Tuesday 15 April 2014

The 'rich' are jumping the queue.

The 'rich'  are jumping the queue, said Petrie Hoskin on the radio earlier. 
She was referring to the NHS and this ongoing idea of charging everyone in the UK £10 a month to use it. Rich people can go private so, jumping the queue.

Two issues here. Firstly, as we discussed the other day, the £10 extra idea isn't very popular. It will be even less popular when its discovered that it doesn't raise the 60,000,000 x £10 x12,  that its promoters wish. That it won't apply to children, obviously. Or pensioners. Or people with long term health issues. Or people in prison. Or recent immigrants. Or unemployed, disabled, on benefits and every other thing under the sun that excludes someone, usually for a good reason, from paying. As P'J O'Rourke once almost wrote, "When the government says everyone will pay the new tax, they mean its just going to be you and me. And I'm going to weasel out of it on some pretext.. so its just you."

The second issue is that 'the rich' using private healthcare are not, unless you are a Miliband acolyte,  jumping the queue. They are not even in the queue. They are in a different queue. They paid for a ticket to be in the NHS queue but they decided against using it, and so bought another, more expensive ticket, to join the private healthcare queue. They weren't able to get a refund on the NHS ticket.
In fact, instead of jumping the queue , they actual left the queue and so accelerated the queue for everyone behind them. And they paid for a portion of those people's treatment, even though those people now won't be paying a penny for the 'rich person's' treatment.

But we hate the rich, which seems to be anyone earning about £40k, so when they don't take a free to use service that they are entitled to, and instead pay money that has been taxed to access a private service,  they are making the poor suffer. 



Sackerson said...

Well, yes and no. Some private healthcare is surgeons (NHS trained) moonlighting after their NHS work, which (apart from golf) may be a reason they're not staffing NHS theatres round the clock.

And the pressure on the NHS is such that you get rationing by delay. My late mother-in-law had a lump and the date for hospital investigation (not the operation) was set for something like 6 weeks away; we paid for a private scan which was sent to the GP and on the strength of that m-i-l was okayed for a lumpectomy - which happened on the day that she would have had the inspection. Removing that delay in the process may have prolonged her life.

But it was jumping the queue, or getting over a roadblock, whatever. And not everyone can afford to do that.

Doesn't Ireland have some GP consultation charge? Stops trivial and missed appointments - but might tempt some to useless home remedies that effectively delay life-saving treatment.

No easy answers.

Electro-Kevin said...

Sackerson beat me to it.

Few people on 40k get private health cover.

At last nights branch meeting we heard three hardship cases pleading for donations. Employees reduced to half pay and then zero pay because of long-term illness awaiting NHS operations - typically 18 months. Cataracts, hip joint and knee joints.

These people have paid a lot of tax into the system.

£10 for missed appointments ?

OK. But how about large tax rebates for people left so long on waiting lists that they are losing their jobs ?

Jim said...

If more people, those who could,paid for the private scan, then the waiting lists for the rest would be reduced. They wouldn't be going first, but they would be going sooner.

Yet it seems many want to end private healthcare, like private education. It wouldn't reduce the waiting lists or the education very much. The very rich would go elsewhere. America's private health is pretty good. So are their private schools. Same in Switzerland too I gather.

But those who can only just afford either now, would be priced out.
How does that help anybody?

hovis said...

Indeed the monopoly provision of training (and experience) by the NHS does complicate the situation (and BQ's narrative). As a profession doctors are fully signed up to the NHS to be their cash cow as long as they can do private work as well. Supply is restricted. Much goes back to Bevan and his need to "stuff their mouths with gold" to get agreement at it's inception.

Bill Quango MP said...

EK- This proposal is not the £10 missed appointment one. Its the £10/month charge EVERYONE {?} pays for using the NHS. Its to give the NHS a massive annual cash injection to hire another 10,000 gps and 20,000 nurses etc.

personally I'm always against ANY new trivial tax. Because it becomes a far less trivial amount or pointless. The poll tax was tiny compared to today's council tax. The air fuel duty was £5 each. Now it's nearer £200.
And so on..A fishing licence for a boy is a £5. Why even bother?

When Nigel Lawson introduced a mobile phone tax the HOC cheered. Idiots! Its one of the few daft taxes that was repealed.

Blue Eyes said...

My earlier comment seems to have been swallowed by the Zionists at the Times.

If there is a problem with the balance between NHS-financed medical training and how much work the NHS-trained doctors do "privately" then that is a matter for the doctors' contracts, surely. The problem is that if you squeeze people with extremely valuable skills too hard they will simply eff off to Australia or wherever. If you follow the argument all the way through, the NHS should be apologising to / re-paying people outside the UK because it seems to me that the NHS sucks in many professionals trained in other jurisdictions. The underlying aim surely is to get the most efficient use of NHS spending.

What is the counter-factual? If the NHS had an absolute monopoly it would have to either pay top doctors more to compensate them for their lack of private practice or it would see quality drop as the top people left to earn more overseas.

