The NHS is broken, what should happen?

[weltweit]

Germany is a universal multi-payer insurance system. Money comes from individuals and employers, top up from state and federal funds, and unions often make contributions too. If you earn more than a certain amount (can’t remember what it is- 5k a month or so I think) you can choose to top up or opt out of the state system with private insurance.

so what about people with lower incomes, what level of care do they get?

Hospitals can be state, private or charitable. Waiting times are so low they don’t collect the data as standard...

that certainly does seem special.

A colleague who had an issue in Australia went through all sorts of tests including an MRI scan all almost immediate with no waiting times either.

.the system is integrated so, for example, if you have a break, physio is part of the standard care plan and is likely to be in a pharmacy or local healthcare centre, really close to you so it’ll be daily initially.
I’ve used it. It’s outstanding. A friend of mine whose kid has cancer is in Germany at the moment (paid for by the nhs) getting treatment not available here, in a state of the art facility, with parental rooms, psych care and social support as standard. Totally different experience

 

[Manter]

so what about people with lower incomes, what level of care do they get?

that certainly does seem special.

A colleague who had an issue in Australia went through all sorts of tests including an MRI scan all almost immediate with no waiting times either.

State. You can’t pay for private insurance unless you earn above a certain threshold

 

[redsquirrel]

I have heard good things about German and also Australian health systems but I don't know how they work.

The Australian health system is terrible, deliberately incorporating private providers

 

[kalidarkone]

I wonder how much of the difference might be cost of drugs, because as I understand it the NHS buys drugs quite effectively?

Well I know that when day case surgery patients are prescribed paracetamol and codine phosphate to take home we only give them the codine phosphate and not the paracetamol because it is so expensive for us to provide it whereas it's only 19p fromantic the supermarket.

 

[Athos]

Well I know that when day case surgery patients are prescribed paracetamol and codine phosphate to take home we only give them the codine phosphate and not the paracetamol because it is so expensive for us to provide it whereas it's only 19p fromantic the supermarket.

I'm fascinated by the fact your autocorrect contains the word 'fromantic'.

 

[kabbes]

There are definitely problems in the NHS beyond the financial but a key problem is that to fix those problems, you’re going to have to throw a lot of money at change projects. The reverse problem, however, is that the inefficiencies the problems causes are costing money too. It seems to me very worthwhile to spend the money that will ultimately save money, but that isn’t how government budgeting works.

(A key example is the fact that there is no central database of patient details. The personal experience of this is that huge amounts of time are wasted re-explaining the same case history to different people, who all enter it into their own systems and differences in those case histories naturally arise over time, because who remembers all the details? Meanwhile, the large amounts of physical paper involved get lost or sent to the wrong people and then more work is needed to untangle the errors. The kabbess has ended up with multiple pointless appointments because she’s simply been referred to the wrong department. The whole admin system is in meltdown and it needs proper money spent to fix it. I dread to think how much resource is being haemorrhaged thanks to the errors it currently generates.)

 

[Sasaferrato]

how long ago?

A long time. AFAIK though, their system has not changed. I appreciate though that I may be depending on outdated info if things have changed in a major way.

 

[purenarcotic]

Does Germany have the same principle of universal healthcare that is free at the point of use for all? If you don’t work do you still get the same access? What is the difference between state and private healthcare? Does it create a two tier system where you get better treatment if you pay?

