PDA

View Full Version : Doctors read my mind



IR35 Avoider
3rd June 2007, 09:52
http://www.timesonline.co.uk/tol/news/uk/health/article1875521.ece

Charging patients for the most convenient appointments of the day is one of my policies.

There are many times when I would gladly have paid for a more convenient appointment in order to minimise loss of earnings, but the option didn't exist.

By definition not everyone can have the most convenient appointment times (or be operated on by the most experienced surgeon.) Auctioning off these premium services to the highest bidder is a sensible way of integrating private and public funding. It doesn't contradict NHS equality ethos since these services are then defined as ones (like "to expensive" cancer drugs) that fall outside the definition of what the NHS provides. At the same time, because the person is only paying for the premium aspect of the service, and not the basic components, they're not paying for their treatment twice, as happens when higher-rate tax payers pay for private treatment.

chicane
3rd June 2007, 11:20
Personally, I think the fact that I contribute to this country should, in itself, allow me greater flexibility than the work-dodgers in whatever medical treatment I need. Without the need to pay yet another stealth tax.

threaded
3rd June 2007, 11:25
Personally, I think the fact that I contribute to this country should, in itself, allow me greater flexibility than the work-dodgers in whatever medical treatment I need. Without the need to pay yet another stealth tax.
Agreed! You are already paying extra, because you pay taxes!

swamp
3rd June 2007, 11:34
Medicentre costs £59 for half an hour, and it's open Saturday and Sunday.

It gets no state subsidy (AFAIK), so how can GPs on the NHS expect to charge £20?!!

I'll have my taxes back and pay £59 when I need it.

Churchill
3rd June 2007, 11:37
Medicentre costs £59 for half an hour, and it's open Saturday and Sunday.

It gets no state subsidy (AFAIK), so how can GPs on the NHS expect to charge £20?!!

I'll have my taxes back and pay £59 when I need it.

Where's your social conscience?

hyperD
4th June 2007, 07:08
Where's your social conscience?
I think it went when I saw loud, kebab eating slappers mit kindern having free accomodation.

I wondered where 40% (rising by 20% a year) of my council tax was going.

Rantor
4th June 2007, 07:34
I think it went when I saw loud, kebab eating slappers mit kindern having free accomodation.

I wondered where 40% (rising by 20% a year) of my council tax was going.

Another Guardian journalist vents his rage....

SizeZero
4th June 2007, 09:10
PATIENTS should be charged £20 for the convenience of seeing their GP for a 10-minute appointment in the evening or on a Saturday morning, according to doctors’ leaders.

If you are so ill that you need a doctor in the evening or Saturday, a home visit, then you wont mind paying. If you don't work - there's no reason why you can't get a daytime appointment.

Two of my best friends are doctors in Northern towns with high ethnic populations. There is a growing number of a particular ethnic group which requires the man of the house to be present when his wife or children are examined. These men usually work very long hours during the day and can't see any reason why the GP out-of-hours service shouldn't fit around their shifts, rather than the other way around. They think nothing of ringing the on-call service to get a GP out to deal with their child's influenza at 11pm. This is a massive strain on their out-of-hours service and means genuine people who need urgent medical care (but can't get to an A&E unit) are waiting for hours.

Incidently, if you call a vet out at that time to your pet, it's around a £50 call out charge, iirc?

angusglover
4th June 2007, 09:18
I think it went when I saw loud, kebab eating slappers mit kindern having free accomodation.

I wondered where 40% (rising by 20% a year) of my council tax was going.

Well said that man!!!!!

Old Greg
4th June 2007, 09:25
Seeing as we all pay so much in taxes anyway, perhaps they should waive the £20 fee for those inside IR35.

BoredBloke
4th June 2007, 09:26
I think this is a dodgy road to start going down on as far as the NHS is concerned. It is supposed to be free to use. Personally I'd like to see charging of those who fail to attend. If they allow this charging, then I fully expect to see more charges start to appear without any reduction in taxes.

angusglover
4th June 2007, 09:28
How can it continue to be free? We have so many immigrants arriving n the country that any money we invest is instantly consumed by immigrants and health tourists that are not paying any money in.