I am one of the nasty rich people (I earn more than £40k these days) and I resent how much I have to spend on the NHS each month because whenever I try to use the NHS I basically cannot. I worked out the last time I couldn't get a GP appointment that for the same annual membership fee to the NHS I could get the top BUPA cover TWICE over. Effectively I am paying my health insurance as well as cover for some layabout who chooses not to pay for his own.

For that reason I refuse to get private insurance because I refuse to pay three times over. However as I found when I could not get a GP appointment, my willingness to stump up to get it sorted increased hugely when I actually needed something. So I imagine that if I got something serious and needed a private scan or whatever I would shell out. Does that make me evil? Paying for the NHS but also being willing to pay my own way? The left should be praising me. I am leaving the "free" service less burdened so the "poor" can use it more easily.

Anyway, the NHS does not need yet another £120 a year from me. It needs to stop wasting money through incompetence and fraud. It needs to rein in its bullshit political schemes and concentrate on being a health service.

Remember Tony Blair? One of the best things he ever said was that public services need to be good enough to retain the support of those who have the choice of whether to use them or not, because if they lose that support then swing voters will stop supporting the spending which goes on those services and the whole thing will crumble.

I support the principle of the NHS and I even tolerate the socialism of it all because it has proved to be a very efficient system, but it has gone mad and ever since Andy Burnham's GP contract has been swallowing money and not producing more for it. I therefore do not support an extra tax and do not condone criticism from Marxists of people who pay not to wait to be allocated a place in the queue.

Sackerson said...

@ Blue Eyes (first comment): yes, but m-i-l then got an operation well ahead of when she otherwise would have had it, so she bumped someone (or many someones) a stop further down the line.

Electro-Kevin said...

BQ - Why not a tax increase and be done with it ?

Call it what it is. In a way private healthcare is a tax increase also. Being deprived of services for which a person is still paying amounts to the same thing - paying twice, in effect, for the level of service that should be there.

I have often said that it is not a matter of the most efficient way to raise taxes (Laffer) but the way in which they are misspent.

I don't believe there will ever be enough tax under the current model.

Blue Eyes said...

Sackerson that is not right. She may have got the treatment sooner, but she did not stop anyone else from getting the treatment (eventually). I went to a malaria country for a holiday last year. I was told by Brit ex-pat friends to buy a malaria testing kit to take home so that if I got the symptoms I could take the test so that when I went to the GP I could say for sure that I had malaria instead of being fobbed off or sent for tests. Does that mean I am queue jumping? By buying a £3 testing kit in an East African pharmacy? Really?

Of course not. In that scenario I have saved the NHS money by not having to test me for malaria and maybe even saving further money down the line by treating said malaria more quickly. Stop feeling guilty.

David Camerson's ridiculously-named Patients' Passports were an ingenious policy and it is a pity that Labour did not copy the idea. Half the cost of opted out treatments would have been saved - yet it was slammed by Labour as "taking money out of the NHS".


Sackerson said...

@ BE: I'm not saying they didn't get treated, but as you concede, they got treated later - and for someone else, that could have been crucial.

I felt slightly uncomfortable about it at the time, but I'm not the sort to sacrifice a person for a principle.

dearieme said...

"I'm not the sort to sacrifice a person for a principle." Then it's not much of a principle.

Anonymous said...

What about treating life threatening conditions for free and have a percentage charge for all the life-style treatments (ie; fertility treatment, sex-change ops etc)?

Sackerson said...

Hi DM, long time no speak! Perhaps it's about a conflict of principles, and observable probabilities vs theoretical possibilities.

Nick Drew said...

anon@6:59 is speaking an obvious truth - but it rapidly (and logically) leads back to the fatty-charge and the smokers' charge, which gets us into some very difficult waters in which politicians flounder and drown

we all know that fatties, along with the ageing population, are making the NHS infeasible in its present hybrid state

the ageing thing is a substantially more real and pressing problem than climate change, but it ain't getting the same attention or £

and the NHS + Big Pharma are busily and systematically making it worse ! oh, irony

'dynamic equilibrium' will be reached when we all reach an age where our needs are such the NHS can no longer afford to treat us

a very nasty prospect

Bill Quango MP said...

So - no real consensus. Which is a large part of the problem.
The NHS is the biggest taker of taxpayer's money in government spending. All politicians want to bring its spiraling costs down, without once mentioning the 'private' word. PFI has been a failure.
So we are left with raising more taxes to fund the NHS or accepting that its always going to appear a shoestring operation.

It is something that is magnificent and has to be supported by universal subscription. It transformed the nation, and influenced the world.

But its a problem. As ND says how can we continue to fund a service that has ongoing, unlimited, increasing demand placed on it?


Anonymous said...

Bill Quango MP: "Its to give the NHS a massive annual cash injection to hire another 10,000 gps and 20,000 nurses etc."

Yea! Tell that to the horse marines!

What you'll get is another layer of bureaucrats clogging up the system.

hovis said...

