NHS funding

Hecateh · NHS funding

What should and shouldn't be funded by the NHS?

Not funding patients who have paid for some private drugs???

(To me this is ridiculous)

Funding for IVF - and in what circumstances?

Funding for 'self inflicted' illness - e.g. smoking rlated / obesity / sports injuries ????

Any other thoughts on how the NHS could better organise its use of available funds?

Davbro

The one I will comment on is the IVF. I think for those who cannot have children naturally there are enough parentless children in the system to cater for this.
In a similar vein I do not agree with bringing children from abroad as Madonna did.

MandyJ

Interesting topics.
The one I feel most strongly about is not funding people who have used some private medicine - this is a real minefield as where is the line going to be drawn? If you have a procedure privately which leads to problems later in life - are you then going to be refused NHS care? When my daughter damaged her knee we looked at having the repair done privately. If we'd gone ahead and in 20 years time it needed further treatment, could they turn round and say "you've started so you must finish privately". If you fund some of your treatment yourself isn't that a good thing?? So many stupid stupid inconsistencies in this approach.

IVF. I'm very ambivalent about this becasue I don't think it's a woman's "right" to have a child. It's a privilege. And although my heart bleeds for infertile women and I can understand their anguish I'm not sure that the NHS should pay. Bet I'm opening a can of worms with that statement, don't shoot me down please. So many many poor children in care and needing adoption - shouldn't more effort be made to make this a possible option? Better to save the children already alive and maybe suffering, spend the resources on cures for childhood diseases.
(Hope I can say such a controversial thing on here without anyone taking offense)

Self-inflicted?? Driving a car? Fixing tiles on your roof? RSI because you're on internet forums all day?? Not going to the dentist regularly and ending up with major dental work needed? Life itself is self-inflicted....This is a very dangerous area to start imposing rules...

Hecateh

You've come close to reflecting my thoughts there Mandy.

I agree that IVF shouldn't be available on the NHS, but have extra sympathy for those made infertile by treatment for illness I.E Not cancer itself causing infertility but radiotherapy. I do think, where possible/sperm should be harvested prior to this treatment.

Maybe, any sort of 'elective' treatment should be done in partnership rather than refusing care to anyone who has chosen to go part private.

I got my tummy tuck and boob life on the NHS because I had done half the job, paying for my weight loss surgery - now is that different? And I fully accpet that getting big in the first place was about putting too much of the wrong sort of food in my mouth and not being active enough.

These subjects are controversial in themselves and no view is unacceptable - what is unnacceptable, I I don't think anyone will do this, is putting someone else down for having a different view.

MissMuppet

I had 3 nose jobs on the NHS and Marc is on the waiting list to have surgery on his jaw... I guess these are medical though, although there is some cosmetic work involved in both!

Hecateh

I don't (well I can't really) object to certain cosmetic surgery being done on the NHS as it can have great benefits, medically and mentally. What I guess I do think is that each case has to be assessed individually and that no-one has the 'right' to surgery that isn't essential.

Doctors and surgeons obviously get their training in the NHS and need to practice apart from anything else. Neither of my ops has had 'perfect' results. Neither the tummy tuck nor the boobs are symmetrical and if I had paid thousands I may have been a bit disgruntled about it = as it is I'm just so grateful.

I think that maybe people could be assessed and given points in relation to how much they should pay and how much the NHS should contribute when it is elective surgery. But I know there is no way of making it fair - and even if it was fair it wouldn't ever be perceived as fair. Some people would always be able to get the better of the 'system' and others would always lose out.

Nannyp

But, you couldn't breath properly, through no fault of your own (or are you now about to own up to your cocaine addiction

)

I feel terribly sorry for those who cannot conceive, and yet like most replies on here, I believe that there are many children in the world who have no parents.....

I think that there is a real problem of funding, and I can see that those with "self inflicted" injuries, disease etc will be the one's who will be scapegoated.

The NHS is no longer what it set out to be, and that is the problem.

Davbro

A report on the news this morning was showing how expensive it is for equipment and operations. The conclusion was that in the future there will probably have to be some sort of top up payment from the patient.