It should be free if you have paid in, but no money in should mean no treatment.

Ardesco
4th June 2007, 09:30
It may shock you to know that most immigrants actually pay tax.....

angusglover
4th June 2007, 09:33
And how do you work that one out?

Especially since we have millions of illegals...and that is only the ones we know about....

Old Greg
4th June 2007, 09:44
And how do you work that one out?

Especially since we have millions of illegals...and that is only the ones we know about....
I'm wary of spending another week on this kind of track. But how many millions of illegal immigrants are there (that we know about?) I would suggest that most immigrants do pay tax (it amuses me that a forum partly dedicated to the avoidance of tax produces such passion about others not paying their fair share.).

How much NHS resources do they (illegal immigrants) use? (For general information - they probably do receive emergency treatment from NHS but wouldn't be registered with GPs).

Ardesco
4th June 2007, 09:54
And how do you work that one out?

Especially since we have millions of illegals...and that is only the ones we know about....

I would suggest that the majority of immigrants are not illegal and do in fact pay tax. The only way any immigrant will end up not paying tax is by working for some dodgy geezer who pays cash in hand and doesn't pay Tax/NI. Lets face it for the vast majority of people tax is paid before you get given your wedge, like it or not.

angusglover
4th June 2007, 09:55
You can suggest but you would be incorrect. Even if they receive emergency treatment, it is still a drain on our resources especially if they are here illegally.

The country is now full of East Europeans that have paid nothing into the NHS but are now eligble for NHS benefits. In fact, we pay them benefits for kids that do not even live here...or in cases..do not even have!!!

BoredBloke
4th June 2007, 09:55
The best thing about this is that before the new GP's contract, they were obliged to do out of hours and saturday surgeries. The GP's hated it, but it was part of their terms and conditions. In the new contract the GP's were hoping to negotiate an opt out of this. The governments starting point was to give the opt out for a 6% reduction in income. Which feckin idiot did the DoH have in negotiating on their behalf? I suspect it was a GP.

Old Greg
4th June 2007, 09:59
You can suggest but you would be incorrect. Even if they receive emergency treatment, it is still a drain on our resources especially if they are here illegally.

The country is now full of East Europeans that have paid nothing into the NHS but are now eligble for NHS benefits. In fact, we pay them benefits for kids that do not even live here...or in cases..do not even have!!!
But I don't understand where the millions of illegal immigrants comes from - that's why I reckon that most immigrants pay taxes.

As for East Europeans - they work, pay taxes, they're entitled to services. So does benefit fraud exist? I'd be surprised if it doesn't - it does in sections of the non-immigrant community, why wouldn't it in the immigrant community?

Ardesco
4th June 2007, 10:08
Eastern Europeans are generally seen as some of the hardest working immigrants. I have seen a lot of Polish construction workers working in the streets in London doing a very good job, you can be sure that construction workers working for the council are paying thier fair share of taxes.

angusglover
4th June 2007, 10:54
But I don't understand where the millions of illegal immigrants comes from - that's why I reckon that most immigrants pay taxes.

As for East Europeans - they work, pay taxes, they're entitled to services. So does benefit fraud exist? I'd be surprised if it doesn't - it does in sections of the non-immigrant community, why wouldn't it in the immigrant community?

So are you saying that we do not have millions of illegal immigrants?

I disagree with most immigrants pay taxes. There are hundreds of thousands that do not work and are just here for a free meal ticket. These are the ones that consume our resources but give nothing back.

DimPrawn
4th June 2007, 11:04
Who cares about tax, health and immigrants.

As long as our houses are worth millions, nothing else matters.

:happy

Ardesco
4th June 2007, 11:33
The number of people applying for asylum has been pretty static at approx 6-7000 every quarter for the past couple of years. You can probably assume that most illegal immigrants will attempt to get into the country legally to begin with and then dissapear once they are refused entry.

