the nhs
Comments
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For a Fun Thursday Challenge, have a pop at defining "self inflicted injury".VTech wrote:I've heard in arguments on question time that if people were charged for alcohol related injustices and time at A&E it would be a 30% saving to the NHS.
I've. I idea if this is true but I have no problem with charging people for self inflicted injuries.Mangeur0 -
falling off a bike is self inflicted, i would happily pay if it meant quicker A&E. i would support a private sector version of A&E too.0
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the playing mantis wrote:i would happily pay if it meant quicker A&E. i would support a private sector version of A&E too.
Even at £1200 for a consultation, course of antibiotics, and a check up? (The amount I paid in the US.)0 -
i only go to A&E for trauma. i would pay that for fixing trauma related injury, not something that required a course of antibiotics, as thats something a GP could/should be dealing with.0
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the playing mantis wrote:i only go to A&E for trauma. i would pay that for fixing trauma related injury, not something that required a course of antibiotics, as thats something a GP could/should be dealing with.
SO you're sayinga wound gone septic isn't deserving of emergency treatment?
Likewise, if I get knocked off my bike by a car, that's self inflicted? Somebody whacks a cricket ball into my face? I'm involved, as a passenger, in a car accident?"In many ways, my story was that of a raging, Christ-like figure who hauled himself off the cross, looked up at the Romans with blood in his eyes and said 'My turn, sock cookers'"
@gietvangent0 -
the playing mantis wrote:i only go to A&E for trauma. i would pay that for fixing trauma related injury, not something that required a course of antibiotics, as thats something a GP could/should be dealing with.
You obviously have no idea how serious, or fast-moving, infections can be. But thanks for the medical advice.0 -
Ooeer, stop being angry in your replies.
Back on subject. I am happy to pay for self inflicted and I'm sure most decent honourable people "who can afford too" would also be happy to pay.
There are those that can't afford and those that think they shouldnt need to but we can't do anything about those.
If your drink and fall you should pay, maybe not all but at least towards the overall cost, maybe a set fee of £250 ?
If you fall of your bike then maybe a £125 fee ?
Decent people will pay if they can.Living MY dream.0 -
no i dont, as i have no wish to be in medicine. thanks for the lesson, if things like that can be that serious then yes i would pay.
disgruntled goat not sure what your point is, my comment was about myself falling off a bike, i should have made it clearer. however re self inflicted injuries, others have made that rod. playing cricket riding a bike are all choices, if you get hurt doing them whoevers fault it is it could be argued they are self inflicted as you chose to do the activity that created the risk. car accidents are slightly different i would suggest.0 -
VTech wrote:Ooeer, stop being angry in your replies.
Back on subject. I am happy to pay for self inflicted and I'm sure most decent honourable people "who can afford too" would also be happy to pay.
There are those that can't afford and those that think they shouldnt need to but we can't do anything about those.
If your drink and fall you should pay, maybe not all but at least towards the overall cost, maybe a set fee of £250 ?
If you fall of your bike then maybe a £125 fee ?
Decent people will pay if they can.
thats a good idea0 -
the playing mantis wrote:no i dont, as i have no wish to be in medicine. thanks for the lesson, if things like that can be that serious then yes i would pay.
Yeah sorry - it was just the implication that going into a&e with an infected joint was an over-reaction.
The wider point is that I think many of us don't really appreciate how much private medicine can end up costing, how much the costs can vary, and how little power a patient has to get a good deal.
In the US yesterday, they released a shed of data showing that the average cost for a patient with heart failure varied from as little as $7k in one hospital to as much as $50k in another. Pricing is not transparent. The 'customer' is often in no fit state to go somewhere else. The result is a pretty crappy market.0 -
Or a luck-based stealth tax that involves paying for the same service twice, depending on how you look at it.the playing mantis wrote:thats a good ideaMangeur0 -
VTech wrote:Ooeer, stop being angry in your replies.
