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If you were the health minister, where would you make the cuts? Watch

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    I'm really struggling with this question. What are your thoughts and ideas?
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    I would discuss Lansley's plans to cut out tiers of management and how this would save quite a lot in administration costs for the NHS. Basically: cut out managers.

    There is an interview prep thread here that you might want to take a look at.
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    I'd be really canny and make the doctors make the cuts, thus because every last bit of funding, and potential funding, has special interest group attached to make lots of noise and create some awful publicity - the doctors will look like *****, not me.

    If it were me, I'd expand NICE, work out the QALY's of everything and start from there - cutting the bits that don't actively save lives first.
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    (Original post by Renal)
    I'd be really canny and make the doctors make the cuts, thus because every last bit of funding, and potential funding, has special interest group attached to make lots of noise and create some awful publicity - the doctors will look like *****, not me.
    Are you Lansley's advisor by any chance? :p:
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    I'd introduce notional access fees in medicine in the same way as exists in Dentistry. Every doctor I speak to tells me about 90% of their time is spend with unemployed loons with minor ailments who absorb huge amounts of resources with little prospect of a satisfactory clinical outcome. A small access fee - say £20 - waived in the event a doctor observes a case of genuine medical need would flush out a lot of time wasters from the system and ensure people only hassled their doctors when they felt it was truly urgent.

    You wouldn't believe the proportion of people for whom a visit to the doctor is regarded as routine social activity. If they want that sort of luxury they should pay for it.
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    (Original post by HLS)
    I'd introduce notional access fees in medicine in the same way as exists in Dentistry. Every doctor I speak to tells me about 90% of their time is spend with unemployed loons with minor ailments who absorb huge amounts of resources with little prospect of a satisfactory clinical outcome. A small access fee - say £20 - waived in the event a doctor observes a case of genuine medical need would flush out a lot of time wasters from the system and ensure people only hassled their doctors when they felt it was truly urgent.

    You wouldn't believe the proportion of people for whom a visit to the doctor is regarded as routine social activity. If they want that sort of luxury they should pay for it.
    The only problem I see with that (and it is a major one) is that people will start pseudo-diagnosisng themselves: they will think about if their symptoms are actually 'important' or not. Although that is kinda the point, it could lead those in a lower socioeconomic class (i.e. not very well educated, can't afford the access fee) who don't actually understand what their symptoms are avoiding the doctors for things they see as 'minor' but which could actually turn out to be very serious. I can't think of an example off the top of my head (which is annoying because I was given a really good one by a doc) but just think of conditions which are life-threatening which show very minor symptoms.

    I think on the flip-side, instead of preemptively punishing everybody I think the people who, as you say, regard it as a 'routine social activity' should be punished themselves.

    N.B.: I am a hippy and I really passionately believe in the right of people to receive healthcare free at the point of need.
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    (Original post by Beska)
    The only problem I see with that (and it is a major one) is that people will start pseudo-diagnosisng themselves: they will think about if their symptoms are actually 'important' or not. Although that is kinda the point, it could lead those in a lower socioeconomic class (i.e. not very well educated, can't afford the access fee) who don't actually understand what their symptoms are avoiding the doctors for things they see as 'minor' but which could actually turn out to be very serious. I can't think of an example off the top of my head (which is annoying because I was given a really good one by a doc) but just think of conditions which are life-threatening which show very minor symptoms.

    I think on the flip-side, instead of preemptively punishing everybody I think the people who, as you say, regard it as a 'routine social activity' should be punished themselves.
    People attempt self-diagnosis anyway - more now than 10 years ago since the mass acceptance of the internet. You get people now with serious conditions who avoid seeing a clinician for various reasons; denial, not wanting to 'cause a fuss', belief that the problem will correct itself etc etc.

    Any system of univeral access will have to be rationed if it is to be implemented effectively. The health system has already achieved a great deal in this regard anyway (try actually getting to see a doctor who isn't your GP these days without a referral - unless you're on the brink of death, you'll almost invariably be met with a firewall of nurses who will usually send you on your way with paracetamol).
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    (Original post by HLS)
    People attempt self-diagnosis anyway - more now than 10 years ago since the mass acceptance of the internet. You get people now with serious conditions who avoid seeing a clinician for various reasons; denial, not wanting to 'cause a fuss', belief that the problem will correct itself etc etc.

