General Chat

what exactly is stopping us from getting them to pay - if you are abroad, even in an EU country, the first thing you are asked for is money!! Go to a BUPA establishment, first thing you are asked for is money!!

The NHS was never set up for direct payment by users and does not have any real capacity in its system to make such charges. Relative to overall NHS spend claims by foreigners which are not covered by the EU E111 emergency card are tiny. Changing NHS systems so as to incorporate systematic charging would be wildly uneconomic.

Foreigners working in the UK are of course on the same basis as anybody else. UKGov intends to retain the current system post brexit so long as the 27 reciprocate.

Both in the UK and in the EU people needing urgent medical treatment will receive it without a priori payment conditions. However the EU health bodies are much better at following up subsequent charges and E111 claims.

There are of course abuses of the system but reformers should be careful not to throw out the baby with the bath water. Given the poor state of the Welsh NHS it has other matters to worry about.

Regardless of a person's status in the UK medical practioners are bound by the Hippocratic Oath to give any trreatment needed to preserve life. This oath takes precedence over UK administrative rules and regulations inc those of Border Force

Well the 'poor state' of the Wales NHS has ensured that we don't pay for prescriptions.

There is shocking abuse of this system by English tourists who make an appointment with a GP whilst on holiday here and ask for repeat scrips (and even paracetemol which costs about 50p in a supermarket). Wrong!!!

Yes there are some consultants that we wait longer for than in England, orthopaedics being one. To balance that we have some Neurological centres that are world class.

Swings and roundabouts.

The UK must be more aggressive in recovering monies post treatment we cannot afford to provide all and sundry treatment for free.

I have long thought that people should pay for operations in this Country .we do have a service help for all .but it is abused I paid my Taxes when I worked as did many people .& now I get free . help & Care waiting for op at the moment .we are all humans & never know when we need help .when we go abroad correct me if wrong you take insurance out for medical emergency .& many counties .you only get medical help if you have insurance .USA for one .if we all contribute something think how much better the service would be .even donations in a waiting room .GP or Hospital ..they ask at Animal Charity*s PDSA for one .why not human beings ?

Agree Barbra.

Rollo I have no idea what you are talking about, but hey I only live in Wales, what do I know :-D

not a lot evidently

I always thought that Wales made a mistake in letting everyone have free prescriptions.
I am aware of a lot of young people who go to the doctor to get pills for a minor condition that they could have bought from a pharmacy ,or even supermarket.

I also hate the waste that goes on, and I don't think it is just in Wales,of pharmacists who keep on sending out meds even though folk are stockpiling.
I spoke to my doctor about this and was told that pharmacists will keep on as they get paid.

I had loads of things left over when my husband died,all sealed oxygen masks,night bags ,leg bags, incontinence pants etc and I offered them to care homes and nobody wanted them.It took me almost 2 years and I eventually got them to a home who appreciated them.

If they cut down the waste,and managed things in a businesslike way it wouldn't be in the state it is.

Ann - many years ago I worked in an A&E department and some tourists did offer to pay, but there was no system in place for them to pay at the time or for them to be billed later. It would appear that not much has changed :-)

Brenda - managing items such as you mentioned in a care home is (or was) a nightmare! They had been prescribed for a particular person, and if they died and had bags, catheters, pads etc left, we were not supposed to use them for anyone else! Using them for someone else was seen as theft!!! I kid you not. It appeared CQC would prefer us to send things back to the pharmacy, even though they could not be prescribed for anyone else, than allow us to use these things for anyone else in the home. It beggars belief really. Glad I am out of it all now :-)

Lyndi, that's what I thought about payments - no proper system in place!!
The Thatcher imposed highly paid managers on Hospital trusts, (salary about £172,000 each per year). Then there are senior Managers and Directors - all on an eye watering salary.
In 2003 and 2011, expensive but rubbish computer systems (I believe the current one vaguely works), were introduced, then abandoned at a cost of billions, when a few admin and a simple computer system in every hospital could have ensured most payments were made, to offset the cost of the shambles caused by Government interference.

Further to the comments re: "leftovers".

Early last year I was executor for a relative's estate. It soon became apparent that there was a lot of medical items to be disposed of. Both from prescriptions and those purchased over the counter. My first port of call was the relative's gp surgery. I was told to take all the unopened packets, etc. to them.
They could not be used there, but there was a charity that sent a medical practitioner round surgeries on a regular basis. All items would be sorted/checked and be sent overseas to other charities.

