"The three myths of the NHS"

[Dolphin]

Bagehot
The three myths of the NHS
The National Health Service is a great institution. It is also the subject of fairy tales

https://www.economist.com/britain/2018/06/30/the-three-myths-of-the-nhs

It may seem a bit churlish to turn up to a birthday party and spit on the cake. Myths can serve a useful function in boosting morale, particularly when morale has been eroded by a decade of austerity. But the myths that surround the NHS have also done harm. They have given the Labour Party an excuse to demonise Conservative reforms as “backdoor privatisation” rather than subjecting them to serious criticism. They have discouraged the NHS from learning from other countries. They have made it impossible even to think about boosting NHS revenue by charging patients a nominal sum for visiting the doctor. They may even have allowed scandals to go uncovered because nobody can bring themselves to blow the whistle on saintly NHS workers. Britain is right to celebrate a service that provides all Britons with free health care at a reasonable cost. But they are wrong to treat the NHS as an object of awe rather than a human institution with all the imperfections that being human entails.

 

[Jonathan Edwards]

That bit sounds balls to me.

All we need to learn from other countries is that if you spend 40% more again than we do now (as other counties do) you are likely to have a brilliant system without needing any commercial motives.

 

[Arnie Pye]

They have made it impossible even to think about boosting NHS revenue by charging patients a nominal sum for visiting the doctor.

I've always thought that if this founding principle of the NHS was abandoned it wouldn't take very long for the charge to rise from £5 per GP visit to £10 to £20 to £30.

I've also often wondered what would happen if doctors charged the patient directly, then got the diagnosis wrong repeatedly. Would the patient get a refund? (This is meant to be an unfunny joke - of course we wouldn't get a refund!)

 

[BruceInOz]

I've always thought that if this founding principle of the NHS was abandoned it wouldn't take very long for the charge to rise from £5 per GP visit to £10 to £20 to £30.

I think Australia's system proves this point. Doctors get a basic payment from the government but are free to charge what they like, including so called "bulk billing" or accepting nothing more than the government payment. So where there is oversupply of doctors (eg. Sydney area) many doctors bulk bill so patients have no gap. But in smaller centres where there is an undersupply of doctors the gap payment can be $30 or $40. I'm sure there are those on the right that see this as a feature to help even out supply but it sure sucks for patients in smaller centres.

 

[LightHurtsME]

But in smaller centres where there is an undersupply of doctors the gap payment can be $30 or $40.

And how much time they get for this $40? (putting aside the possibility that they may things wrong again and again and how that adds up - in smaller places where I assume pay is lower than in e.g. Sydney)

 

[BruceInOz]

And how much time they get for this $40?

The clinic I go to charges $75 for a 15 minute appointment. The government rebate is $37 leaving a $38 gap. But because I have a pensioner concession card, my doctor bulk bills me so I pay nothing. I think the government rebate is a little higher since I have a concession card but he would still get much less than his usual fee by bulk billing me. I am in a small city. I don't know what happens elsewhere.

 

[Sean]

My GP clinic bulk bills. I am in a semi-rural area.