MandyJ

A top-up payment sounds very dangerous to me, either we have an NHS or we don't. If we do then treatment should be free. Full stop. The rot has already well set in with prescription charges, but if any part of essential treatment is charged then it's not the same service as we understand it. The obvious conclusion is to go to a full private/insurance based service.
After all, anyone who works pays for their treatment anyway, it's not actually "free" for a lot of people anyway - so those who already contribute through their taxes/NI shouldn't have to pay more

Cosmetic surgery - I can't agree that it should be done on the NHS unless there are actual medical or psychological reasons for it, and by psychological I don't just mean "my self-esteem is a bit low"....
Society needs a bit of a reality check here, think about the truly important health issues[/quote]

Davbro

It is not only Prescription charges Mandy, there is payment at the dentist (even NHS, if you can find one), and optician now which was originally on the NHS.

MandyJ

Quite, forgot about the dentist/optician. Now they are charges that REALLY make me cross as they mean so many people simply don't bother to go, leading to horrendous problems - which the NHS have to deal with, whereas if there had been free preventative care in the first place there wouldn't be such a drain on the system later!

katieqr

it looks like i m in the minority here. i think ivf should be available on nhs. i have 2 kids and would have been devastated if i hadn t been able to. adoption isnt always a solution- i prob wouldn t have been able to due to disabilitys. everyone s circumstances are different so can t be generalised.

cosmetic surgery i m not so sure about.

i ve had to use nhs constantly for past 25yrs and see big changes. ops that i had before were only 8wk waiting lists and now up to a yr. the care and attention i would say have improved and a lot more detailed - ie pre op assessments.

i need new reading glasses but for now i m putting it off cos they re so expensive. i m getting a tooth extracted this month but cos it s getting done in hosp it won t cost but it would ve if my dentist had went ahead with it. a bit strange, i thought.l

dragonfly

Personally... I dont think that the NHS should fund IVF. Its a privilage to have children not a right. And when i saw the news report last weeks that the NHS refuse IVF to smoker i thought, about time! If they want children enough they would pack it in. I dont beleive IVF is right anyway, feels wrong to me. Even when i was told i would have no children (polycystic overies) i always said this.
It daves words... there are enough parentless couples to cater for this!!

I think NHS should cater for people in pain/the sick not cosmetic (barring serious accidents/burning). I never understood why NHS coughs up millions of pound every year on IVF and here in wales prescribing people paracetomal that cost 16p in supermarket, when you have to pay a fortune to get anti biotics when you have an abcess on your tooth from a nhs dentist.

please dont get me wrong, i think they work hard and is a brilliant idea/service, but i think they went off the point a bit..

angelfruit

Okay - I'm going to stick my neck out ....

IMHO I would like to think that all treatment is available to a country's own nationals free of charge. I think that dental, opthalmic, chiropody and other charges should also be completely free for those under 18 and over 60.

I have no problem with anyone having any form of cosmetic treatment done on the NHS, as in many cases - this prevents much more serious surgery through self-harm/mutilation, or costs of mental health treatment etc if this is not undertaken.

However, whilst I subscribe to the view that parenthood is a privilege and not a right. I believe that some form of assisted IVF should be available to couples meeting certain criteria. I think it should be offered on the basis that any other embryos that are fertilised and are not used should be used for the further progression of medical science to assist in all diseases, disorders, genetically predisposed conditions etc.

I have been extremely lucky and have four beautiful, healthy children - however, I have many friends that have been bankrupted by the fact that they needed assistance and lived in an area where IVF was unavailable on the NHS. In some cases they remain childless (but otherwise healthy) - having made no 'charge' on the NHS.

I believe that all emergency treatment should be free, as should all surgical treatment - but in the case of medicines (not critical to ones life/existence) I believe that these should be paid for on a 'sliding scale of ability to pay'. Why should somebody on £200k pay the same amount as somebody on £20k or less. The elderly and children should always be provided for unless their wealth is such (in the case of the elderly) that they could easily afford to be self-funding (and let's face it how many really wealthy OAP's are there out there?)

That said - I have every admiration for the NHS. I feel eternally sorry for those that work in the institution. Horrified that many of our own newly qualified nurses are having to emigrate to Australia and the like to get posts. I also find it an outrage that so much is spent on failing administration and not on frontline services.

Hospitals should operate in a local way and not nationally. They should have their own team of in-house cleaners and caterers. They should have proper nurses, whose career is a vocation and not just a qualification. Nurses that care about their patients and their well-being. Clerks can do the paperwork!

BRING BACK MATRON!!