I had lots of items at home after hubby died . How to dispose of them was a problem .seemed no one was interested in taken them back even though they had been delivered and not used from the NHS . Once delivered no one wanted to know

Unopened boxes could be reused as they hadn't been contaminated , i thought at the time what a waste of money

I even had vials of morphine not used . Plus a vial box with used needles that needed disposal but the district nurse who administerd them said she couidnt take the box for disposal. I had to ring around local chemists to find one that could take the box plus the unused vials

All in all I thought there was a big waste of NHS money

Further to comments on Wales - Translate - whilst Wales may offer free prescriptions etc it is us poor taxpayers on England that are paying the bill......!

Re wasted prescriptions - Yes it is a problem but the cost is estimated at around £300 million each year. Seems a lot? not when you consider the total cost of the NHS each year is £116,000 million. The difficulty is that to reduce the wastage further gets increasingly more difficult until it reaches the point that the extra you would need to spend is more than the amount you save.

I'm in Wales and do not agree with free prescriptions - it was done once before for the whole of the UK and people just abused it

I can't understand the logic that if you are prescribed medication for a thyroid problem then all of your medication is given free.

Whoever thought that one up?

"The NHS was never set up for direct payment by users and does not have any real capacity in its system to make such charges. "

It wasn't envisaged that such expensive treatments would become available, or that people would travel from abroad to get treatment for 'free at the point of delivery'. Even tourists who become ill while in this country fall into that catagory. One person said it was set up to deliver first aid, not for elective surgery. That would include hip and knee replacements.

Just because it was never set up to take payments, there's no reason why it shouldn't change.
"But we've always done it that way" isn't acceptable in industry, and shouldn't be in the NHS.
Take a leaf out the private health care providers and adopt their charging policy.

Band Aid costs £X
Plaster of Paris costs £Y etc
Operating theatre time £Z etc etc.

Produce an NI or NHS number, EU reciprical medical card or medical travel insurance and you'll get the full NHS treatment. If you've none, you'll be temporarily patched up so that you are 'fit to travel' and sent on your way. The Bill will be sent to your Embassy or used to balance off the costs occured by UK citizens n their country of origin.

Loads of people are looking for volunteering opportunites - there's bound to be some would be willing to fill an administrative rota.

Brian
People with life threatening illnesses such as thyroid problems cancer Kidneys problems and diabetics
get their prescriptions free

They could die without their medication

Agreed, Joy.
But it shouldn't be beyond the whit of mankind to devise a system for the exemption to be specific to the life-threatening conditions and not a blanket exemption.
My B-i-l has one thyroxine tablet per day but all other medication from antibiotics to skin cream to toothpaste to laxatives to cough medicine is also free. Why?

fair point Brian

A visit to a GP costs $75.00 (in WA, I'm not sure about the rest of Oz but feel that it may be the same) of which $35.00 approximately is refunded to the patient via Medicare.

Some GP's, but not many, will bulk bill patients which means that the patient pays nothing.

Most GP's do bulk bill children and also concession card holders (aged pensioners, low income health care card holders etc.)

Prescriptions can cost up to $38.00 per item or $6.20 for concession card holders. There is a 'Safety Net' for prescriptions:

https://www.humanservices.gov.au/customer/services/medicare/pharmaceutical-benefits-scheme-pbs-safety-net

Treatment at Public Hospitals is free. The effect of this, given the high cost of seeing a GP is that many people take themselves to the A $ E dept. of the hospitals for conditions easily diagnosed and treated by GPs, thus clogging the public hospital system.

However, as with all Conservative Governments everywhere, there is, in my opinion, a move to privatise the healthcare system in its entirety.

Brian,
If you look at the list of prescription exemptions, you may notice that it includes any endocrine condition.
Hypo or hyper thyroid can lead to other illnesses or health complaints which is why prescriptions are free.

We live in Scotland where all prescriptions are free anyway.
Daughter and her new husband between them receive treatment and medication for 3 of the conditions on that list although both keep in good health and rarely require other prescriptions

After treatment for hyperthyroidism, my daughter no longer has a working thyroid
= Levothyroxine for life.
She also has type1 diabetes
.= Insulin for life
( both caused by auto immune system)
Her husband has Congenital Adrenal Hyperplasia or CAH
= Cortisole and steroids for life

They don't have children yet but, CAH is inherited and the others are familial