Maybe we could think of something original to plan for it in the long term, say a social care insurance payment. if we then combined NHS and Care provision under a single management entity we could do some efficient planning of where and by who health and social care are best provided.
Elections are not the place to decide such policies, In fact for them to be lasting they need to be bi-partisan.This is one area where a body such as the Lords or a Royal Commission would potentially work well,
The views of Sir Andrew Dilnot who carried chaired a commission into elderly care for the coalition Government in 2011 makes interesting reading
Itâs also telling that the only country that implements the Tory plan is the USA. Every European country treats it as a shared problem for everyone.
Sounds sensible.
An enlightened society should also look at respecting the wishes of those who decided in advance that they donât want to be sat dribbling in a chair 18 hours a day to have control over their own destiny and end their life early if they so wish.
Iâm not sure I said this, but I do believe it. Itâs one of the only two important (IMHO) âaxesâ of the whole debate. We need to make up our minds about which ailments/misfortunes weâre going to put at the pooled end of the axis and which weâre going to put at the individualised end.
The other axis is the extent to which we want to divert money out of this system as profit for third parties, to do with whatever they wish (which might be things we approve of, if they wish). At one end we have the core NHS which, in principle at least, does not divert any of the taxpayersâ money out as third party profit. At the other end we have private medicine and entirely private social care businesses which, as with all businesses, are obliged to work only in the interests of their shareholders (anything they do which is in the interest of their patients or staff is done to maximise the net benefit to the shareholders). Somewhere in between are, for example, private businesses who work for the NHS.
VB
Quite a big bit. Apart from staff costs, pretty much everything the NHS procures has some private company on the end of it making a profit, whether itâs an NMR scanner, a drug or a bog-roll.
I confess I donât know what the staff-to-stuff ratio in the NHS budget is. In my bit of government science it was an almost unavoidable truth that it was 1:1. On any scale between about one million pounds (a smallish project) and a few hundred million pounds (the whole organisationâs annual budget) we always spent as much on people as on kit (including external services, which were generally just a small part of the budget).
Somehow I imagine that the core NHS spends most of its money on staff and not much on stuff. Surgeons are expensive and healthcare is labour intensive. When I was young the NHS in Oxford employed more people than the university and all the colleges put together. Back then the NHS was the second largest employer in europe (after the Red Army). Bogroll is cheap. NMR machines are long-lived (so cheap per year). I concede that drugs can be pricey though. And if you turn staff into contractors then you can make them look like one-off spends.
VB
My daughter (currently in final year nursing training) says the waste in the NHS is appalling. Things such as you only need one of something, but they come in packs of three/five, etc. The rest are then thrown away as once the pack is opened then the rest are deemed contaminated. Surely the purchasing power of the NHS could address this type of thing. The resultant savings could be huge. Or am I being too naive?.
Sadly a lot of the profits made from the NHS are for PFI contracts which have proven to be gold mines for the suppliers.
The use of equity in housing to pay for private aged care is a very, very risky prospect in terms of a policy. Imagine who is not going to vote for this for a moment; the elderly are obvious, but also their children who may see that nice three bed semi they expect to inherit disappearing (and if they are in their 50âs their own bequest to their children also disappearing) and their grandchildren. Only those renting or with less than ÂŁ100K equity in their houses are in a position to not give much of a toss. A side product of this is to make home ownership less attractive at the margin.
It seems to me that attacking this as a wealth tax is missing an opportunity for the LibDems, Labour, SNP etc. Calling it a Dementia tax and portraying Mrs May(hem) as a callous burglar who is taking free lunches from babies and infants and (sticking with the drooling and nappy wearing theme) also the aged. This should be a huge free hit for the opposition parties. Itâll be interesting to see how it goes.
This depends entirely on the numbers.
Plastic syringes cost essentially nothing to make. Sterilising them once theyâre inside the bag that theyâre in can be quite a bit more expensive though. The sterilisation cost is the same whether thereâs one syringe in the bag or five. If the whole sterilised bag costs 50p with five syringes or 45p with one syringe then the saving is 5p. (I am completely guessing these numbers). If the nurse whoâs gone to get the syringes costs ÂŁ20/hour (she may not be being paid that, but that may be what she costs) then in six minutes sheâs cost four times what the syringes cost and forty times what might have been saved by using one syringe instead of five. If thereâs time available to work on money-saving then spend that time making the nurse more efficient. Forget the syringes.
VB
Unfortunately theyâd have to be other than useless, which would include having a credible alternative. But letâs see.
VB
You are forgetting that it would also require an engaged electorate who were capable of understanding the issues, but otherwise spot on!
For most providers 75% of their total spend will be on staff and associated employment costs. The rest will be usually drugs, dressings and equipment, followed by indirect costs of IT services, buildings etc. Some of this will be procured from the private sector like drug companies etc, some from other public sector bodies.
For commissioners, the cost of treating older patients has started to rise ( and remember 75% ish of the total money spent on your health will be done so when youâre over 70), and the bill for Continuiing Healthcare is one of the big top 5 spends.
As Mark correctly states, youâre going to pay for this one way or other because thereâs not enough money to make it work now, and thatâs only going to get much worse with an increasingly aged population needing greater amounts of care for longer periods.
Of course if more care is independently funded and provided in our homes then the number of and capacity within our current 200 ish acute hospitals can and should be reduced accordingly. Not only is care of medically fit older people too expensive in acutes, itâs also harmful and reduces their function and life expectancy too.
But then MPs would have to grow a pair and explain that one to their constituents and stop hiding behind very simplistic âsave our hospitalâ sloganeering.
No, most of the profits in volume terms are from drugs, dressings and devices.
Iâll give you though that by % mark up that the first wave one PFIâs were robbery but they by themselves do not account for where anywhere near the vast majority of revenue or profit is taken.
it occurred to me that this policy can only be aimed at the existing elderly and my generation. too many youngsters are or will now, make the decision to rent rather than buy. The source of capitol will effectively dry up.
it also occurred that Health Care equity release will potentially become a thing. Imagine a Company promises to pay you a percentage of the value of your property in the form of guaranteed care in your dotage.I donât know if equity can underpin an insurance scheme, it strikes me that financial products will be created in some form though. If we assume one million people at thirty grand a year, thatâs a lot of billions to be ignored.
Finally those who didnât take up a private pension when Thatch removed compulsory company pensions, decideding to depend on property equity, may well find themselves right royally fucked.
Iâm not racist, says UKIP candidate suspended by party for posting racist tweets.
You couldnât make this shit upâŚ