Now I don't know how many illegal immigrants are in this country (And i suspect nobody does, we can only throw about random figures in the hope we get it right) but even if you multiply the number who apply for asylum by 10 (which is probably way over the top) thats only 70,000 every 3 months or just over a quarter of a million a year (280,000 to be exact).

The above also assumes that nobody gets thrown out of the country (I should think a substantional percentage do get removed, maybe not as many as you would like, but hey sh*t happens)
Now where do you get millions from?

On the flip side of the coin I think we are getting in the region of 180,000 legal immigrants a year who do pay thier taxes. As i said before the vast majority of immigrants pay thier taxes.

angusglover
4th June 2007, 11:42
The number of people applying for asylum has been pretty static at approx 6-7000 every quarter for the past couple of years. You can probably assume that most illegal immigrants will attempt to get into the country legally to begin with and then dissapear once they are refused entry.

Now I don't know how many illegal immigrants are in this country (And i suspect nobody does, we can only throw about random figures in the hope we get it right) but even if you multiply the number who apply for asylum by 10 (which is probably way over the top) thats only 70,000 every 3 months or just over a quarter of a million a year (280,000 to be exact).

The above also assumes that nobody gets thrown out of the country (I should think a substantional percentage do get removed, maybe not as many as you would like, but hey sh*t happens)
Now where do you get millions from?

On the flip side of the coin I think we are getting in the region of 180,000 legal immigrants a year who do pay thier taxes. As i said before the vast majority of immigrants pay thier taxes.

So, using your figues of 280,000 per year. Over a 5 year period, that is millions. Over 5 years, the number that actually get repatriated is very small, hence the issues being experienced at the home office.

If you read my post, I said "illegal". This means not the ones that go through immigration anc come in legally. Of the ones that come in legally, how many actually pay taxes? How many actually then go on to receive benefits because they cannot get a job? Couple that with the outflux of British tax payers means the purse actually gets smaller.

Overall I think you are living in a blinkered world with a very rosy view.

gingerjedi
4th June 2007, 11:58
Back on subject

I do find it hard to explain to my NHS dentist that Wednesday 2:30 is probably not the best time for me as it would mean losing half a day's money, the best bet is to try and schedule other things on the same day like a hair cut or something.

Ardesco
4th June 2007, 11:59
As stated above the 280,000 a year is a complete guess that is likely to be far in excess of the real figure. Do you really think that 10 times the number of people that apply for asylum are running into this country undetected every year?

Bear in mind that people coming here to claim free money and use the NHS will first of all apply for asylum so that they get a house and benefits, if you are illegal you don't get these things. For the purposes of getting benefits and free housing use the 7000 a quarter (before rejections and repatriations) figure.

Worst case scenario we are paying for 28,000 immigrants to get housing and benefits a year, hardly millions is it. But I guess that doesn't fit into your nice blinkered view that anybody can run into this country and get themselves a house and benefits whilst evading the authorities who give them said house and benefits.

I know the Home Office is imcompetant, but not THAT incompetant.....

angusglover
4th June 2007, 12:04
As stated above the 280,000 a year is a complete guess that is likely to be far in excess of the real figure. Do you really think that 10 times the number of people that apply for asylum are running into this country undetected every year?

Bear in mind that people coming here to claim free money and use the NHS will first of all apply for asylum so that they get a house and benefits, if you are illegal you don't get these things. For the purposes of getting benefits and free housing use the 7000 a quarter (before rejections and repatriations) figure.

Worst case scenario we are paying for 28,000 immigrants to get housing and benefits a year, hardly millions is it. But I guess that doesn't fit into your nice blinkered view that anybody can run into this country and get themselves a house and benefits whilst evading the authorities who give them said house and benefits.

I know the Home Office is imcompetant, but not THAT incompetant.....

The 280000 is the figure that is quoted by various immigration bodies.

Not sure where you get your figures from but do you work for the Home Office?

Ardesco
4th June 2007, 12:06
It is!! :eek: you mean that my rough guess of take the number of people who have applied for asylum and multiply it by 10 is how everybody else gets thier figure for illegal immigrants too.....

