Westminster Politics 2024-2029

Turns out it wasn’t just about freeing up beds but introducing private healthcare into the NHS



Also

 
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But hahaha the Tories are out great stuff lads we've done it. Sensible back in politics.
 
So those dividends add up over time! This paragraph is damning.
Yup, always felt lucky that we have Scottish Water. A couple of winters back, everyone on my street lost their water after a series of pipes burst down the road from us. We were all furious, having a moan all day about it. We still talk about it now.

We were without water for about eight hours in total. A crew turned up at 1am, ripped the roads up, and it was fixed by 4.
 
Wes Streeting has pledged to end what he called the “begging bowl” relationship between the Department of Health and Social Care and the Treasury, arguing that his department must play a role in achieving Labour’s economic growth mission.

Speaking at the Tony Blair Institute’s conference earlier today, the Health Secretary also said he is “optimistic” about talks with junior doctors this afternoon, describing the change in government as an “important reset moment”, though he reiterated that Labour does not believe their pay demand is affordable.

Asked how he plans to fix the NHS that he has described as “broken”, Streeting said: “One of the things I’ve said to my department and to the NHS is we need to rethink our role in government and in our country at large. This is no longer simply a public services department. This is an economic growth department.”

He emphasised the link between the “health of the nation and the health of the economy”, telling attendees: “We’re going to be a government that firstly recognises that fact and recognises that as we get people not just back to health but back to work, that’s a big contribution to growth.”

Streeting continued: “If we can marry our health and social care system with the incredible life sciences and medtech ecosystem we have in this country, we can be a powerhouse for the life sciences and medtech revolution here in this country… and in the world. And that is an economic growth mission.”

He added: “I’m now responsible for one of the largest workforces in the entire world that have a presence in every community in this country. As anchor institutions, the NHS, the social care system, we can be drivers of economic growth in every part of the country.”

The Health Secretary said: “That is a major shift in mindset. It’s a rethinking of the role of the department and it also means – and the tough messages I delivered in opposition are not going to change now we’re in government.

“It also means ending the begging bowl culture, where the only interaction the Treasury has with the Department of Health and Social Care is: ‘We need more money for X, Y and Z.’

“The starting point has got to be: ‘We will help you achieve your mission for growth and improve the prosperity and lives of everyone in this country, by making sure that we are with you, lockstep in driving growth.”

Elsewhere in the interview with journalist Jon Sopel, Streeting said cutting NHS waiting times is his “immediate focus” but that Labour will also be “embarking on a long-term plan for both health and social care”.

He said: “We’ve got to make sure that we keep our eyes on the long-term horizon because if you look not just at the challenge today… but the challenges which I consider to be existential for the future of the NHS, which are growing ageing population, rising preventable chronic disease and rising costs pressures…

“If we don’t make the right reform decisions now, in the medium term, let alone the long term, future generations and future Health and Social Care Secretaries will curse us, because we didn’t take the difficult long-term decisions at the right time and we saddled future generations with a National Health Service that is unsustainable.

“I am optimistic about the future of the NHS, and I think that the same equitable principles upon which it was founded in 1948 can and must survive and thrive in the 21st century. But that is not inevitable.”

Asked about the NHS continuing to be free at the point of use, Streeting said: “Free at the point of use is about fairness and equity and defending a system that means when you fall ill you do not have to worry about the bill. And I think that is an equitable principle that is worth fighting for.”

He added: “However, people are already making the choice, and what we’re seeing is the opening up of a two-tier system, where those who can afford it are paying to go private and those who can’t are being left behind.

“And one of the reasons I was determined in opposition to take on the left on this issue, is this isn’t simply a pragmatic argument that says: ‘Well, we can get waiting lists down faster if we use spare capacity in the private sector.’ Though that’s important.

