drug companies.
So now what happens? The simple answer is that the government takes an insurance policy out on every NI numbered UK resident.
? What this does is stops all non UK residents getting free treatment in our hospitals
? Everyone gets treated to a high standard because if you owned one of the hospitals you want the payments from the insurance companies.
? The patient now has a choice where to be treated.
? The patient can upgrade their insurance policy if they choose.
? The patient can have options on the policy to include travel.
? Once insured and hospitals are private owned there will be NO false claims on the dhss
?
Quick breakdown
? It is cheaper to insure our people than run the NHS
? We do not have the trouble with false claims and use of our hospitals
? The hospitals will be better run, just think if Sir Richard Branson owned a few they would be run better than most hotels
? No illegal immigrants using our free service.
? No slackers in their hospital jobs as now they answer to share holders etc
? Insurance companies will be falling over themselves for the contract but there must be a set percentage set for future policy’s
? If the hospital does not reach the standards they will loose it and be resold, set out in the lease.
? We do not have problems with unions and all the other pen pushers that seem to get a free ride.
If you are insured by the government regardless if you are in employment, you have free health care !!!
Yes this system need fine tuning but I did not want to write a ten page essay just give you the core of the idea.
Best Regards
Keith Pearce (keith@opimusinvestments.com)

“No illegal immigrants using our free service”

I have had regular contacts with my local hospital for more than 8 years, during which time they have asked to see my birth certificate (born in Lambeth, London, before WW2) and proof of residence (20 plus years paying full rates to the local council). In January, I got a phone call to enquire about “your ethnicity”.

@ A&E

Lol I was going say they would probably avoid it or would pretend to watch it and call it propaganda by the evil BBC, however it appears I was beaten to the punch.

I have to say you win the internet discussion today A&E it only took you two posts to reveal Bob as a stubborn conspiracy theorist. I thought he might be but thanks to you now everyone can now see it.

I doff my cap to you.

@ Keith

‘Yes this system need fine tuning but I did not want to write a ten page essay just give you the core of the idea.’

Thanks for the post.

There are allot of ideas there, do you have links possibly to the finer details as it is very hard at the moment for me to analyse these core ideas without having greater information.