Says it all really :laugh

angusglover
4th June 2007, 12:12
http://www.timesonline.co.uk/tol/news/uk/article382035.ece

Even the Home Office admit that the number is AT LEAST 500000 but also admit that it could be MUCH higher. And this was 2005, so you can imagine how bad it is now. Or are you saying that we shipped them all out already?

Says it all really :spank:

angusglover
4th June 2007, 12:14
It is!! :eek: you mean that my rough guess of take the number of people who have applied for asylum and multiply it by 10 is how everybody else gets thier figure for illegal immigrants too.....

Says it all really :laugh

HAHA, that shows that even you can use Google....

hattra
4th June 2007, 12:35
It is!! :eek: you mean that my rough guess of take the number of people who have applied for asylum and multiply it by 10 is how everybody else gets thier figure for illegal immigrants too.....

Says it all really :laugh

Migrationwatch gives a figure of c. 270 - 295 thousand net inflow per annum. (I know their figures are open to debate, but as the government ahve admitted they don't have the faintest idea, they are at least a working figure).

As for your assumptions about benefits - you are actually incorrect. A common scenario (one Mrs. Hattra encountered frequently in her former job in the NHS) is: Doctor is recruited from overseas, arrives in this country, takes (free) hospital accomodation (actually intended for junior doctors doing their 6-month stints before moving to the next specialism) - moves family into accomodation. After 6 months, parents arrive. Mrs Hattra gets asked how they apply for pensions, social security, medical care, council house etc. Parents then get aforementioned benefits. They are not illegal immigrants, but they are economic migrants who bring no benefit to this country, being retired people with no personal wealth to support themselves.

wendigo100
4th June 2007, 12:36
I worked on immigration a few years ago. In 2003, when Tony Blair promised to reduce the number of "asylum seekers" (economic migrants) coming in, did he tighten border checks?

Did he feck - HMG started reclassifing them as nationality, settlement or general entry cases. Those figures shot up at the same time as asylum cases dropped to 28,000 a year, so that figure is unreal anyway.

Old Greg
4th June 2007, 13:03
So are you saying that we do not have millions of illegal immigrants?

I disagree with most immigrants pay taxes. There are hundreds of thousands that do not work and are just here for a free meal ticket. These are the ones that consume our resources but give nothing back.
I disagree that there are: '...millions of illegals...and that is only the ones we know about....', which was your point.

Illegal immigrants are tricky to count - I wouldn't pretend to know how many there are.

There are some legal immigrants who don't work - there are some British citizens / British-born citizens who don't work as well. And there are some incredibly wealthy people who don't pay their share of taxes (all done legally, I'm sure, but it still ain't right).

So I agree that there's a challenge to ensure that everyone contributes to society as well as benefitting from it, but I think immigration is a distraction, and I think we should remember that the people at the top present a challenge as well as the people at the bottom..

Rantor
4th June 2007, 13:07
[QUOTE=Old Greg] And there are some incredibly wealthy people who don't pay their share of taxes (all done legally, I'm sure, but it still ain't right)./QUOTE]

Why not if it is legal? Surely if it isn't right the correct course of action would be to make it illegal?

Old Greg
4th June 2007, 13:18
[QUOTE=Old Greg] And there are some incredibly wealthy people who don't pay their share of taxes (all done legally, I'm sure, but it still ain't right)./QUOTE]

Why not if it is legal? Surely if it isn't right the correct course of action would be to make it illegal?
I meant not morally 'right' (in my own view of morality). And not everything that is immoral is illegal. So to pick up your point about illegal, I'd like to see the law / tax rules changed.

An example is the way Philip Green / his missus had a 1.1 billion pound dividend in 2004-5 with no tax paid due to residency in Monaco. God knows how the law could be changed to prevent this, but that's what I mean by 'it ain't right'. My point is that this also has an effect on public services because it reduces national tax income. Others may feel that this is justified, as this is a personal moral and political view.

gingerjedi
4th June 2007, 13:21
[QUOTE=Old Greg] And there are some incredibly wealthy people who don't pay their share of taxes (all done legally, I'm sure, but it still ain't right)./QUOTE]

Why not if it is legal? Surely if it isn't right the correct course of action would be to make it illegal?