“It was also a principled argument that said: ‘Why should those without means wait longer while those who have means are seen faster?’ That’s an affront to my left-wing principles. I don’t know why it isn’t an affront to theirs.”


https://labourlist.org/2024/07/labo...althcare-treasury-economic-growth-tony-blair/

To me he seems to be saying that, getting people healthy means more people getting into work and thus driving economic growth so the NHS should not be seen or positioned as a drain on public resources. He then references that he wants the equitable principles of it's founding to continue before later going on to say that he considers free at the point of use being one of those equitable principles before acknowledging that the reality is that we do have a two tiered system now as NHS waiting lists/issues are meaning those who can afford it are skipping the queue by paying for private treatment while those who need to wait for NHS treatment are being left behind.

Others will have their own takes.
 
Pogue that’s because your right wing.

No that’s because I’ve worked in public health services which charged a nominal fee for GP or A&E visits (primarily to minimise the number of punters wasting everyone’s time with trivial nonsense) while also ensuring nobody ever had to pay for the really expensive stuff like inpatients stays or surgery. I’ve also worked in the NHS. The idea that “free at point of use” is some sort of sacred cow, which must never ever change, is a nonsense.
 
Reeves : we want people off of benefits and in work, there are too many people on long term sick due to the NHS backlogs and poor mental health services. This will improve productivity in the economy and lead to growth

Streeting: the NHS is important for economic growth.

:confused:
 
No that’s because I’ve worked in public health services which charged a nominal fee for GP or A&E visits (primarily to minimise the number of punters wasting everyone’s time with trivial nonsense) while also ensuring nobody ever had to pay for the really expensive stuff like inpatients stays or surgery. I’ve also worked in the NHS. The idea that “free at point of use” is some sort of sacred cow, which must never ever change, is a nonsense.
Blanket fee or means tested?
 
Blanket fee or means tested?

Means tested.

The most equitable way to run a health service is that those who can pay should pay a nominal fee (so long as the costs are capped and we avoid the sort of insane expense you see in the US) while those who can't, don't. I've always thought it mad the way some people are absolutely adamant that nobody should ever pay to access the NHS. It just doesn't make sense.

Another really obvious thing we do in Ireland (which I don't think you do in the UK?) is to charge €100 to anyone who turns up to A&E without a GP referral. Free if referred by a GP. Again, means tested, so those who can't afford these fees don't have to pay them.
 
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Means tested.

The most equitable way to run a health service is that those who can pay should pay a nominal fee (so long as the costs are capped and we avoid the sort of insane expense you see in the US) while those who can't, don't. I've always thought it mad the way some people are absolutely adamant that nobody should ever pay to access the NHS. It just doesn't make sense.

Another really obvious thing we do in Ireland (which I don't think you do in the UK?) is to charge €100 to anyone who turns up to A&E without a GP referral. Free if referred by a GP. Again, means tested, so those who can't afford these fees don't have to pay them.

If it’s means tested is national insurance not exactly that? Or are we only punishing sick people now?
 
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Another really obvious thing we do in Ireland (which I don't think you do in the UK?) is to charge €100 to anyone who turns up to A&E without a GP referral. Free if referred by a GP. Again, means tested, so those who can't afford these fees don't have to pay them.
So if you break your arm you have get a GP referral first? Or can you get the money back later if you're not time wasting?
 
So if you break your arm you have get a GP referral first? Or can you get the money back later if you're not time wasting?

You need the GP referral first, or you have to pay. And, having worked in A&Es, I can assure you that a hell of a lot of people think they’ve broken a bone when they haven’t.

Obviously, if you’re badly hurt enough that an ambulance brings you in then there’s no charge.
 
If it’s means tested is national insurance not exactly that? Or are we only punishing sick people now?

I’m afraid I don’t know what you’re on about here. Especially the bit about “punishing sick people”? I was talking about whether or not the NHS should be always be free at point of use, for everyone. I don’t think it needs to be. Or at the very least, alternative options should be on the table in discussions about how to run the best possible public health service.
 
So if you break your arm you have get a GP referral first? Or can you get the money back later if you're not time wasting?
You pay when your arm is healed enough to hold up your debit card to the equitable contactless payment machine.
 
