[nailer]

I live here and don't pay the TV license. I don't consume BBC content, and dislike how they try and send angry letters for not paying for something I don't use (the BBC FireTV app runs at about 6 frames a second and is frustrating to use). Imagine if Netflix was claimed to be 'mandatory' and they could enter your home to check you're 'really' not using Netflix.

The NHS is popular, and people like it, but it's also very inefficient and it can become a political nightmare for anyone who tries to address that.

[arethuza]

"very inefficient"

Given the health results for the amount we pay I think the NHS is actually very efficient - most of the problems with the NHS seem to have come about through ideologically motivated meddling and an an unwillingness to resource it properly.

[nailer]

I should perhaps get some real stats, but it seems almost everyone in the UK has some story of NHS staff not caring about their own performance. I waited three hours in urgent care once when the nurse in charge said she couldn't do anything without a scan - the front desk nurse could have said the same thing. I also has whooping cough and could have killed a friend's infant due to an NHS doctor that didn't bother to read national bulletins.

[rounce]

> Imagine if Netflix was claimed to be 'mandatory' and they could enter your home to check you're really not using Netflix.

Poor analogy, Netflix would also have to be owned but not funded by US Govt.

TV licence people can't exactly kick in the front door and search you for broadcast reception equipment, they're not the police, more like slightly more official bailiffs. They may threaten you with all sorts of legal toil but their powers are quite limited, they rely on their reputation to scare you into submission.

[nailer]

> Netflix would also have to be owned but not funded by US Govt.

Well yes, that's part of the scenario. That doesnt dismiss the point there's a news and entertainment company that thinks everyone watches their content and therefore sends them angry threats

[chrisseaton]

> more like slightly more official bailiffs

No they're _less_ official than bailiffs.

Bailiffs can force their way into your home to take your property to pay for some fines and taxes.

A TV licence person can do absolutely nothing - they're just a normal member of the public.

[rounce]

Don't bailiffs need to have been allowed to cross the threshold of the premises (ie. you open the door to them and then they prevent you from closing the door)? It's illegal for them to kick your door in.

I mean't more official in that TV licence people work for a government owned organisation. Though I hadn't realised they didn't even have bailiff powers.

[chrisseaton]

> It's illegal for them to kick your door in

Not true in all cases!

https://www.gov.uk/your-rights-bailiffs

> Bailiffs are allowed to force their way into your home to collect unpaid criminal fines, Income Tax or Stamp Duty, but only as a last resort.

If these circumstances don't apply they can take things from outside your home, such as your car.

TV Licensing People certainly can't drive off with your car.

[rounce]

I stand corrected, gov.uk is so easy to use I've really no excuse for not looking this up earlier.

> TV Licensing People certainly can't drive off with your car.

It would make for a very interesting Top Gear replacement if they could though.

[teknologist]

By the way, they can't actually legally enter your home without your permission. You can just turn them away at the door

[albertgoeswoof]

Can you elaborate on how the NHS is inefficient? I.e. what metrics measure this? What in comparison to?

Ideally with data and not anecdotes

[arethuza]

The "reasoning" I usually hear about this is basically:

- The public sector is inefficient (1)

- The NHS is in the public sector

- Therefore the NHS is inefficient

[1] Apart from the bits that the person repeating this argument is proud of (e.g. SAS) or scared of (e.g. GCHQ)

[C1sc0cat]

Re waste they haven't worked in the private sector then.

[agent008t]

From my experience:

1. Hardly any way to see a GP outside work hours, so you have to take time off.

2. Cannot see a GP near to where you work, it has to be near to where you live. Which, combined with point 1, is a pain.

3. If you don't use the NHS and go see a private GP instead (which makes economic sense given how much your time off costs vs a private GP costs), you still have to pay for it.

4. Hard to get an appointment at short notice; registration is a pain and very inconvenient.

5. Unless you are dying, they are unlikely to offer any real help/proper tests, but then again that depends on individual GP and is probably not that different between NHS/private.

6. No personal accountability for your health. You end up paying for all the clowns that drink too much on a Friday night and end up in an ambulance and other people that do not take care of their health. Old people seem to go to a GP just because they are lonely.

I have not had to use NHS hospitals luckily, but I am guessing if you are not dying the wait times could be bad.

[albertgoeswoof]

But these are all great efficiencies. It’s a total waste of money to optimise gp locations for people that are well enough to go to work and can afford a private gp if they want it.

If you’re really sick you’ll be seen very quickly, and you’ll be extremely glad the doctors aren’t busy pandering to people with minor conditions.

[C1sc0cat]

That's what some one pointed out its the receptionists job to filter the worried well and prioritise those that need it more.

[meigwilym]

> From my experience:

> Old people seem to go to a GP just because they are lonely.

I somehow doubt the above.

[namdnay]

That's not inefficiency, it's quality. Anyone who has lived in France for example will tell you that the NHS isn't that good. However, it's very cheap. Hence the efficiency

[C1sc0cat]

So most people have sick pay to go the doctors

[KaiserPro]

There are inefficiencies in the NHS. Mostly due to it not actually being national, but regional. NHS is split into england, wales, scotland and NI. Then in eact country a county will be split up again into Primary Care Trusts, which cover between 100k-500k people.

This leads to oddities like there is a national contract for medical staff (nurses, surgeons and doctors etc) but hundreds of different employers.

Each PCT negotiates it's own suppliers, and has a number of stakeholders who are normally GPs. Its all totally ballsed up.

Thats not even touching the IT systems.

However using per capita spend on health, it is ridiculously efficient https://data.oecd.org/healthres/health-spending.htm

[C1sc0cat]

It can cause problems if you have serious conditions and you are having to be treated in two or three trusts eg my local hospital cant do all my bloods.

The outsourced local Patient transport fiasco in my trust caused no end of problems people missing dialysis treatments etc.

[nailer]

> That's not even touching the IT systems.

Yeah, there's a disparate mix of up to date tech and unpatched Windows XP systems, since there's no centralised tech management - some trusts care about patient data and external threats, others don't.

[ceevatuvant]

lower survival rates for cancer

longer waiting times

an inflexible system with no opportunities to pay for top ups to standard care

https://iea.org.uk/wp-content/uploads/2018/07/Healthcare-Bri...