Back on subject. I am happy to pay for self inflicted and I'm sure most decent honourable people "who can afford too" would also be happy to pay.
There are those that can't afford and those that think they shouldnt need to but we can't do anything about those.
If your drink and fall you should pay, maybe not all but at least towards the overall cost, maybe a set fee of £250 ?
If you fall of your bike then maybe a £125 fee ?
Decent people will pay if they can.
Have a think about the can of worms you're opening here!
Drink and fall over = £250 charge. Do you not think there is just the slightest of chances that the drinker will pursue the bar or barman that "allowed" him to get in that state for compensation? The bike manufacturer sued for a product not fit for purpose? Whether your injury is "self inflicted" or not, all tax/NI payers have already made a contribution to the NHS in the hope that it will look after them when they need it for whatever reason. Pregnancy is self inflicted, should people be charged for obstetric services? work injuries are self inflicted as many people choose the job they do and could have avoided the injury.
We're all gonna die sometime but we've got to live a little before then!Wilier Izoard XP0 -
The government-run panel that decides who deserves free care and who needs to be pay - it's going to be very popular.0
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There's some rubbish being spouted.
So you go into A&E and rather than triage your first encounter is with someone who has to interview you to decide if your injury is "self inflicted" or not.How long would that process take and define "self inflicted"?
If you're commuting to/from work and have an accident that's free treatment, if you're going on holiday though? shopping? Visiting someone in hospital?
Is there a right to appeal, some people are really not thinking are they. :roll:Tail end Charlie
The above post may contain traces of sarcasm or/and bullsh*t.0 -
pliptrot wrote:The USA is a perfact example of just how f^&ked-up, not fit for purpose and incredibly expensive a health care system can be once you let the private sector in.
Apart from all the highly efficient privately provided, public sector health services in Europe that is.
You're right that the USA is rubbish as its 100% private, but one could point out pretty much how the UK 100% publicly provided service is just as sh*te.
Somewhere in the middle ground is where we want to be - free at the point of use as originally intended and the method of delivery should be irrelevant. If the public body can provide the most efficient service then thats who should provide it and if it isn't then they shouldn't.0 -
Most of the European systems are not free at the point of use. And doesn't the NHS already spend a lot of its cash through the private sector?0
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I genuinely find this thread has dropped in quality. Charging someone for falling off a bike? Are you serious? What if this person chose to commute by bike and fell off, is that still self inflicted. What if they get hit while on their bike, is that automatically self-inflicted since they were on a bike. Does walking down the street and missing a small hole with sends them into the gutter count as self-inflicted?
You guys can not actually be serious.
If anything, cycling lowers the burden on the NHS as the people are fitter. I highly doubt the small percentage of people falling off and ending up in hospital is even 1% of the money saved by having a healthier population.
Some people these days.....0 -
MountainMonster wrote:I genuinely find this thread has dropped in quality. Charging someone for falling off a bike? Are you serious? What if this person chose to commute by bike and fell off, is that still self inflicted. What if they get hit while on their bike, is that automatically self-inflicted since they were on a bike. Does walking down the street and missing a small hole with sends them into the gutter count as self-inflicted?
You guys can not actually be serious.
If anything, cycling lowers the burden on the NHS as the people are fitter. I highly doubt the small percentage of people falling off and ending up in hospital is even 1% of the money saved by having a healthier population.
Some people these days.....
I have to agree with this.
Where do we stop with 'self-inflicted'?
How do you decide how much extra bodyweight is the cause of a joint problem requiring an operation such as a knee or hip replacement?
Would smokers get refused lung cancer/heart disease treatment etc.?
What about those who have smoked but have since given up?
How about those in need of emergency care; do we allow them to continue bleeding out whilst their pockets are searched for a credit card to swipe because they chose to step into the road at the wrong moment?
Further, who makes these spur-of-the-moment decisions, and what checks exist to ensure that people deserving of free care aren't charged or that those who should pay don't get their care for free?