I’m afraid I don’t know what you’re on about here. Especially the bit about “punishing sick people”? I was talking about whether or not the NHS should be always be free at point of use, for everyone. I don’t think it should be.

I am replying to you, but this is a general point, rather than one you need to reply to.

Two immediate pitfalls come to mind. First, if you institute a system of means testing for health, for the whole country (which includes a system that ensures people who cannot pay do not), then you need to ensure that the cost of the bureaucracy does not swallow up the money raised in fees or payments. Especially as you need to factor in staffing costs, inflationary pay increases, updates in technology that cost money, and so on. Blair tried a national NHS IT system which costed billions and did not work, so how does a government ensure data collection and retention securely?

Secondly, you need to engage in a lot of messaging to ensure people who need help are not dissauded from doing so (see UK dentistry as an example), and in that case, how much would publicising the new system cost against the revenues raised?
 
You need the GP referral first, or you have to pay. And, having worked in A&Es, I can assure you that a hell of a lot of people think they’ve broken a bone when they haven’t.

Obviously, if you’re badly hurt enough that an ambulance brings you in then there’s no charge.

Surely though that means people that are not sure and are worried about money will sit at home and hope it gets better, as people do with teeth problems here. A couple of weeks ago my daughter seriously hurt her ankle, I tool her to A and E after a couple of hours, it wasn't broken but she was on crutches and still is as she had torn ligaments, very glad I didn't have to pay, if I had I would probably have waited longer as I thought she had just turned it or bruised it initially, but the over riding message from the team in our local A and E was "better safe than sorry" charging turns that on its head.
 
I’m afraid I don’t know what you’re on about here. Especially the bit about “punishing sick people”? I was talking about whether or not the NHS should be always be free at point of use, for everyone. I don’t think it should be.

We already pay for the NHS via National Insurance and Taxes which are both progressive and therefore means tested.

So by abandoning that principle and considering the burden a public/national responsibility, you’re suggesting that the burden is on you to pay if you become sick?
 
We already pay for the NHS via National Insurance and Taxes which are both progressive and therefore means tested.

So by abandoning that principle and considering the burden a public/national responsibility, you’re suggesting that the burden is on you to pay if you become sick?

Nobody is abandoning that principle. And these fees don't fund the health service. They're nominal fees which the vast majority of people only pay very rarely and are in no way a financial burden. Put it another way, how many A&E visits have you made in the last, say, five years? How badly would you be out of pocket if you'd bypassed your GP each time and paid the full £100 per visit?
 
Surely though that means people that are not sure and are worried about money will sit at home and hope it gets better, as people do with teeth problems here. A couple of weeks ago my daughter seriously hurt her ankle, I tool her to A and E after a couple of hours, it wasn't broken but she was on crutches and still is as she had torn ligaments, very glad I didn't have to pay, if I had I would probably have waited longer as I thought she had just turned it or bruised it initially, but the over riding message from the team in our local A and E was "better safe than sorry" charging turns that on its head.

Why didn't you see a GP?
 
Why didn't you see a GP?
Because, it can take 2 weeks to get a GP appointment here and it was 7pm on wednesday night and she was in lkots of pain and couldn't walk. It is impossibnle to get a GP appointment on the day here in England
 
Why didn't you see a GP?
Presumably because his daughter seriously hurt her ankle.

"Sorry darling - the most important person in my life - but you'll have to wait until tomorrow morning at 11:45 before we get that checked. If you could stop crying that would be great, ta."
 
Because in most places they're Monday-Friday and if you're not in their phone queue at 8am they tell you to phone back tomorrow. That or they'll tell you to call 111 or go to A&E.
 
Getting an appointment would be hell in England/Wales. Maybe your point would carry to calling 111 though.

It might make sense to give a 111 referral equivalent weight to a GP referral is you wanted to start charging for emergency visits? We don't have a 111 service in Ireland but there's usually a way to see a GP in an emergency.
 
Aaaaaaaanyway, I'm not insisting that the NHS should immediately start charging everyone to see their GP or ED. I'm just pointing out that a public health service can charge fees for certain services, while still remaining a public health service.