Its pretty obvious to most that the 'middle earner' pays more than their fair share of tax whilst the top end earners are left well alone, I agree with the assumption that its better to have them paying some tax than have them live somewhere else and pay none.

So no they don't pay their fair share but what can you do.

Old Greg
4th June 2007, 13:23
[QUOTE=Rantor]

Its pretty obvious to most that the 'middle earner' pays more than their fair share of tax whilst the top end earners are left well alone, I agree with the assumption that its better to have them paying some tax than have them live somewhere else and pay none.

So no they don't pay their fair share but what can you do.
I suppose we're not allowed to shoot them and send their families to comuplsory re-education work camps any more, eh? It's political correctness gone mad.

Rantor
4th June 2007, 13:29
[QUOTE=gingerjedi]
I suppose we're not allowed to shoot them and send their families to comuplsory re-education work camps any more, eh? It's political correctness gone mad.

Exactly, what this country needs is a bit of old fashioned stalinism to sort these whinging captilaist lickspittles out once and for all. :glasses

gingerjedi
4th June 2007, 13:33
[QUOTE=gingerjedi]
I suppose we're not allowed to shoot them and send their families to comuplsory re-education work camps any more, eh? It's political correctness gone mad.

I'm not talking about inherited wealth here, I'm talking taxable earnings of which the gearing is set so the middle earner pays more than both high and low end earners, but its only fair etc etc...

HTH.

Ardesco
4th June 2007, 13:39
Ok I admit my figures are way off (I belive I said that in my original post anyway).

I also do not disagree that the middle class have a greater tax burden than anybody else, however the immigrants that come into this country and work pay no less than our lower classes and many of the professional immigrants that come into this country come into the middle class bracket.

So I stand by original statement that most immigrants do pay thier way. As for doctors coming in and then bringing thier family over, this family is not going to get a nice new council house and a bunch of benefits as the doctor earns too much so it's not really the same thing.

I don't disagree that we have a problem with immigration, however I do dispute the fact that immigrants are the source of all our woes.

angusglover
4th June 2007, 13:53
So I stand by original statement that most immigrants do pay thier way. As for doctors coming in and then bringing thier family over, this family is not going to get a nice new council house and a bunch of benefits as the doctor earns too much so it's not really the same thing.

I don't disagree that we have a problem with immigration, however I do dispute the fact that immigrants are the source of all our woes.

I think the statement trhat "most immigrants pay taxes" is very naive.

And as for the doctor part, what the issue is is not that they don't get a new council house but more that they come over here as relatives (in some cases bloody loads of them) and then do not work, do not pay tax but still consume resources from NHS etc.

I move we go to an American system where we all pay for health cover. No pay, no cover.

And just to quote, I did not say "immigrants are the source of our woes". I made the point that we cannot continue to give give give while people take take take.

Rantor
4th June 2007, 14:00
I move we go to an American system where we all pay for health cover. No pay, no cover.
You might (though I doubt it) want to look into this a bit further - the current system ain't that popular in the US.

angusglover
4th June 2007, 14:00
I guess not but we need to do something. We are chucking money into NHS and seeing no benefit as it gets swallowed up instantly....

Old Greg
4th June 2007, 14:20
I guess not but we need to do something. We are chucking money into NHS and seeing no benefit as it gets swallowed up instantly....
Back to where we were a few posts ago! I've just come out of a long stint in the NHS, and I only half agree with you (and I don't agree that it's immigration swallowing the funding). Now I'm no fan of NL's appalling mismanagement of the NHS, but here are some areas where I think there have been some improvements (hence no benefits it's a bit harsh):

Decreased waiting times (I remember working on projects to reduce the maximum waiting time between Outpatients to Surgery from 2 years). The fact is waiting lists have massively decreased, even if there is still a hidden waiting list for patients waiting for diagnostics (which was always there). This has made a serious positive difference to the lives of a lot of patients, and is in my view one of the very few achievements of this government.