How much would that cost to administrate?
What form of repercussions would exist when mistakes were made?
How would you compensate those who suffer at the hands of incorrect decisions?
I bet the same people calling for such a system would be the first to be up in arms when the papers uncover the scandal of a little old lady refused free treatment for something. Such a circumstance becomes inevitable when you make the system intentionally discriminatory and add so much complication to the system.
I understand the thought process behind the suggestion, but making individuals carry the burden of mistakes that could befall anyone is completely counter to what I believe is great about the NHS, and by extension what is great about this country. People are so keen to knock this country for the disappearing sense of 'society', whilst simultaneously looking to dismantle many of the community-spirited institutions that we should be proud of. The NHS and the welfare state are just two examples of the types of thing this country should be immensely proud of having rather than looking to dismantle them entirely so that they can pay a little less tax and have a little more money for themselves.
I suppose now I'm a commie, by some people's standards at least
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The post is good but how do we fix the problem ?
Can we continue to always support smokers, fat people who eat too much, druggies, drinks.
Where does it stop ?
We just can't afford it. It's crippling the country. I'm not saying we should get rid or keep but it's not sustainable.Living MY dream.0 -
Rigged wrote:MountainMonster wrote:I genuinely find this thread has dropped in quality. Charging someone for falling off a bike? Are you serious? What if this person chose to commute by bike and fell off, is that still self inflicted. What if they get hit while on their bike, is that automatically self-inflicted since they were on a bike. Does walking down the street and missing a small hole with sends them into the gutter count as self-inflicted?
You guys can not actually be serious.
If anything, cycling lowers the burden on the NHS as the people are fitter. I highly doubt the small percentage of people falling off and ending up in hospital is even 1% of the money saved by having a healthier population.
Some people these days.....
I have to agree with this.
Where do we stop with 'self-inflicted'?
How do you decide how much extra bodyweight is the cause of a joint problem requiring an operation such as a knee or hip replacement?
Would smokers get refused lung cancer/heart disease treatment etc.?
What about those who have smoked but have since given up?
How about those in need of emergency care; do we allow them to continue bleeding out whilst their pockets are searched for a credit card to swipe because they chose to step into the road at the wrong moment?
Further, who makes these spur-of-the-moment decisions, and what checks exist to ensure that people deserving of free care aren't charged or that those who should pay don't get their care for free?
How much would that cost to administrate?
What form of repercussions would exist when mistakes were made?
How would you compensate those who suffer at the hands of incorrect decisions?
I bet the same people calling for such a system would be the first to be up in arms when the papers uncover the scandal of a little old lady refused free treatment for something. Such a circumstance becomes inevitable when you make the system intentionally discriminatory and add so much complication to the system.
I understand the thought process behind the suggestion, but making individuals carry the burden of mistakes that could befall anyone is completely counter to what I believe is great about the NHS, and by extension what is great about this country. People are so keen to knock this country for the disappearing sense of 'society', whilst simultaneously looking to dismantle many of the community-spirited institutions that we should be proud of. The NHS and the welfare state are just two examples of the types of thing this country should be immensely proud of having rather than looking to dismantle them entirely so that they can pay a little less tax and have a little more money for themselves.
I suppose now I'm a commie, by some people's standards at least
All sound sensible questions which in turn have mirror opposites, how far do we go before making hard hard decisions? The NHS was created in the post-war period when the population was rake thin but ultimately a lot fitter through years of rationing and was designed to help the poorest in society get the same medical care as everyone else. Back then very expensive treatments for many illnesses didn't exist, if you had something like leukemia then that was your lot unfortnately. I'd happily bet that the founders of the organisation would be horrified to find out it now wastes a lot of money just because people can't keep their hands out of the biscuit barrel and take a walk occasionally. I can't see how it can go on in it's current form to be honest but I'll happily admit I'm glad I won't have to make decisions on who gets what, definitely not a task I envy.0 -
Gregger wrote:etc
You come off a motobike "at 100mph". so your speeding and you expect everyone to pick up the bill for your reckless ness?
