NHS plans will mean putting wealthy first, says doctors' leader

[alp227]

Source: The Guardian

Hospitals will be forced to treat wealthy foreigners to raise cash rather than treat poor patients as they are hit by cuts to the NHS budget and the government's radical pro-market reforms, the leader of Britain's doctors has warned.

In an interview with the Guardian, Hamish Meldrum, chairman of the British Medical Association, predicted the government's health and social care bill would see the NHS being rebuilt on a "philosophy that relies on a market-based health system rather like the one we see in the United States.

"There, those who pay or are insured get a better service than those who do not and rely on state-funded Medicare. Until now our system has been built on social solidarity where patients get appropriate treatment in the appropriate time."

He said the government was forcing all hospitals to become foundation trusts and these would be gearing up to lure private patients from home and abroad as budgets were squeezed. This decision, he argued, would only be possible because the government plans to abolish the cap limiting the proportion of total income hospitals can earn from the paying sick.

Read more: http://www.guardian.co.uk/society/2011/sep/01/nhs-plans-put-wealthy-first

[nadinbrzezinski]

1. I wonder what could go wrong...

no really...

[dipsydoodle]

2. Over there you may not be aware

that "wealthy foreigners" would be unlikely to want to use our NHS accommodation or food come to that - more likely to want to use our private hospitals if they did come here.

I'm not saying the issue isn't of concern - just that they've got an odd way of expressing it.

[No Elephants]

3. For perspective:

The hospital closest to my home is on any short list of best hospitals in the world. Indeed, wealthy people (or employees of, say, oil companies and the like) do come there from all the world.

Because it is closest to my home, an ambulance is likely to take me there, unless the ER can't handle any more people. And that has happened a few times, unfortunately.

The quality of care there has gone down since I first moved to Massachusetts, but prices have gone up and up.

A couple of years ago, I was there Thursday night and Friday night. It was Thanksgiving weekend, so I never saw a doctor with rank above resident, although I am sure there were phone consultations (which were probably billed separately anyway--I'd have to check.)

I got a CT scan and blood tests and a couple of days of IV nutrition. (Because of my long standing medical history there and my complaints that weekend, a twelve year old could probably have made the diagnosis, but I appreciate the CT scan anyway.)

I was in a garden variety semi-private room. The bill for three glorious days two romantic nights (as a travel ad might say) and IV nutrition was well over $15,000.

More recently, I was there overnight for a fracture, so I could eat whatever I wanted (after the 15 hours waiting in the ER for a diagnosis, during which I could have no medication, no food and no water--my only complaint was pain in the shoulder, following a fall on that shoulder).

You would not believe how unappealing the food was. The soups and some desserts are good, though. (If you get anything for breakfast other than cold cereal and milk, you'll be very sorry.) That, too, has gone downhill over the past ten years. Used to be decent.

However, as always, I was barely home before I got a letter asking me to donate. And they're forever buying up some of the most expensive real estate in the U.S.

Thank whomever and whatever, I have wonderful private insurance. If I didn't, I'd probably be homeless, given the health issues I've had. And I never even have something like cancer, which would get REALLY expensive.

While I'm okay, I cannot bear what others go through, including dying for inability to afford meds.

In all, I'd probably rather have a national health service.

[MADem]

4. Huh? No one with real money would WANT to use the NHS!!!

The only rich people who would use NHS would be people who were vacationing and got into a car accident, had a heart attack, that kind of thing--emergency services. Then NHS would make them pay through the nose for what they got. I can't imagine a NHS hospital competing with private concerns without really changing their focus, to say nothing of the whole "bedside manner" thing....and why would "wealthy Arabs" want to go to an NHS facility for heart surgery, when the usual practice is to import the doctor to their location to do the work at a state-of-the-art facility at home? Or, better still, go to the US, where we already know how to do that kind of thing?

[muriel_volestrangler]

5. It wouldn't be the NHS; it would be the same hospital, but a private wing

So they can use the best of the NHS-trained staff, and charge a lot. The important part of this story is:

"the government was forcing all hospitals to become foundation trusts ... the government plans to abolish the cap limiting the proportion of total income hospitals can earn from the paying sick."

'Foundation trust' hospitals are designed to operate independently of any NHS plan for the supply of healthcare to the area; they offer services, at a price, to NHS boards responsible for areas. If they also will be allowed to do as much private work as they want, they will have effectively been taken out of the NHS, and are just private, non-profit providers who do some work for the NHS. At the moment, the cap on how much private work they can do ensures that the public investment in NHS training and facilities eventually benefits the public. So it will be entirely up to hospital management how much public provision they do. Some may feel obligated to still do as much as they do now; some may not, and may prefer a but of empire-building instead.