Improved facilites (especially in updating of the old mixed sex Nightingale Wards) - although there's been a disgraceful waste of money on PFI schemes.

We all know the litany of wasteful spending:

I mentioned PFI
Massive pay increases for all staff and GPs (it can be argued whether this has all been wasted, but it was not implemented with any robust views of the benefits).
Multiple restructuring of organisations.
Expenditure on management consultancy etc.

So it is a mess, but there have been some changes for the better.

Ardesco
4th June 2007, 14:33
And as for the doctor part, what the issue is is not that they don't get a new council house but more that they come over here as relatives (in some cases bloody loads of them) and then do not work, do not pay tax but still consume resources from NHS etc.


How is this an issue? What is the difference between a foreign doctor's family using the NHS and a British doctors family using the NHS? Both families have a bread winner who contributes to Taxes/NI and therefore the NHS.

Why should the immigrant family not be allowed to use the NHS when the british one can?

Old Greg
4th June 2007, 14:42
How is this an issue? What is the difference between a foreign doctor's family using the NHS and a British doctors family using the NHS? Both families have a bread winner who contributes to Taxes/NI and therefore the NHS.

Why should the immigrant family not be allowed to use the NHS when the british one can?
There's a fair chance that all those little immigrant children of doctors will grow up one day to be British doctors, paying taxes all of their own, and maybe even having their own little future taxpaying doctors one day.

As far as the NHS is concerned, kids are a bit of a side issue. The NHS does not spend money equaly on everyone, but expenditure instead disproportionately goes on a relatively small cohort of patients (mostly aged > 60) with multiple chronic health problems (e.g. heart conditions, breathing problems, diabetes, stroke history). Maybe some immigrants do bring elderly relatives with them but this is, I expect, a small minority (I have no figures to back this up, it's just a hunch). Most 'dependents' coming over are non-working spouses and children, I reckon.

Stan
4th June 2007, 17:48
How can it continue to be free? We have so many immigrants arriving n the country that any money we invest is instantly consumed by immigrants and health tourists that are not paying any money in.

Watch out you've got drool on yer chin ;)

The stealth privatisation of the NHS continues. Follow it to it's conclusion and if you work then you will have to pay for all treatment and if you are unemployed you get all treatment free.

IR35 Avoider
4th June 2007, 18:15
[QUOTE=Rantor]

Its pretty obvious to most that the 'middle earner' pays more than their fair share of tax whilst the top end earners are left well alone, I agree with the assumption that its better to have them paying some tax than have them live somewhere else and pay none.

So no they don't pay their fair share but what can you do.
Correct me if I'm wrong, but I suspect by "middle-earner" you mean people earning something like 30-60K per year.

A quick Google led me to a government statistics web page that indicated that median individual income for women in 2003/2004 was £163 per week and for men £303, so I calculate "middle income" should mean roughly 52*(£163+£303)/2 = 12K.

Anyway, half of all government income from income tax and NI comes from the top 10% of earners, so broadly speaking I would disagree that top-earners are under-taxed.

One document I've Googled indicates that in 2002 a single person with no children would have been in the top 10% of the population for income if they had an after-tax (including after council tax) income of £1700 a month. I know this is not quite the same thing as individual taxable income, but it was the best statistic I could find quickly that would illustrate what it would mean to be so "rich" that you fell in top 10% and therefore were one of those carrying a disproportionate share of the tax burden.

Old Greg
4th June 2007, 18:32
[QUOTE=gingerjedi]
Correct me if I'm wrong, but I suspect by "middle-earner" you mean people earning something like 30-60K per year.

A quick Google led me to a government statistics web page that indicated that median individual income for women in 2003/2004 was £163 per week and for men £303, so I calculate "middle income" should mean roughly 52*(£163+£303)/2 = 12K.