 

[Edie]

Germany is a universal multi-payer insurance system. Money comes from individuals and employers, top up from state and federal funds, and unions often make contributions too. If you earn more than a certain amount (can’t remember what it is- 5k a month or so I think) you can choose to top up or opt out of the state system with private insurance. Hospitals can be state, private or charitable. Waiting times are so low they don’t collect the data as standard....the system is integrated so, for example, if you have a break, physio is part of the standard care plan and is likely to be in a pharmacy or local healthcare centre, really close to you so it’ll be daily initially.
I’ve used it. It’s outstanding. A friend of mine whose kid has cancer is in Germany at the moment (paid for by the nhs) getting treatment not available here, in a state of the art facility, with parental rooms, psych care and social support as standard. Totally different experience

As a country, we need to seriously think about moving to this model. We have this insane assumption that waiting times, lack of basic services, not being able to get appointments, lack of beds, are somehow just inevitable and gawd bless the NHS. While our neighbours look on in disbelief.

kabbes the inefficiency due to admin errors and antiquated systems belies belief. In one DGH I work in you still have to fax requests. They get lost, so patients sit and wait for extra days or even weeks for an investigation, delaying discharge to the tune of £400 a day (or whatever an acute bed costs per night). Or walk over bloods to the lab across the road because the taxi that comes to take the bloods is booked for 16:30 every day (wth!!! why 16:30?! that’s the dumbest time ever). Or there’s literally nowhere to park so some staff with physical disability like my ward clerk pay £17 a day parking (whaaaa?!) or on occasion the OTs who go out to do home visits have to sit and wait for up to an hour for a parking place. The list of these insanities goes on and on and on. Wasteful, utterly pointless, occasionally unsafe, practices. Who is overseeing this? Who is in charge ffs. It’s too big, too antiquated, too stuck. And now this inefficient service is underfunded to the point of not operating.

We need to talk about this, and make some decisions about how to change it.

 

[Proper Tidy]

Funded through insurance like germany or from central revenue like NHS is irrelevant to how the service is delivered though

 

[LDC]

Oh god... I've been meaning to write something on this topic for ages. I'll take a deep breath and start with a few things here, but first I think in this discussion it might be useful to lay out a couple of things...

I work in the NHS and have done on and off for about 9 years, a few years working on ambulances and then a few in an acute medical walk-in department. I've also worked a bit in healthcare in a few other countries for short periods of time.

I am 100% committed to free healthcare as a universal service to all.

Right, the NHS is fucked, and we can probably all repeat a whole load of experiences, statistics, and newspaper articles to show this, the questions are what are the problems and how do they get fixed.

I might say more on the problems in another post, but for the moment I find it depressing and incredibly narrow minded that the arguments about the NHS pretty much start and finish with funding. Of course this is a (massive) issue, but it's far from the only one, and I think you could probably continue to throw increasingly large amounts of money at the NHS as it is now and it would happily swallow them up and I seriously doubt you'd see that much of an improvement without some massive structural changes - within the NHS and within society.

There's no way of fixing healthcare in this country without a huge restructuring of how we live and work. Where we get our food, how we work, housing, etc. all need to be under the microscope and sorted out. Focusing on healthcare for the moment though, how would I start to fix these problems?

In no particular order...

Flatten out the wage differentials within healthcare. Doctors, especially consultants and above need to take a pay cut. (I know, goes against worker's stuff right, but fuck them, they can just not send their kids to private school to save money...) and nurses, healthcare assistants, ward clerks, etc. need a rise. Becoming a doctor needs to be opened up to people beyond the (upper) middle classes, and all healthcare related training should be free (including medical degrees) to balance this wage cut for them out a bit. Get rid of massive amounts of the management. Cut the working week hourly length, and shifts need to be shorter and with more flexible working options.

Bring all services back under the NHS umbrella. Start a national drug manufacturing program making all the drugs we need. Abolish prescription charges. Bring dentistry back under the NHS too and abolish all dental charges.

Start a national ambulance service. It's fucking ridiculous it's split the way it is. You could get rid of fuck loads of management and save millions in all sorts of area and management would be offered free re-training as nurses or healthcare assistants or whatever they want as we'd be having...

A massive program of recruitment to all healthcare professions across the board. Alongside this a program to wind down using any agency staff, and especially locum doctors (one I know is on £250,000 a year through an agency ffs.) And with this would come a huge new program of employing community healthcare workers (or some sexy title) that would work in neighborhood clinics that are popping up when we....