Sorry - but you did ask x

Davbro

dragonfly

I feel the same way dave. My friend and ger husband earn just under £100,000 k between them. They work very very hard for that money and trained hard.

But they are penalised... why should they pay more than me, they pay 40 percent tax which i think is unfair.
Why should they pay more tax, they should pay same percent as us. And i think that should stand in health care.

nobody should be penalised for high acheivements.

Sorry katie... i do disagree :( I dont see haveing a baby or not affects your health.

(hope you still wanna play scrabble with me) and why my tax money should pay for it.........

Hecateh

I believe essential surgery should be free for everyone - and that includes opticians and dentist. and definitely includes surgery that leads to pain relief eg hip surgery.

I believe that certain ops that will improve quality of life should be available on the NHS but not as a right. The patient should be prepared to do their bit in terms of health. For example I wouldn't refuse surgery to someone who is a smoker, but a smoker whose illness was directly caused or exacerbated by smoking and who refuses to give up would not get my vote.

As you all know I had my tummy tuck and boob life on the NHS. I certainly saw that as a privilege and not a right - but wa not going to turn it down when offered. In view of seeing it as a privilege, it has certainly been a factor in my eating more healthily and taking more exercise. The NHS has invested in me it's up to me to ensure that investment pays. IE because of that surgery I will, barring unrelated illness, cost the NHS in the long run.

I do believe those in higher income brackets shoud pay a higher rate of tax because I believe we all have equal worth as people and that the amounts of money people earn are not related to how hard they work. I know there is a correlation but not a fair one by any means. No one will convince me that a tanker driver is worth more than a teacher. When high earners get pay rises they get a higher pay rise than a low earner.

2% of 100k is worth a lot more than 2% of 10k.

Paying for CD's is different - we make our own choices when deciding what to buy.

I can't agree with the student loan. The high earners that got their degrees in the past are paying nothing back yet they are taking money off young people who are still earning less than 20k per year.

Davbro

dragonfly

As
I do believe those in higher income brackets shoud pay a higher rate of tax because I believe we all have equal worth as people and that the amounts of money people earn are not related to how hard they work. I know there is a correlation but not a fair one by any means. No one will convince me that a tanker driver is worth more than a teacher. When high earners get pay rises they get a higher pay rise than a low earner.

2% of 100k is worth a lot more than 2% of 10k.

This is true... of course... which means if my friends hubby just paid 24 percent like all of us, he would be paying more... I dont see why he should pay 40%..... he is being penalised for his acheievements.. where as jonny benefits gets his rent paid, dental paid, council tax paid, water paid, free school dinners etc...
My friends hubby.. NOTHING FOR FREE..... so he gets less from his government even though he puts more in!!
He does pay into bupa etc through his company. But he shouldnt have to top up NHS if they bring that in. I mean, he gives more than most.

BTW.. I never would believe a tanker driver is worth more than a teacher. Every job is a necessary as another. I think they were spoilt brats by that protest, but it will happen more and more now because the company gave in... Maybe every teacher should strike for a week at a time.. then they'll get the pay they deserve.... and nurses and fireman.

katieqr

Sorry katie... i do disagree :( I dont see haveing a baby or not affects your health. (hope you still wanna play scrabble with me) and why my tax money should pay for it.........

sorry, sarah, not too sure what u mean?

(catch u on scrabble later.....)

dragonfly

I dont think that IVF counts as health care. I think its somthing of a privilage. Therefore should not be funded by the tax payer.!!!

(god i feel mean)

katieqr

got u now! i imagine folk getting ivf must pay their taxes too.

everybody feels diff about these things and have their
own priorities.

Hecateh

Hecateh

Having different views is right and healthy and enables us to 'see' other ideas. So long as we don't resort to personal insults (which I'm sure we won't) it's great to share different angles on things.

We can all think we are right - none of us can know!!!

dragonfly

Hecateh

They did earn it true

But

Three Points

Who decides which 'jobs' get the highest saleries, are these always fair as to the amount of work, effort, training, responsibility?

How did they decide to be cleverer, or be born into a family where good education and or connections - or is that just luck - and if so does it make them a better person.

salaries are calculated in full knowledge of the proportion that is spent in tax. I do feel sorry for those just on the cusp of the 40% cut off as they see very little benefit for their extra income BUT in general, the higher wages can only be that high because so much of it goes back to the government in revenue.