    Any system of univeral access will have to be rationed if it is to be implemented effectively. The health system has already achieved a great deal in this regard anyway (try actually getting to see a doctor who isn't your GP these days without a referral - unless you're on the brink of death, you'll almost invariably be met with a firewall of nurses who will usually send you on your way with paracetamol).
    Yup definitely - I am talking about the lower socioeconomic classes in particular, those that probably don't have the education to be able to self-diagnosise, or don't have a computer etc. I think an access fee will disproportionately hit them more than those that are actually going to the doctors for frivolous things. Those that have the time to go to the doctors for ridiculous things will probably have the money to pay for the privilege.
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    My point is the Health System is often abused by those who make no contribution to it. The great mass of unemployed - and remember almost 30% of working age adults are not in employment - disproptionately devour NHS resource. A simple levy for those who turn up with no valid reason for doing so would discourage time wasters and free doctors up for those with genuine need. Those who turn up with good reason would not have to pay the levy.
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    I would introduce a fine for all patients who present to the ED purely because they are either intoxicated with alcohol or under the influence of illicit drugs. These patients are an ever increasing burden on the NHS and in particular ED departments.

    I would hope this would prevent people actually attending ED with this problem but if not at least there is some financial gain to the NHS.
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    I would attach a £10 cost to presenting to the ED - if there is genuine medical need (eg bought in by nee naw/otherwise obviously in distress this is irrelavent) patients should be triaged by F1+SHOs, reg and consultant man (or woman) the shop floor - money taken at reception, if they get through the SHO, then the money is refunded. Treatment would still be at the point of need, and free.
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    well i wouldn't set up a cancer drug fund and continually undermine NICE for a start..
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    From shadowing a doctor, less unnecessary paperwork. Everything is repeated it seems.
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    Controversial as it may be, things like IVF would be top of my lost to get rid of. Sad as it is if you can't hav children you could still foster or adopt. Having said that I have no idea whatsoever how much of the NHS budget is spent on it.

    I fully support Ataloss in the suggestion of charging all the drink divs who hurt themselves! Don't NZ or Oz charge for this?
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    (Original post by Egypt)
    Controversial as it may be, things like IVF would be top of my lost to get rid of. Sad as it is if you can't hav children you could still foster or adopt. Having said that I have no idea whatsoever how much of the NHS budget is spent on it.

    I fully support Ataloss in the suggestion of charging all the drink divs who hurt themselves! Don't NZ or Oz charge for this?
    Problem is,how do you charge? Most pissed people won't pay, and those that really need help are in no condition to. Unless you ring up the parents and bring them in - but I can see issues with that too....
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    billing system? it's virtually impossible to do it without creating loads more admin, i cant imagine many front-of-house people being interested in shaking the tin at the intoxicated.
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    (Original post by geekdiddy)
    I'm really struggling with this question. What are your thoughts and ideas?
    I'd cut administration. Sack the workers with wishy washy job titles. Make the top job at a given hospital or trust to an actual doctor.

    Then I'd charge fat people/alchoholics (but not smokers as they pay enough tax already) and sufferers others of any other medical conditions directly caused by their own choice of lifestyle over a prolonged period of time and wasnt just an accident.

    Then I'd cut IVF, because more likely than not, the Earth doesn't need another one of you two and if you have been blessed with such good genes you wouldn't be infertile now would you?

    Then I'd cut back treatments on the terminally ill because they're frankly incurable. As a sweetener pill, offer the next of kin 50% of what the hospital would have been expected to spend as treatment as cash in hand.

    Now I'm no doctor or even a medical student but I think I'd do a pretty good job as the Health Minister.
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    (Original post by The-Real-One)
    Then I'd charge fat people/alchoholics (but not smokers as they pay enough tax already) and sufferers others of any other medical conditions directly caused by their own choice of lifestyle over a prolonged period of time and wasnt just an accident.
    I know you're probably trolling, but I'd say approximately 99.9999% of illnesses are self-inflicted. Only a handful of congenital ones aren't.

    Would you charge people who are injured in a car crash? Charge somebody who slips and breaks his leg? Charge somebody who is cutting vegetables and slices his finger? It is a slippery slope. A chef is trained to cut vegetables, if he cuts his finger is it still an accident? Should he be charged?
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    (Original post by The-Real-One)
    Now I'm no doctor...
    Good.

    Troll. (I hope.)
 
 
 
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