I think that's fair - which is why the challenge of fixing the health system is quite so difficult imo. We're all happy with fewer better hospitals on paper until it's our closest A&E closing. My point isn't to hate on NIMBYs, but to explain why it's quite so hard to fix the health system. As soon as you try to, every man and his dog from the council to the local MP and the campaign group try to stop you.
I'm not sure we need new hospitals though. As with stroke, it's about having fewer hospitals delivering services so that when you do go, you're seen by a highly specialised team. So applying the same stroke rationalisation to chemo. The next step, and likely dream world for now, would be all those specialised teams under one roof. That might be more possible outside of London. The NIMBY challenge I'm referring to is not about building a new hospital on a brownfield site near one's house. It's about closing down underperforming maternity services to make sure people are going to bigger and better maternity services, even if that means a 10-minute extra journey. The results from stroke really are something imo.
The thing is though that some of these old hospitals really aren’t fit for purpose any more…..a prime example for me is Ealing that is literally falling apart….. I would also suggest, that while not knocking the HASU model, with CVAs, you also must look in advances in medicine and time windows of care provided. For example, our Stroke window, in which we were told to convey people to a HASU under blue lights, used to be 4 hours from onset of symptoms ….however with advances in Thrombalisation this has now increased to 10 hours, meaning many more people are conveyed at speed to a HASU, where a better outcome is often obtained
Agree with this. I went to my local GP, and went to my local hospital, at the time Watford General, and nothing serious was picked up on and I was sent on my way. It was only when I was referred to Charing Cross, a specialist neuro centre, that they had the expertise to recognise the symptoms, run some tests and then save my life. If I only had access to the local services, there is a good chance I'd have died in 2007. I've now also seen the model here (in France), and in some ways it is similar to the UK, with GP's usually being the first point of call, but the system is semi-private, which makes a huge difference. There are also dedicated paediatric GP's, which takes a huge amount of pressure off the GP's as they don't spend any time looking after kids, and more particularly, worrying parents! The Government cover 70% of healthcare, the rest is covered by a VERY affordable insurance system. The government gives a price they think each service should cost, for example, €500 for an MRI scan, and we pay €26 a month for my family of four. If I choose to go and see a very expensive doctor, who'll give me cushions and play nice music when I'm having an MRI, but it costs €750 for the extra service, that is my decision and the remaining €250 comes out of my pocket. It means the system remains (just about) affordable for the Government, and people can choose to pay what they can afford.
This possibly sounds like the way forward here. Unfortunately, and I suspect Raving was alluding to this, any mention of reforms to the NHS is met with screams of "you're just wanting to privatise the NHS" etc etc. The discussion is always immediately shut down. In my opinion, our NHS is long overdue a major set of reforms, whereby those that can afford it, contribute over and above their NI contributions at the point of care when they need it, whilst still keeping it free for those who can't afford it.
It'll be political suicide for whoever does it, but it is needed. Exactly as you say, those who can afford it will pay and cover those who can't afford it. The only thing I'd add, which should also appease another argument against semi-privatisation, is that as soon as you are diagnosed with a severe illness, that requires a lot of care, you are moved on a scheme where you are 100% covered by the state. That is the way they ensure the really sick are cared for, but the people who just want to use the system, potentially when they don't need to, because it is convenient, do have to pay.
When the NHS was created, there were around 35 million people in the UK. Now we have 67 million. That's a big part of the problem. A Labour government found the resources to create the NHS. In many ways, if there is to be root and branch reform, it would be best done by a Labour government, to avoid claims that the Tories were trying to privatise it.
Not just that - people died much earlier, typically with one condition. Now people live well into their 80s, often with 3+ conditions.
Wow !! Col, I knew there was a socialist inside you somewhere. Sadly as Tory policy seems to be profit over everything I can never see our socialist dream coming to fruition any time soon. Instead, services are run to breaking point so that the Right Wingers like Goldie can talk about how it would be better if privatised….. all the while that lovable scallywags like Michelle are buying new yachts , paid for by the public.
They can’t get away with just selling. Much better to bleed it dry and stoke calls for more and more privatisation.