Anyway, half of all government income from income tax and NI comes from the top 10% of earners, so broadly speaking I would disagree that top-earners are under-taxed.

One document I've Googled indicates that in 2002 a single person with no children would have been in the top 10% of the population for income if they had an after-tax (including after council tax) income of £1700 a month. I know this is not quite the same thing as individual taxable income, but it was the best statistic I could find quickly that would illustrate what it would mean to be so "rich" that you fell in top 10% and therefore were one of those carrying a disproportionate share of the tax burden.
I'm not in a position to dispute any of your figures. But the really rich manage to live in tax havens and seem to pay next to nothing.

vetran
4th June 2007, 23:21
Most employed people would happily take doctor appointments during the day if they could book it in advance. Unfortunately you have to get up early and soft soap the receptionist to get an appointment for Tomorrow. You normally get 'well we only have one at 2:30 today'. Yet a third of appointments aren't attended. So have a 2 strikes and you are out policy miss 2 appointments in a 2 year period and it costs you £10 each.

There is no preference given to working people for 8am or 5pm appointments so it disrupts employers / small businesses.

Not sure why I should pay more for a service that twice as much of my tax money has been poured into to pay for £10,000 works of art and shiny boardroom tables not clean instruments or medical staff who can speak english.

wendigo100
5th June 2007, 06:40
It is well known that NHS managers and clinicians are gaming the target system to make waiting times, etc, look better.

Sure, two patients with simple ops see an improvement, but the difficult cancer patient shunted aside for them might not. And all of a sudden we stopped being able to book GP appointments more than 48 hours in advance, so now it looks like everyone is seen within 48 hours!

Rantor
5th June 2007, 07:33
It is well known that NHS managers and clinicians are gaming the target system to make waiting times, etc, look better.

Sure, two patients with simple ops see an improvement, but the difficult cancer patient shunted aside for them might not. And all of a sudden we stopped being able to book GP appointments more than 48 hours in advance, so now it looks like everyone is seen within 48 hours!

Absolutely, its only human nature.

The recent mega-investments in the nhs that have shown such uneven, and often marginal, improvements seem to indicate that the basic model is not fit for purpose.

I can't see how things can change as the nhs is nearly a state religon (there is a good original quote on this.) I have members of my family who work in the nhs who will seriously say that taxes should be set at whatever level necessary to pour in however much money it takes.

More realistically, many people are afraid of us going to the other extreme (American style.) Given that debates on controversial subjects in Britain ain't always that nuanced this is not an unreasonable poistion.

It only took a year of living in a country with a wellstructured healthcare system to see the difference in terms of quality, choice, speed and affordability.

I can't see anything really changing too much for the better in the near future for the biggest employer in europe.

Old Greg
5th June 2007, 08:51
It is well known that NHS managers and clinicians are gaming the target system to make waiting times, etc, look better.

Sure, two patients with simple ops see an improvement, but the difficult cancer patient shunted aside for them might not. And all of a sudden we stopped being able to book GP appointments more than 48 hours in advance, so now it looks like everyone is seen within 48 hours!
There certainly is gaming, but waiting times have still dropped considerably for surgery - therer simply aren't masses of people waiting for 2 years + for surgery. Cancer and suspected cancer patients don't, in my experience get shunted around for simple ops (not saying it has never happenned) and cancer is one area where there is very little gaming (I've never known of any) simply because the DH will come down like a ton of bricks for any breach of cancer waits and a hundredfold for a cover-up of it.

The 48 hour business for GPs is a different kettle of fish in that it was a very poorly implemented project ('Advanced Access'), which was intended to give everyone the opprotunity of booking within 48 hours (I remember when I lived in London and couldn't get a routine GP appointment for 2 weeks). But it got badly mangled in implementation as as you say, has caused a whole load of problems.

Mailman
5th June 2007, 10:29
If you don't work - there's no reason why you can't get a daytime appointment.
Apart from the fact that you cant get in anyways because all the other poor sick scum are stinking up the system! :D

Mailman