OH and another one.

To get the revenue we need to run the country a certain amount has to be raised. If the weathy were not taxed at a higher rate then everyone else would have to pay more tax to make up. Therefore people who are struggling to make ends meet just couldn't. More people would be on the poverty line at the very least - there would be more ill health etc etc.

People on high incomes work very hard (in the main) I know. So do people on low incomes. There is already more than 10 years between the average life expectancy of someone on a high income compared to a low one. Some of this is accountable by life style choices but much of it is due to ineqauality of access to the best medical care and hood healthy food.

If inflation continues to rise the way it is, it will more seriously affect those living on low incomes than those on higher ones and on the highest - in terms of lifestyle there will be no affect.

dragonfly

But they are effected by all this, as i said earlier about they get nothing off of for free.
Their mortgage has gone up too...
Their bills have gone up too...
Their still have to pay child care cost, council tax etc. Which is higher. Apart from NHS they got NOTHING for free, and prejudiced against because they have done well.

The reason they worked to become what they became if because it paid well.

This has effected them too, and they have noticed.

Mr and Mrs cant be bothered get all this stuff for free........ (I know theres genuine people on unemployment benefit etc.. but i know alot that are not genuine)....

I feel for this country to sort out its financial difficulties, its needs to scrap EVERYthing and start again... and start by getting people in work.. like giving them a job if they dont find one themselves etc.. they'll soon get off there asses and find a job they want. Not by taxing hughers earners a higher percentage and not by taxing inhertience etc..
Get the free loaders off the tax payers money.

Hecateh

dragonfly

It is true to say that i do get frustrated when lower earners than me and dan get so much more government assitance that they can afford a few holidays holidays a year and better quality food and nites out than us.

My friends Liz and Mark, I would say have more job-related sacrifices than me. Drop anything and everything for work.. to scared to leave it because they cant afford to lower the income. MArk travels to and throw india, usa and leeds (i know leeds is so glamerous lol) spends one night a week at home!! Now he has a family he hates doing it.
Missing out on their kids grow up.

I might not be able to afford nice holidays or my dental treatment.. but if danni cries i pick her up and cuddle her better and i saw every milestone...............
We couldnt afford a top up system with the nhs....

Hecateh

It does sound as though they are sacrificing a lot for their lifestyle. It is a choice they are making though - they can afford to change - they are at the moment choosing not too as they don't want to change their lifestyle. It would apear that you and yours are happier and more content regardless of the lower income.

So long as we have sufficient money to feed and shelter us money does not equate to happiness and in fact can raise the barrier that high that people are less happy wiht a higher income.

dingsy

Guest

A whole can of worms indeed!

I do think that the (UK) government needs to put its sensible head on for a while (OK, so it'll probably need to find such a head first, but that's another debate

). Maybe the first thing to change should be the automatic right to free welfare (heath and social care) for immigrants and migrant workers. That would plug quite a big hole, I'd have thought.

It is also important to think back to the beginnings of the Welfare State as we know it; the idealism that brought about its inception. It was believed that if people were offered free healthcare, people would be fitter and therefore need less healthcare; in fact, healthcare is a bottomless pit, and however well you care for folk, they get sick and they have accidents etc etc. The other problem to add into this little melting-pot is that medical science has advanced so much in the past 60 years, which has pushed costs up-and-up.

Similar problems face the Old Age Pension scheme - 60 years ago, men were only expected to live a year or two beyond the retirement age of 65; thereby only claiming pensions for a very short period. Now, people are commonly living into their 80s and 90s, thereby claiming OAP for 15, 20 or even 30 years! This inevitalby stretches the funds available.

I'm not sticking up for the government, past or present; but it's not a problem I'd like to have the personal responsibility of solving, either

I do feel that elective cosmetic surgery should be on some sort of clinical basis; Hec's ops were NOT purely cosmetic - the boob-job was, in particular, necessary to protect her back due to the weight-balance problem. I think that IVF on the NHS should have some sort of similar criteria for deciding; a long-established, stable and loving relationship as a minimum, plus X number of years trying to conceive naturally. Of course, those undergoing cancer treatment young should be given the opportunity of egg or sperm-harvest and then free IVF - a real clinical need there.

I strongly agree that there are lots of "parentless" children around, and that perhaps simplifying the adoption process for couples unable to concieve naturally might be a better answer.