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The NHS has been in continuous reform. Thatcher / Blair / Brown / Lansley / Hunt. Most of these reforms have included injecting private sector and internal mar

The NHS has been in continuous reform. Thatcher / Blair / Brown / Lansley / Hunt. Most of these reforms have included injecting private sector and internal markets into the system. You may agree or disagree with these reforms, but it's difficult to argue that they don't incur overhead. Outsourced contracts need administration, legal frameworks; private parties take profit or else they wouldn't exist. I'd argue it is likely that most of the extra funding is seeping out through these reforms, plus the legacy of not nationalising the whole health system - GP surgeries, pharmacy, generic drug manufacturing - when the NHS was formed. I agree with you on the prevention aspect. but my thought is that a more joined up system including GPs, pharmacy and especially social care, would manage a lot of lifestyle related issues much better.

Silhouette 4y ago
I expect you're right about all of this. The famous "joined up thinking" at a national scale across a whole government is frequently what is missing. Sometimes it's missing within "only" one area such as health and social care but that area alone is already huge and almost unbelievably complicated to run. There are probably a lot of real costs in our current healthcare system that never make it onto the books as well. For example in many parts of the country it is impossible for an adult to register with a dentist as an NHS patient right now. There are zero dental practices within a reasonable distance of many people willing to accept new NHS patients. That appears to be because the deal governments currently offer to NHS dentists makes no sense financially so it's hard to blame the dentists. But the effect is the same - many of those people are not getting regular dental check ups and preventative or early treatments. The ones who are went private and paid themselves. That's money going into private healthcare not from the tax man but from the individual patient but that still means the individual patient no longer has that money to be able to afford higher taxes that could better fund the NHS. Unfortunately the lack of huge public outcry as this frog has been boiled only proves that a government strategy of slowly eroding even essential healthcare provision to encourage privatisation by the back door can be effective.

Silhouette 4y ago

I expect you're right about all of this. The famous "joined up thinking" at a national scale across a whole government is frequently what is missing. Sometimes it's missing within "only" one area such as health and social care but that area alone is already huge and almost unbelievably complicated to run. There are probably a lot of real costs in our current healthcare system that never make it onto the books as well. For example in many parts of the country it is impossible for an adult to register with a dentist as an NHS patient right now. There are zero dental practices within a reasonable distance of many people willing to accept new NHS patients. That appears to be because the deal governments currently offer to NHS dentists makes no sense financially so it's hard to blame the dentists. But the effect is the same - many of those people are not getting regular dental check ups and preventative or early treatments. The ones who are went private and paid themselves. That's money going into private healthcare not from the tax man but from the individual patient but that still means the individual patient no longer has that money to be able to afford higher taxes that could better fund the NHS. Unfortunately the lack of huge public outcry as this frog has been boiled only proves that a government strategy of slowly eroding even essential healthcare provision to encourage privatisation by the back door can be effective.