etc
You're damn right I do... As you so inelegantly point out - people can have the snip, breast enlargement, gastric band, so on and so forth - why shouldn't they reset all my broken bones from a road accident (which, before you see fit to mount your high horse called Indignation again, wasn't as a result of excess speed)
Indeed, why shouldn't they deliver my children, have a valiant if somewhat inconsistent attempt at curing my dad's leukemia, or cutting five organs out of my mother in law before the cancer got her? (But then the amount of NI and Income Tax I pay in any given year gives me a strange sense of entitlement, especially since I'll never see a state pension, and seem to be entirely ineligible for any form of state benefit except £74 a fortnight.)
True, this is inconsistent with my belief that people who get plastered and fall on their face on a Saturday night should contribute something, but that's more a personal gripe based on living in a seaside town which fills up every weekend with halfwits provincials with something to prove to each other.
The health tourism is an underlying problem, and the midwife at my youngest's birth quite openly admitted that they do see rather a lot of women from eastern Europe and the sub-continent having a holiday in Britain in the final weeks of pregnancy. There was also a piece on Radio 4 recently investigating the pensioner ex-Pats who return from the Costa del Wherever when old age overtakes them, or when they develop something serious that they don't trust the locals to sort.
That last bit is a rather interesting conundrum - rocking up expecting labour assistance is one thing, but returning to Blighty expecting to have your cancer removed in old age is something else entirely.
One of my closest friend's father has done just this. He's a property developer by trade, and naffed off to the Gulf a decade ago. Before that he was buggering about in Spain during the explosion of golf resorts. Don't think he's been resident in the UK in any real sense for twenty years. With this in mind, aged 58, he eventually decided that the doctors in the UAE were not right in the diagnosis of stomach ulcer, and came back to see the GP where is sister lives. Lo and behold, he's absolutely riddled with cancer. Terminal cancer. Much the same situation as my Father, really. True to NHS, they've done the same thing with him; consultants, chemo, radio, palliative, etc. Difference is my Dad only ever worked in the UK, and paid tax his whole working life, whereas mate's Dad didn't/hasn't.
Now whilst I don't begrudge him the treatment at all, it does raise the question - should we be publicly fixing him, when he's not really resident? A&E is obvious, but long term care?
The only case I know of in reverse is twenty years ago when a friend of a friend got sunstroke whilst on hols in Spain. Went to see a doctor there who discovered he had an undiagnosed heart condition... so they immediately medi-vac'd him back to the UK0 -
The problem is, we really are a country of people who say "it's not possible to police, what if this, what if that" and we never get anything done.
You only need to read the above for proof of that. I suggested for self inflicted injuries based on being drunk and next thing were talking about falling of a ladder and bike and so on.
It's been the blight of Britain for decades and I believe is so inbuilt into our nature now that we are at a point where something major needs to happen before we can ever fix it.
The sad thing is that we are a nation of clever people, we fix issues, we solve puzzles but allow lazy and foolish people change the building blocks of our future.
In general I honestly believe that people want to have better systems, better infrastructure so why don't we push these ?
I would suggest that people get concerned over the ones they will upset and decide its better to keep quiet.
Ill give a few examples.
1) second, third generation unemployed where not working is inbuilt into the family life where father, mother, kids, grand kids all don't work and have never shown and intention to work. These may be viewed as "leaches" by some but to councilers and MP's offer a good vote if security for them is maintained.
2) drug addicts who are happy to take medication and support from the NHS wihe it any real want of assistance costing billions overall when support and crime are counted.
3) fatties, people who get ill, need medication and support, will never work or add to the growth (no pun) of our country and will cost us a fortune by the time the fat has clogged the arteries so much that the ticker packs up.