Totally re-structure healthcare provision. Open up a health clinic in every neighborhood. It would have a skill mix of nurses, doctors, dentists, psychologists, some alternative healthcare types, advanced practitioners, midwives, physios, sexual health folks, and diet and exercise advice people. They'd know their patients. The centres would be nice welcoming places you could drop in to or get an appointment at easily. They'd do all the normal GP surgery stuff, plus minor injuries (x-rays) and maybe some minor ops, and they might even have a very small ward for overnight stays. The other side of this would be having some massive specialist hospitals covering larger geographical areas and that deal with complex medical problems like cancer, renal, serious trauma, etc etc.

Introduce basic healthcare classes at school for all ages taught by those community healthcare workers we've recruited. They'd be weekly and you'd cover different topics as you got older until you were 16. Teach healthy eating, how to exercise, sexual health, dealing with simple ailments, what is and isn't an emergency, stress management, first aid, dealing with grief, expectations of death, and how to exercise. And on that topic....

Compulsory twice weekly PE classes at all schools including teaching everyone to swim. Yup, read it and weep you weedy anarchists....

On that note if I was benevolent dictator I'd probably start a compulsory national service year for everyone when they hit 18, they'd be living in a hut in Scotland/Lakes/wherever working on a massive nation wide tree planting project, but that's another post...

Anyway, that will do for starters.

 

[Manter]

Does Germany have the same principle of universal healthcare that is free at the point of use for all? If you don’t work do you still get the same access? What is the difference between state and private healthcare? Does it create a two tier system where you get better treatment if you pay?

Yes everyone gets healthcare. If you lose a job (redundancy etc) your employer has to continue paying, so it doesn’t become a taxpayer burden, and if you have never worked it’s covered by your social payment. Plus unions and associations inject a lot of money- the system runs at a surplus, largest in the world. Can’t remember the numbers, but they have a lot of money.
Private healthcare means you get to choose complimentary therapy, and a different range of hospitals. Anecdotally reduces waiting times from 1-3 weeks to less than a week (I mean waiting times for things like hip operations not gp appointments). Private healthcare insurance also sometimes covers some other things like childcare costs, transport costs etc. I know someone whose very disabled son lives in a co-working community that is insurance funded (they share chores depending on need, work to run a business hospitality centre and in craft- the insurance funds district nursing and infrastructure) C 10% of the population have it, same as UK, but it comes with restrictions on rentering the public system, and your employer is on the hook for paying still. It’s not two tier as much as parallel (this is based on working there a lot and having lots of German friends, I haven’t lived there for years and years). Private hospital rooms for example have private written on the door, ie privately funded, but are shared like public hospital rooms. It’s very very different to our system.

if you are a non- national you can be completely excluded from healthcare unless you contribute. One way in which they managed free movement very differently to us.

system has its problems- there were some scandals about cancer survival rates if I remember- but it’s streets ahead of ours in terms of experience and outcomes

edit to add- dentistry and glasses aren’t covered by state insurance iirc.

Edited again- you have to pay a nominal fee- €10 ish- for the first medical appointment of each quarter. No idea why

 

[Manter]

Funded through insurance like germany or from central revenue like NHS is irrelevant to how the service is delivered though

It does and it doesn’t. It all coming out of central government and social care being funded separately means one is a poor relation of the other. Government here has top down funding and efficiency motives, whereas it’s different in a system that you see payments go into with every pay cheque, that business is paying for, that unions and associations and professional bodies all have real financial stakes in (not just philosophical views about or fondness for). Who pays and how they pay does affect how funds are seen and how they are used.

Funding isn’t the only problem, of course. But it is one, and I don’t think the only answer is more- it’s also more but out of the top-down control of whichever partisan lunatic is in the Health job this week, trying to make an impact before the next reshuffle.

