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This. I wish people would stop saying the NHS is free because it's not. It's equal for everyone regardless of your income and that's awesome as far as I'm conc

This. I wish people would stop saying the NHS is free because it's not. It's equal for everyone regardless of your income and that's awesome as far as I'm concerned. Some others, not so much, particularly those who think that they shouldn't pay for someone else's treatment.

chrisseaton 6y ago
> It's equal for everyone regardless of your income Are you familiar with the term 'postcode lottery'? And what impacts which postcodes you can live in? Your income.
- uncledave 6y ago
  Yes. That's why there is the NHS Choices Framework which allows you to choose both GP and outpatients. My GP is 40 miles away. My daughter is treated for her condition at Guys even though we're 20 miles away and there is a different local hospital. The postcode lottery doesn't exist unless you're dragged into an A&E.
  - chrisseaton 6y ago
    > My GP is 40 miles away... Great! Everyone can afford the time and expense of travelling far away to a better GP... oh no wait that also depends on income.
    - uncledave 6y ago
      Erm no it doesn't You think I actually go and see the GP? No they call me instead and talk any problems through. I haven't been to a GP for about 10 years and have had a few appointments and referrals. As for the transport costs, for referred appointments that's covered under HTCS if you can't afford to travel.
      - chrisseaton 6y ago
        > I haven't been to a GP for about 10 years and have had a few appointments and referrals. Good for you? What about people who do need to regularly go and see their GP? > As for the transport costs, for referred appointments that's covered under HTCS if you can't afford to travel. What about those GP visits some people less fortunate than yourself need? And HTCS is for extremely low-income people. It doesn't cover normal working class people's extra costs. People less fortunate than yourself struggle to get equality in the NHS. Sometimes they don't even have the knowledge and confidence that you do to use the systems you're talking about. Fundamentally they shouldn't be required, rather than fortunate people saying 'I'm alright Jack'.
        vidarh 6y ago
        While I absolutely agree with you in principle, it's still worthwhile for people to know that a growing number of GPs offer permanent (as in not just during covid) video consultations, and that they can choose treatment, and GPs, further away. Though I think we agree it'd be much better if they didn't need to.
        DanBC 6y ago
        GP registration in England is a little bit complex. If you live within the GP catchment area, and their list is open, they must register you and there are very limited reasons why they can decline that registration. GPs must offer certain services to this group of patients, including home visits if needed and an out of hours service (although that's often contracted out). If you live outside the catchment area they have a choice. They can either: register you and provide full service, or register you but not provide out of hours or home visits, or not register you. Full details are in the Primary Medical Care Policy and Guidance Manual (PGM): https://www.england.nhs.uk/publication/primary-medical-care-policy-and-guidance-manual-pgm/ https://www.england.nhs.uk/publication/primary-medical-care-...
  - matthewmacleod 6y ago
    Honestly that whole system is nice idea on the surface that rapidly becomes a nightmare - in my view doing little except encouraging health inequality. One of the big problems is that "choice" is much more expensive for some people than others; this means that while I might be able to take a day off an visit a hospital a couple of hours away, it's much harder for someone who does't have access to transport, healthcare, funds or whatever else is required. So that system ends up offering choice only to people who can afford it, and you end up shuffling the poor people off to the less effective local healthcare facilities and your postcode lottery is back.
    - aksss 6y ago
      Are there countries/cities you would point to that have gotten this right? (i.e. proximity of everyone to better quality care regardless of neighborhood?). I mean, some of it is just a function of where doctors prefer to live when they are successful enough to have a say in the matter. Those with a say, like all of us, probably prefer nicer neighborhoods/offices.
ljf 6y ago
The NHS is free at the point of delivery. https://en.m.wikipedia.org/wiki/National_Health_Service_(England)#:~:text=At%20its%20launch%20by%20the,need%2C%20not%20ability%20to%20pay https://en.m.wikipedia.org/wiki/National_Health_Service_(Eng... It is not free like a free buffet. But if you have a need, and a doctor/nurse agrees, then you get the treatment at no cost/free.

chrisseaton 6y ago

> It's equal for everyone regardless of your income Are you familiar with the term 'postcode lottery'? And what impacts which postcodes you can live in? Your income.

uncledave 6y ago
Yes. That's why there is the NHS Choices Framework which allows you to choose both GP and outpatients. My GP is 40 miles away. My daughter is treated for her condition at Guys even though we're 20 miles away and there is a different local hospital. The postcode lottery doesn't exist unless you're dragged into an A&E.
- chrisseaton 6y ago
  > My GP is 40 miles away... Great! Everyone can afford the time and expense of travelling far away to a better GP... oh no wait that also depends on income.
  - uncledave 6y ago
    Erm no it doesn't You think I actually go and see the GP? No they call me instead and talk any problems through. I haven't been to a GP for about 10 years and have had a few appointments and referrals. As for the transport costs, for referred appointments that's covered under HTCS if you can't afford to travel.
    - chrisseaton 6y ago
      > I haven't been to a GP for about 10 years and have had a few appointments and referrals. Good for you? What about people who do need to regularly go and see their GP? > As for the transport costs, for referred appointments that's covered under HTCS if you can't afford to travel. What about those GP visits some people less fortunate than yourself need? And HTCS is for extremely low-income people. It doesn't cover normal working class people's extra costs. People less fortunate than yourself struggle to get equality in the NHS. Sometimes they don't even have the knowledge and confidence that you do to use the systems you're talking about. Fundamentally they shouldn't be required, rather than fortunate people saying 'I'm alright Jack'.
      - vidarh 6y ago
        While I absolutely agree with you in principle, it's still worthwhile for people to know that a growing number of GPs offer permanent (as in not just during covid) video consultations, and that they can choose treatment, and GPs, further away. Though I think we agree it'd be much better if they didn't need to.
        DanBC 6y ago
        GP registration in England is a little bit complex. If you live within the GP catchment area, and their list is open, they must register you and there are very limited reasons why they can decline that registration. GPs must offer certain services to this group of patients, including home visits if needed and an out of hours service (although that's often contracted out). If you live outside the catchment area they have a choice. They can either: register you and provide full service, or register you but not provide out of hours or home visits, or not register you. Full details are in the Primary Medical Care Policy and Guidance Manual (PGM): https://www.england.nhs.uk/publication/primary-medical-care-policy-and-guidance-manual-pgm/ https://www.england.nhs.uk/publication/primary-medical-care-...
- matthewmacleod 6y ago
  Honestly that whole system is nice idea on the surface that rapidly becomes a nightmare - in my view doing little except encouraging health inequality. One of the big problems is that "choice" is much more expensive for some people than others; this means that while I might be able to take a day off an visit a hospital a couple of hours away, it's much harder for someone who does't have access to transport, healthcare, funds or whatever else is required. So that system ends up offering choice only to people who can afford it, and you end up shuffling the poor people off to the less effective local healthcare facilities and your postcode lottery is back.
  - aksss 6y ago
    Are there countries/cities you would point to that have gotten this right? (i.e. proximity of everyone to better quality care regardless of neighborhood?). I mean, some of it is just a function of where doctors prefer to live when they are successful enough to have a say in the matter. Those with a say, like all of us, probably prefer nicer neighborhoods/offices.

ljf 6y ago

The NHS is free at the point of delivery. https://en.m.wikipedia.org/wiki/National_Health_Service_(England)#:~:text=At%20its%20launch%20by%20the,need%2C%20not%20ability%20to%20pay https://en.m.wikipedia.org/wiki/National_Health_Service_(Eng... It is not free like a free buffet. But if you have a need, and a doctor/nurse agrees, then you get the treatment at no cost/free.