4) drunks + binge drinkers, again, people that cost us a fortune and could easily be resolved with assistance and fines. The cost in this sector are astonishing.
5) assault and fighting, why should we pay ? Why don't courts make the guilty pay for the medical side as well as compensation to the victim ?
6) prisons, why can't we make them do hard labour and earn some of the costs they bear on society ?
7) dangerous sports, A&E burden of fixing people injured during dangerous sports.
There will be some who on the outside look like they fit into one of the categories I've mentioned. Maybe someone who is fat but maybe through no intention and doesnt eat 10,000 calories a day or someone who falls off a bike on a club Sunday ride.
I just don't agree with the argument that we can't police it because someone will say if you are mopping your floor at home and slip it will be classed as a dangerous situation and won't be covered so let's not put something into place.
I get problems everyday at work, I'm sure you all do but do we just drop our tools and stop ?
Yesterday I was working on a software that wasn't quite right, I ended up driving over 600 miles all told and didn't get home until 2.30am having left at 5am the previous day but I got it fixed.
We tried the "something isn't as it should be, let's down tools and wait for someone else to fix it" routine with our unions in the 80's (my childhood, and it destroyed business and killed tens of thousands of jobs.
These actions don't fix anything, they cause so many problems.
If something is wrong why shouldn't we have a try to resolve it ? Of course we can't make everyone happy and some will feel punished but if making people pay for foolish or even mildly silly behaviours offer us some benefits overall I'd sign up.
We may end up with a negative side, lets say my mom has 3 glasses of wine and falls and cracks her ankle and needs an OP and due to being over the limit is charged a fee then so be it. We owe it to ourself to at least try to get a fix.Living MY dream.0 -
My father and I have spent the last year and a half getting one of our projects up and running. I love Britain, but a common statement heard coming from our mouths when we meet with our stake holders is "Stop being so British, you are just looking for every reason something will fail. Focus on the reason it will succeed."
Does anyone know why rather than looking for the positives the British tend to only focus on negatives and why something won't work? This is a nation of innovators for goodness sake with some of the greatest thinkers coming from here.0 -
VTech wrote:
1) second, third generation unemployed where not working is inbuilt into the family life where father, mother, kids, grand kids all don't work and have never shown and intention to work. These may be viewed as "leaches" by some but to councilers and MP's offer a good vote if security for them is maintained.
2) drug addicts who are happy to take medication and support from the NHS wihe it any real want of assistance costing billions overall when support and crime are counted.
3) fatties, people who get ill, need medication and support, will never work or add to the growth (no pun) of our country and will cost us a fortune by the time the fat has clogged the arteries so much that the ticker packs up.
4) drunks + binge drinkers, again, people that cost us a fortune and could easily be resolved with assistance and fines. The cost in this sector are astonishing.
5) assault and fighting, why should we pay ? Why don't courts make the guilty pay for the medical side as well as compensation to the victim ?
6) prisons, why can't we make them do hard labour and earn some of the costs they bear on society ?
7) dangerous sports, A&E burden of fixing people injured during dangerous sports.
I think, basically, the answer to almost all of these is that we are a 21st Century, civilised society.Wilier Izoard XP0 -
In terms of the burden on the NHS I think the government would do to invest more money in schemes that help reduce the NHS burden. For example more cyclists = healthier nation = lower NHS costs.
When Nye Bevan created the NHS as the Health Minister, he was also the Minister for Housing and could see that by investing in quality social housing (and getting people out of slums) he could reduce the burden on the NHS and save money overall.
From the top of government all the way down to individual hospitals all the money is parcelled up and everybody is only responsible for saving the money in their own parcel. It creates a fuck you buddy environment where decisions are deliberately made that cost us more money but save money from someone's individual budget.