 

[Athos]

Yes everyone gets healthcare. If you lose a job (redundancy etc) your employer has to continue paying, so it doesn’t become a taxpayer burden, and if you have never worked it’s covered by your social payment. Plus unions and associations inject a lot of money- the system runs at a surplus, largest in the world. Can’t remember the numbers, but they have a lot of money.
Private healthcare means you get to choose complimentary therapy, and a different range of hospitals. Anecdotally reduces waiting times from 1-3 weeks to less than a week (I mean waiting times for things like hip operations not gp appointments). Private healthcare insurance also sometimes covers some other things like childcare costs, transport costs etc. I know someone whose very disabled son lives in a co-working community that is insurance funded (they share chores depending on need, work to run a business hospitality centre and in craft- the insurance funds district nursing and infrastructure) C 10% of the population have it, same as UK, but it comes with restrictions on rentering the public system, and your employer is on the hook for paying still. It’s not two tier as much as parallel (this is based on working there a lot and having lots of German friends, I haven’t lived there for years and years). Private hospital rooms for example have private written on the door, ie privately funded, but are shared like public hospital rooms. It’s very very different to our system.

if you are a non- national you can be completely excluded from healthcare unless you contribute. One way in which they managed free movement very differently to us.

system has its problems- there were some scandals about cancer survival rates if I remember- but it’s streets ahead of ours in terms of experience and outcomes

Everybody gets healthcare that's free at the point of delivery, but the wealthy have the option to access a better service, for which they pay more.

So, why not just tax the wealthy more, remove the choice, and improve a single system to be used by all?

Because you can be sure that, when times get tight, those in power will have no qualms about cutting the basic level service (which they and theirs don't have to rely on).

 

[Manter]

Everybody gets healthcare that's free at the point of delivery, but the wealthy have the option to access a better service, for which they pay more.

So, why not just tax the wealthy more, revive the choice, and improve a single system to be used by all?

Because you can be sure that, when times get tight, those in power will have no qualms about cutting the basic level service (which they and theirs don't have to rely on).

I don’t run the German healthcare system. Ask the federal committee?

Also worth pointing out that the health service is far from basic and most people including the very wealthy do rely on it for most of their care. I’d much much rather be ill there than here, and there is a culture of social accountability and relationships completely different to our Anglo-American self interest, as shown by the role works councils, associations and unions have throughout the business and social system, including health

 

[weltweit]

My experiences with NHS adult mental health services is that they are stretched to the limit. And this results in people who should really be in hospital instead being in the community in chaotic and sometimes risky situations.

 

[weltweit]

I do think NHS lead times and performance metrics should be compared more often to other countries, and when the comparison is unfavourable discussion can take place.

 

[Sasaferrato]

The way that nurses are employed needs to change, as does the fiction that a 'nurse manager' is still a nurse.

A hospital should have a matron and a a number of deputies. Next level is the ward sister (charge nurse if you prefer), keep your senior nurses on the wards, not in offices. Compensate by increasing the 'spines' so experience is rewarded by extra salary. It has been used over many decades by the forces, and it works.

I would also address the falling GP numbers by making medical degrees free, with either accommodation included or a bursary. In return, new doctors work full time for the NHS for the same number of years as they spent in training, paid of course. The work starting at the point where they can sign their own prescriptions.

 

[LDC]

The way that nurses are employed needs to change, as does the fiction that a 'nurse manager' is still a nurse.

A hospital should have a matron and a a number of deputies. Next level is the ward sister (charge nurse if you prefer), keep your senior nurses on the wards, not in offices. Compensate by increasing the 'spines' so experience is rewarded by extra salary. It has been used over many decades by the forces, and it works.

Deckchair rearranging on the Titanic an interest of yours?

 

[Edie]

Oh god... I've been meaning to write something on this topic for ages. I'll take a deep breath and start with a few things here, but first I think in this discussion it might be useful to lay out a couple of things...

I work in the NHS and have done on and off for about 9 years, a few years working in the ambulances and then a few in an acute medical walk-in department. I've also worked a bit in healthcare in a few other countries for short periods of time.