Nick a little O/T
"the NHS + Big Pharma are busily and systematically making it worse"

I have always maintained the NHS is a cash cow for those with interests in it Big Pharma + other providers, (doctors included). I therefore sometimes despair that people always witter on about its socilaist nature. Maybe command and control in organisation, but it produces near guaranteed monopolistic profits for the providers through force of law. Politically untuchable due to public PR shroud waving tactics it is something very much more (organisationally and politically) corporatist in reality.

dearieme said...

Hello, Sackerson. Do I understand aright that your solution is to treat anyone trained in the NHS as indentured labour?

Nick Drew said...

hovis - I guess we are all grateful for having our lives prolonged, but ...

absolutely agree that businesses batten on to the NHS - of course they do, any source of £££ is a fair target, particularly a massive source. Other businesses batten on to 'green' policies & the attendent subsidies - the most vigorous advocates of the green nonsense are unsentimental & often pretty ruthless businessmen, red in tooth and claw & as many miles away from the swampies in attitude as they are in where they live

(though some of them carefully dress au Branson and pretend to be hippies)

they too are quite keen to be 'politically untouchable'

Electro-Kevin said...

Remembering that the NHS in post unionised Britain is now the industrial wing of the Labour party in. The BBC it's propaganda unit.

Which is why the Tories (and we) are proper fucked. The NHS is a sacred cow - even to unwitting Tory supporters.

ivan said...

Today I had cause to go to the A&E department of the local city hospital. There were 4 people waiting to be seen by a doctor (max wait 3 min). I reported to reception who called up my information from my medical number, printed out tags and forms, called the doctor that would decide which specialist I would see and three minutes later I was off to see the specialist. All this even though the last time I had seen a doctor was 18 years ago. The specialist was very apologetic because he decided I needed a scan but they couldn't do it this afternoon, would I mind waiting till tomorrow morning.

I will have my scan tomorrow morning and then I will take the results to the specialist tomorrow afternoon and have the small operation then and return home in the early evening.

All I can say is thank goodness I am in France and not in the UK with the NHS.

The other thing I forgot to mention was that most of the hospital has been rebuilt in the last 3 years to improve efficiency and patient care.

Suffragent said...

I wouldn't feel guilty about jumping the queue. All you have done is avoid the pointless levels of bureaucracy. These are present in all large organisations and more so in public organisations. As the NHS doesn't have the minor irritant of making a profit its success is based on results. These are based on A) patient waiting times AND b) Death rates.
The first can be reduced by not adding people to the waiting list. A Doctor Knows what illness you have but instead of treating it, sends you on the merry go round of specialists before you get the treatment should have got in the fist place.
The second is reduced by healthcare trusts avoiding cases with a high probability of mortality ( unfortunately the number of which are increasing because of process A

Bill Quango MP said...

That's amazing Ivan. I am 10 weeks from first being told I need a scan. No sign of it so far.

ivan said...

Bill, apparently that is normal over here. The previous time I saw a doctor here was when I had damaged my elbow. The doctor saw me then sent me off to have it X-rayed where I was given a packet of the prints to take back to the doctor who examined them then gave me an injection in the elbow and told me to return if it didn't feel better in a couple of days. I still have those X-ray prints, things like that are yours and your responsibility to look after. The longest I have heard a person having to wait for a scan was three days and that was because it took that long to arrange transport. If it had been really urgent there would have been a taxi provided.

Sackerson said...

@ Dearieme 11.51: nicely dichotimised. Is there no other choice than indentured labour or value extraction? E.g. getting surgeons to work Friday afternoons?

Indentured labour is how we b*ggered-up Fiji (coming uo to the boil again) and initially colonised America.

DM, you ask such good questions I wonder if you wouldn't write a piece or two yourself? Perhaps on Broad Oak Magazine? Care to respond via email to wved@ymail.com?

Sobers said...

I'll be quite happy to prevent NHS trained doctors doing any private work (which apparently drains the nation of health resources) if at the same time they are forbidden from leaving the country and or to stop doctoring for at least 30 years after finishing training. Which is proving to be quite a problem nowadays, as more and more women doctors wish to retire early, leave the profession, or work part-time. Are they to be forced to continue working because the nation paid for their training and now 'owns' their labour?

If not, then don't complain about NHS trained doctors leaving the NHS to do private work either.

Sackerson said...

So Friday afternoons are out of the question, then?

Bill Quango MP said...

Great posts by all. very interesting.

No one mentioned the 'postcode' lottery of healthcare provision. Do we not worry about it? or just don't know about it?

Anonymous said...

I think it was Norman Lamont who taxed mobile phones.

Unknown said...

Hey,though i dont like chiru much i support him in this incident becoz it seemed kartik was a bit arrogant he could say this humblly too, can he see he was a person who is pride of andhra pradesh kartik behaved like he had fallen from sky . did cambridge unv didn't taught him how to convey such things it was totally like humiliate chiru which shows how well educated he is.Thank you so much!!
iso 13485