It also doesn't help that politicians are generally only interested in policies that will see results before their next election.0 -
So Bank Holiday weekend weekend I was running an inner city A&E where we saw about 1 100 people over the three days. I had some 350 hours of doctor time to sort them all out giving us about 15-20 minutes a patient. Unsurprisingly our wait got up to over 7 hours at times.
I am not going to argue about whether they should have been seen or whether their problems were self inflicted as, quite frankly, it is too complicated to agree the definition and the boundary between who is and isn't treated. I would also suggest that you don't want me deciding whether you get treated or not. It will probably depend what mood I'm in and how knackered I am! Most of the people I saw could have been said to be self inflicted through life style choices but they all needed to be seen at one level or another.
I would never want to see A&E charges. Most people we see would probably be exempt anyway (as they are for prescription charges) and the cost and hassle of collecting the money would be ridiculous.
The simple truth is that the GPs have abdicated responsibility for their patients unscheduled needs leaving us to pick up the pieces. Do remember that GPs are independent health providers and are self employed. They refused to join the NHS when it was set up and have held it ransom ever since. They are an enormously successful and powerful lobby group that effectively runs the BMA and their most vociferous work has been whenever the government has tried to bring them in under the sort of control that the hospitals enjoy. The notion of giving the control of commissioning to them is terrifying. A significant number of GPs working on commissioning groups also run private companies that provide out of hours work and other treatment options to the NHS. Conflict of interest?
A&E is significantly understaffed and it is going to get worse. The A&E doctor specialist training programme has a 50% fill rate nationally so in 5 to 10 years there is going to be a major shortage of doctors trained to deliver the care the public need. In 15 to 20 years it will be close to impossible to staff many departments. Very few people coming out of medical school see A&E as an attractive option. The hours are ridiculous, the shift patterns soul destroying, the targets bear no relation to clinical quality and the support non-existent.
Sorry that's all a bit depressing and I am afraid I do not know what the answer is. Personally I am expanding my skill base so I can get out of the NHS. It's an awful organisation to work for, especially as a senior doctor. All I am expected to do is make sure things happen quickly irrespective of whether they are clinically appropriate or of high quality.
The NHS is dying.0 -
Stick8267 wrote:The simple truth is that the GPs have abdicated responsibility for their patients unscheduled needs leaving us to pick up the pieces. Do remember that GPs are independent health providers and are self employed. They refused to join the NHS when it was set up and have held it ransom ever since.
They're absurdly overpaid too.0 -
VTech wrote:The problem is, we really are a country of people who say "it's not possible to police, what if this, what if that" and we never get anything done.
You only need to read the above for proof of that. I suggested for self inflicted injuries based on being drunk and next thing were talking about falling of a ladder and bike and so on.
It's been the blight of Britain for decades and I believe is so inbuilt into our nature now that we are at a point where something major needs to happen before we can ever fix it.
The sad thing is that we are a nation of clever people, we fix issues, we solve puzzles but allow lazy and foolish people change the building blocks of our future.
In general I honestly believe that people want to have better systems, better infrastructure so why don't we push these ?
I would suggest that people get concerned over the ones they will upset and decide its better to keep quiet.
Ill give a few examples.
1) second, third generation unemployed where not working is inbuilt into the family life where father, mother, kids, grand kids all don't work and have never shown and intention to work. These may be viewed as "leaches" by some but to councilers and MP's offer a good vote if security for them is maintained.
2) drug addicts who are happy to take medication and support from the NHS wihe it any real want of assistance costing billions overall when support and crime are counted.
3) fatties, people who get ill, need medication and support, will never work or add to the growth (no pun) of our country and will cost us a fortune by the time the fat has clogged the arteries so much that the ticker packs up.
4) drunks + binge drinkers, again, people that cost us a fortune and could easily be resolved with assistance and fines. The cost in this sector are astonishing.
5) assault and fighting, why should we pay ? Why don't courts make the guilty pay for the medical side as well as compensation to the victim ?
6) prisons, why can't we make them do hard labour and earn some of the costs they bear on society ?
