"Let's close down emergency care - that'll improve the NHS!"

[Charles RB]

In the face of NHS budget problems, the government has hit on a great solution: shut down and downgrade ten hospitals in England, including potentially scrapping emergency care: (http://news.bbc.co.uk/1/hi/health/5259446.stm)

Talks are under way about removing emergency care from hospitals in London, Surrey, Sussex, Greater Manchester, Lancashire and Cornwall.

The sites will either close or be left to handle basic care, with "super" regional centres seeing the most ill.

So remember, if you get severely ill or hideously injured and need life-saving medical care, make sure you do it in the right part of London if you actually want to get to the hospital in time!

You suck, government.

[Samurai]

Perhaps you Brits need to think about privatized medicine in the areas that'll no longer have a nearby govt hospital...

[BlairH]

Perhaps you Brits need to think about privatized medicine in the areas that'll no longer have a nearby govt hospital...

Exactly. The NHS Ayrshire and Arran health board sucks big time, waiting lists are through the roofs. If you have a seizure in April, you can expect your first seizure clinic appointment to be in October. The Government can't be everywhere at once (nor should it be expected to) and that is why we turn to private institutions.

[Charles RB]

Perhaps you Brits need to think about privatized medicine in the areas that'll no longer have a nearby govt hospital...

So, you've either got to travel further to have life-saving medical care, or pay money to not die. Lovely choice.

Besides, we have private hospitals. They look shinier and better than the NHS now, but they don't have to handle the sheer volume that the NHS does. Dump that all on them and let's see how well they function.

The Government can't be everywhere at once (nor should it be expected to)

If they've said they're going to run national health care available for all, yes they should be expected to be everywhere it's needed. That's the whole point.

[BlairH]

If they've said they're going to run national health care available for all, yes they should be expected to be everywhere it's needed. That's the whole point.
Well, perhaps the reality is not living up to the ideal, and we should look for a newer system to replace the NHS. I quite like the Aussie 2-tier system, maybe we should have a look at that? Somebody far wiser than me told me about the following:

Parkinson's Law (http://en.wikipedia.org/wiki/Parkinsons_law): The demand upon a resource always expands to match the supply of the resource.
Work expands so as to fill the time available for its completion.
Data expands to fill the space available for storage.
Expenses rise to meet income.

As more money is made available for medical treatment, the cost of that treatment rises to absorb the money. Providing more medical insurance through the government will inevitably cause the price to go up, resulting in burdensome costs for those who lack coverage or for those drugs and procedures that are not included in the programs.

We need to wean the medical establishment off subsidies and government money and bring free market forces to bear on the costs. Within limits of course; there is a social contract to provide for those who lack sufficient resources to meet their basic needs.

But the solution to skyrocketing medical costs is to reduce those costs, not to try to find somebody else to pay for them

[Charles RB]

we should look for a newer system to replace the NHS.

I think that's part of the idea behind the PFI contracts - which are making the problem worse.

[BlairH]

I think that's part of the idea behind the PFI contracts - which are making the problem worse.
See my edits.

[Charles RB]

Mmm. The whole idea of bringing in "the free market" into health care and people's lives makes me leery, especially with the PFI contracts arsing things up.

I do like the idea of lowering costs though. There's got to be some way of dumping the masses of red tape in the NHS that soak up the money before it can reach the ground level.

[cactusmaac]

Healthcare costs are going to increase no matter what the structure is, given changing demographics.

However as with everything, the government running things means cock-ups and waste are run of the mill.

[Oke-Doke]

Healthcare costs are going to increase no matter what the structure is, given changing demographics.

However as with everything, the government running things means cock-ups and waste are run of the mill.

I've always wondered why are so many people skeptical of government's ability to manage and implement programs, I'm genuinely curious? Corporations and governments draw their employes from the same labor pool, how is it that their delivery of services could be so different:confused:

[Charles RB]

I've always wondered why are so many people skeptical of government's ability to manage and implement programs

Because we can see their track record and it's pretty sucky.

Corporations and governments draw their employes from the same labor pool, how is it that their delivery of services could be so different

Well, if you look at the record of some of the privatised industries and PFI contracts... it's not.

[cactusmaac]

I've always wondered why are so many people skeptical of government's ability to manage and implement programs, I'm genuinely curious? Corporations and governments draw their employes from the same labor pool, how is it that their delivery of services could be so different:confused:

It's about incentives. In private companies you're under pressure to perform or you're out. There's no real accountability in government for failures and mismanagement, like with the innumerable IT cock-ups that are a regular feature of Private Eye.

[Charles RB]

It's about incentives. In private companies you're under pressure to perform or you're out. There's no real accountability in government for failures and mismanagement, like with the innumerable IT cock-ups that are a regular feature of Private Eye.

I remember that most of these IT cock-ups involve contracts with private companies, who seem to keep getting more contracts despite not performing for no discernable reason...

[Oke-Doke]

It's about incentives. In private companies you're under pressure to perform or you're out. There's no real accountability in government for failures and mismanagement, like with the innumerable IT cock-ups that are a regular feature of Private Eye.

Ok, I can see how that would lower the quality of service. Government may want to overhaul its human resources department, and wave a pink slip around every now and then.

[Iangould]

We need to wean the medical establishment off subsidies and government money and bring free market forces to bear on the costs. Within limits of course; there is a social contract to provide for those who lack sufficient resources to meet their basic needs.


So why, exactly, do you think the US spends around 50% mroe on health care than most other developed countries.

It's not a simple "Government is evil"/"Markets are good"dichotomy.

You need market forces to discipline service deliverers - like in Australia wehre private hospitals; public hospitals and not-for-profit religiously-run hospitals are forced to compete.

And you need government to prevent the suppliers from exploiting their quasi-monopoly power and the limited information avaialble to consumers.

[Iangould]

It's about incentives. In private companies you're under pressure to perform or you're out. There's no real accountability in government for failures and mismanagement, like with the innumerable IT cock-ups that are a regular feature of Private Eye.

Actually it's quite possible to impose those same disciplines on the public sector.

[jaguarshark]

It's about incentives. In private companies you're under pressure to perform or you're out. There's no real accountability in government for failures and mismanagement, like with the innumerable IT cock-ups that are a regular feature of Private Eye.
Which, of course, makes a mockery of the concept of accountable government. But such is the way of the world.
Obviously, private companies have a big role to play in the medical industry, but the term 'free' market should be used fairly loosely here, I feel, because the people in need of medicine and health care aren't really making a 'free' choice.