[neilwilson]

"I pay privately through my employer's plan, and then again for the NHS."

And yet it is the private system in the UK that is taking away scarce supply from the NHS making it more vulnerable.

There is a supply side limit on doctors and nurses, which means private healthcare works like the Fast Track queue at Alton Towers. All it does is allow people with money to jump the queue at the expense of everybody else.

And remember that since the inception of the NHS Primary Care, ie the GPs, have always been private businesses. Yet that is the bit that is completely on its knees at the moment.

This isn't a private vs public argument. It's far more fundamental than that. It how do we share out increasingly scarce resources in a country that is getting poorer.

[robertlagrant]

> And yet it is the private system in the UK that is taking away scarce supply from the NHS making it more vulnerable.

It's not a system doing it. Healthcare professionals are choosing to work for private companies instead of the NHS. If you would like to ban that, then say so, but don't pretend there's an amorphous system to blame.

[neilwilson]

There is an amorphous system to blame - too much demand and not enough supply.

Some of that demand has money, therefore the private system will take capacity away from the NHS to supply the money. Of course it will.

That is jumping the queue.

Therefore as a society we have to ask whether we want to uphold the NHS's founding aim: "Healthcare free at the point of delivery based upon need not ability to pay".

We can't fix the supply shortage by taxing the rich. But we can stop the queue jumping by constraining who private healthcare is permitted to treat and in what order.

For the record I don't like the Fast Track queues at Alton Towers either. That's not the British way. In Britain we stand in line - whether Lord or Leper.

[rleigh]

> how do we share out increasingly scarce resources

We make people pay for them. Like we do with every other resource on the planet.

Healthcare is something which should be accessible for all, and we can of course subsidise the less well off. But it still ultimately needs paying for.

[physicsguy]

The supply side limit is purely because the government chooses not to train sufficient staff. We have a government imposed cap to train 7500 doctors per year at University. Then when they finish, they do two years at FY1 and FY2 level, but there are not then sufficient places for all doctors to go onto a training programme. A friend of mine is applying for the January intake of anaesthetics this year for e.g. and there are something like 25 places in the entirety of the UK for that specialty. So people end up working as locums, working to fill gaps in rotas, which has a high hourly rate. Then, when they do finally manage to get a training place, they take a big pay cut and work more hours. That’s if we’re lucky - because plenty of them just go to Australia where the standard working week for a Dr is 40 hours, and many of them don’t bother coming back. But this is a problem created entirely by the government’s choices.

We also have a hugely archaic system in the Royal Colleges. In no other profession do we expect people to sit regularly very expensive professional exams, and expect the staff to fund them out of their own salary rather than them being funded by their employer. £600 a go is not unheard of.

[neilwilson]

"We have a government imposed cap to train 7500 doctors per year at University."

We do. And you know why. Because the NHS has no more capacity to train any more than that. In fact this last year it has struggled to do that because it was more interested in ensuring its staff had masks on properly than getting the job done. First year medical student placements in hospitals were the first to get the chop.

To train more people in any system, that system has to do less of what it is currently doing and more training. We can't afford that in the NHS, which is already struggling to meet demand.

Ultimately the problem is that we spent the seed cord in the 1990s, and we're struggling to replace it.

[aprdm]

Canada doesn’t allow for private practises and it’s in a bad place

[googlryas]

> It how do we share out increasingly scarce resources in a country that is getting poorer

In this instance, the resources are humans, and it seems you want to force humans to do something they don't want to do. If you want slave-doctors just say so. It worked for the Romans I guess.

[forgotusername6]

This is the argument I hate the most from Americans w.r.t. nationalised healthcare. It's unbelievable

[googlryas]

Except it isn't an argument against nationalised healthcare. The UK has nationalised health care and that is what OP is complaining about. I think it would be more an argument by OP against "nationalised healthcare with legal private healthcare".

The exact argument is "doctors/nurses are limited, and they aren't behaving how I think they should behave. Let's fix the system so they have no choice". I guess that isn't slavery, that is just funneling people into a single path which they clearly don't like, because they reject that path when they have literally more than one option open to them.

[andrewjl]

Who is doing the rejecting and regarding what path? What specific proposed fixes are you referring to?

[googlryas]

It seemed like OP was arguing that private medical practices, which are still allowed in England, should be banned because they're using up all the "resources" the NHS needs (doctors/nurses).

[andrewjl]

I agree that a ban is ineffective. In lieu of a ban the NHS should raise their staffer's pay and fund the increase with financial asset and land taxes.