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The cost of seeing a GP is probably going up to 25€ in 2017


NormanH
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Arrggghhh.............I forget so many things these days but one point I wanted to make was that, under Blair, something called the "internal market" came about.  I don't know if it still exists as my information is at least 9 years' old.

Under this "great" idea of Blair's, GPs were given budgets (some head teachers were also made budget-holders).  The idea was that GPs could look for and get the "best value for money" for hip replacements and other operations that include several days' stay in a hospital or indeed prescribe drugs that cost less but purportedly have the same effects as more expensive ones.

Thus it was that some patients were sent abroad for their operations, places where the operations cost less and the waiting list was shorter.

At years' end, "profits", or money not spent on patients, were shared amongst the GPs!  Yes, I know, you couldn't make it up, could you?

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Mint wrote

Andy, you are right about taxes needing to go up in order to maintain the NHS.  Actually, the NHS funding comes from general taxation and National Insurance contributions do not pay for the NHS,  they pay for pensions.

Unless something is done about NHS funding, then I fear that more and more bits of it are going to be privatised and thus in time only the rich (or the very poor) will be able to access certain expensive procedures.  There are American companies waiting in the wings to pounce on the opportunity to provide private services and they are not there for purely altruistic reasons.

What I think is REALLY REALLY crazy is that NHS services are available simply on the grounds of residence and are not dependent on how much any individual has paid into the system.

The other thing is that, although the NHS is truly excellent, it is not the BEST in the world as politicians like to claim.  Just as a "f''rinstance", with that famous case of the King family having to kidnap their own son to whisk him off to Spain and subsequently to wherever in order to have proton beam therapy, the fact was that, in those days, there was no proton beam therapy machine in the UK.  I believe they now have 3 machines.

NHS funding was based on a flawed principle from the start.  It was never possible to provide to each according to their need and to tax according to their means.  Put another way, there have always been more poor people than rich and no government, as Andy has pointed out, is going to pledge to tax the wealthy more.

Thanks for that correction Mint. It means the argument is a little less transparent, but I think it works like this:

A person on an average income of around £27K, will end up paying 20% on around 17K. So pays around 12.7% tax on his salary. This funds the NHS, border controls, education, defence as well as the whole Whitehall administration. Versus my 13.3% in Germany for health alone.

While I understand the King family story I think there are different nuances that can be put on this, ranging from we cannot afford this through to we do not believe that this treatment is cost effective, through to we do not believe that this treatment works.
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As for the NHS being in deficit well, that is all about to change. Now that the UK has voted to leave the EU those nice Brexiters have said that the NHS will get an extra £350M per week.

Patient choice is the in thing with the NHS. When the GP says that they will refer you then the patient chooses where they wish to go - well, that is the theory.

As for Iduns cost of TV, the two companies that were originally involved in this had to finance the installation themselves and they took the money - it has proved not to be a very good financial return.

I wonder how many people in France do not go for treatment because they do not have top up insurance and cannot afford their 30% part just as in the US if you do not have insurance and no money then you die.

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[quote user="PaulT"]As for the NHS being in deficit well, that is all about to change. Now that the UK has voted to leave the EU those nice Brexiters have said that the NHS will get an extra £350M per week.

Patient choice is the in thing with the NHS. When the GP says that they will refer you then the patient chooses where they wish to go - well, that is the theory.

As for Iduns cost of TV, the two companies that were originally involved in this had to finance the installation themselves and they took the money - it has proved not to be a very good financial return.

I wonder how many people in France do not go for treatment because they do not have top up insurance and cannot afford their 30% part just as in the US if you do not have insurance and no money then you die.[/quote]

Health care is undoubtedly getting more and more unaffordable, both for countries and for individuals.

Should we not get health care after Brexit after exploring all avenues, then it would have to be au revoir France for us[:(]

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The NHS does a very good job in not very easy circumstances. At present though the quality of service you receive is very dependent on where you live. Unlike some people on this forum we are lucky if we can get a GP appointment within a week. The practice does its best but is often short of the correct number of doctors. The latest newsletter tells us that they have not been able to recruit a replacement for one of the doctors who has left. From what I hear from friends this is quite common across the country.

I have also heard from Doctor friends that there is a relatively high rate of no-shows which wastes everyone's time and also a lot of unnecessary visits especially from older people. They are also caught up in inefficient bureaucratic processes.

Compared to other West European countries the UK spends a lower percentage of GNP on healthcare so perhaps there is scope for increasing spending on the NHS and spending less on tax breaks for the very rich and on expensive vanity projects like Hinkley Point and HSE2

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re : Paul's point about people in France not going for treatment because they don't have a topup.

This happened to me once, when I had a leg wound which needed to have the dressing changed daily.

Our french Dr. was happy to see me every day, for which he got a daily feefrom CPAM. But because we didn't have a topup at the time the 30%  was mounting up, so I had to tell him that I could change the dressing myself.

He was surprised, but seemed to understand.

As far as I know they get a separate fee for various types of clinical "actes", eg dressings, special injections, blood , skin and urine samples etc.

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Despite the rave reviews by some British people in France there are growing problems with health provision here too.

There are increasing accounts of déserts médicaux

particularly in rural areas where young Doctors no longer wish to live and practise the life of a Family doctor such as used to be the case.

My GP in Béziers retired last year and couldn't be replaced so two practices have merged with the result that my Doctor is only available in the town centre site to which I go on Tuesdays and Thursdays.

In the village where I have my second  place two Doctors haven't been replaced because of lack of take up, and the new health centre runs  with 2 temporary 'internes' among the 5 .

You can see someone the same day in an emergency, but for an appointment with a specific Doctor you can wait 2/3 weeks...

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Some things in France are more expensive because of the way things are funded though.

I had a biopsy taken of a skin lump which turned out to be nothing. The dermatologist was very keen to remove it anyway even though there was no medical reason to do so, as of course she could then charge for removing it. She was a bit miffed when I said I'd prefer to leave it.
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Yes linda I agree. I think that the pressure in France is to do things in the way that will let the Doctors get 'their pound of flesh' which makes treatments more expensive. I will be having my regular coloscopy next month which in France is done under General anesthetic, which in turn implies a previous cardiac check, lung X-ray and full blood test all of which will cost money and will give work to the various specialists.

At the same time I get those check-ups done.

In the UK I believe that the same procedure  is done with just a sedative.

I am not qualified to say which is preferable medically, but it is clear that the French way is more costly.

On the other hand if I was fit and well I wouldn't cost the French system anything.

My point is that the NHS has a basis annual cost per patient registered, but each act is probably done more efficiently in budgetary terms.

The French system is more costly per treatment but only costs if you are ill, and you could in theory anyway go for some years at zero cost to the service.

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