7) dangerous sports, A&E burden of fixing people injured during dangerous sports.
There will be some who on the outside look like they fit into one of the categories I've mentioned. Maybe someone who is fat but maybe through no intention and doesnt eat 10,000 calories a day or someone who falls off a bike on a club Sunday ride.
I just don't agree with the argument that we can't police it because someone will say if you are mopping your floor at home and slip it will be classed as a dangerous situation and won't be covered so let's not put something into place.
I get problems everyday at work, I'm sure you all do but do we just drop our tools and stop ?
Yesterday I was working on a software that wasn't quite right, I ended up driving over 600 miles all told and didn't get home until 2.30am having left at 5am the previous day but I got it fixed.
We tried the "something isn't as it should be, let's down tools and wait for someone else to fix it" routine with our unions in the 80's (my childhood, and it destroyed business and killed tens of thousands of jobs.
These actions don't fix anything, they cause so many problems.
If something is wrong why shouldn't we have a try to resolve it ? Of course we can't make everyone happy and some will feel punished but if making people pay for foolish or even mildly silly behaviours offer us some benefits overall I'd sign up.
We may end up with a negative side, lets say my mom has 3 glasses of wine and falls and cracks her ankle and needs an OP and due to being over the limit is charged a fee then so be it. We owe it to ourself to at least try to get a fix.
1. How many 2nd and 3rd generation unemployed people do you suppose there actually are? I Googled this to try and find some empirical evidence of their numbers.Using the best official data, the research confirms worklessness is a major problem: in 3.7m working-age households, 18% of the total, nobody has a job. But two-generational worklessness is far rarer...As for homes with two generations that have never worked, the fraction drops further, to less than 0.1% of the total. Of course there will be some "never-worked" families where children have flown the nest, but the little data available suggests these, too, are uncommon.The truly double-generation long-term unemployed family is, then, a rare species. As for the politicians' "third-generation" perma-idlers, these are on the critically endangered list – if not entirely fictional. The Joseph Rowntree Foundation set out to identify and investigate 20 such "never-worked" families in deprived Glasgow and Teesside, but it found not a single one.
http://www.guardian.co.uk/commentisfree ... -editorial
There were virtually no other results.
These occur in such small numbers that their actual impact on the public purse in the grand scale of things is almost entirely irrelevant. They also don't represent any type of 'group' of sufficient size that politicians could actually benefit from securing their votes.
Ideologically, we'd see everyone who's deserving get their entitlements but no one getting something they weren't entitled to. I don't think such a perfect system exists. In light of that, I'd sooner see a system that walks on the cautious side and accepts some overpayments as unavoidable in order to see that all those who need it get it. Yes, that means I pay a little more in taxes each year, but it's more than worth it to me.
Your other points can largely be addressed as a whole. I'm a big believer in prevention is better than cure. Somehow we need to foster the personal responsibility that sees people choose not to smoke, eat and drink to excess.
We've actually done pretty well in cutting down the number of smokers and the attitude towards it, but it will be decades until the benefit to people's health is reflected in the NHS bill. I'd support similar steps to see that alcohol and junk food consumption goes the same way.
We need to look at the social conditions that drives so many of us to drink to oblivion every friday and saturday night, to eat crap with absolutely no regard or understanding of the harm it does to our bodies, to address why people turn to drugs and why people either fall or are born into long-term unemployment. That doesn't mean that we should pull the rug from under those who require society's support either through benefit or health care.
I honestly believe that the papers hold a lot of responsibility for the cynicism that so many people feel towards the state of Britain. They've propagated the false belief for so long that there's millions of people out there who have never worked, never want to, and will never have to. That benefit fraud is rife. That immigration and/or the EU is the cause of all these problems. All of these claims are largely unsubstantiated by any sort of research. Where research is used it's partially-quoted and taken out of context to deliver an entirely different conclusion to that of the research itself.0 -
You and your facts.
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