I am 100% committed to free healthcare as a universal service to all.

Right, the NHS is fucked, and we can probably all repeat a whole load of experiences to show this, the questions are what are the problems and how do they get fixed.

I find it depressing and incredibly short sighted that the arguments about the NHS pretty start and finish with funding. Of course this is a issue, but I think you could probably continue to throw increasingly large amounts of money at the NHS as it is now and it would happily swallow them up and I seriously doubt you'd see that much of an improvement without some massive structural changes - within the NHS and within society.

There's no way of fixing healthcare in this country without a huge restructuring of how we live and work. Where we get our food, how we work, housing, etc. all need to be under the microscope and sorted out. Focusing on healthcare for the moment though, how would I start to fix these problems?

In no particular order...

Flatten out the wage differentials within healthcare. Doctors, especially consultants and above need to take a pay cut. (I know, goes against worker's stuff right, but fuck them, they can just not send their kids to private school to save money...) and nurses, healthcare assistants, ward clerks, etc. need a rise. Becoming a doctor needs to be opened up to people beyond the (upper) middle classes, and all healthcare related training should be free (including medical degrees) to balance this wage cut for them out a bit. Get rid of massive amounts of the management. Cut the working week hourly length, and shifts need to be shorter and with more flexible working options.

Bring all services back under the NHS umbrella. Start a national drug manufacturing program making all the drugs we need. Abolish prescription charges. Bring dentistry back under the NHS too and abolish all dental charges.

Start a national ambulance service. It's fucking ridiculous it's split the way it is. You could get rid of fuck loads of management and save millions in all sorts of areas. They could be offered free re-training as nurses or healthcare assistants or whatever they want as we'd be having...

A massive program of recruitment to all healthcare professions across the board. Alongside this a program to wind down using any agency staff, and especially locum doctors (one I know is on £250,000 a year through an agency ffs.) And with this would come a huge new program of employing community healthcare workers (or some sexy title) that would work in neighborhood clinics that are popping up when we....

Totally re-structure healthcare provision. Open up a health clinic in every neighborhood. It would have a skill mix of nurses, doctors, dentists, psychologists, some alternative healthcare types, advanced practitioners, physios, sexual health folks, and diet and exercise advice people. They'd know their patients. The centres would be nice welcoming places you could drop in to or get an appointment at easily. They'd do all the normal GP surgery stuff, plus minor injuries (x-rays) and maybe some minor ops, and they might even have a very small ward for overnight stays. The other side of this would be having some massive specialist hospitals covering larger geographical areas and that deal with complex medical problems like cancer, renal, serious trauma, etc etc.

Introduce basic healthcare classes at school for all ages taught by those community healthcare workers we've recruited. They'd be weekly and you'd cover different topics as you got older until you were 16. Teach healthy eating, how to exercise, sexual health, dealing with simple ailments, what is and isn't an emergency, stress management, first aid, dealing with grief, expectations of death, and how to exercise. And on that topic....

Compulsory twice weekly PE classes at all schools including teaching everyone to swim. Yup, read it and weep you weedy anarchists....

On that note if I was benevolent dictator I'd probably start a compulsory national service year for everyone when they hit 18, they'd be living in a hut in Scotland/Lakes/wherever working on a massive nation wide tree planting project, but that's another post...

Anyway, that will do for starters.

God me and you really should meet we definitely see eye to eye even about National Service and phys Ed

 

[Cloo]

As I see it, I'm not sure NHS can go on being a totally free service... while it is great we are no longer in the world in which it was set up, the fact us it wasn't set up to cope with:

Frail, elderly people living a long time
Very premature babies surviving with resultant difficulties in many cases
Disabled and chronically ill people living a long time
Recuperating and old people who have no one (aka a woman, let's face it) available to look after them

Obviously it's wonderful women aren't tied to being at home and survival rates and life expectancy are so much better. But can we really cater for them without at least some people paying? I remember editing a set of healthcare speeches from the last few decades and up until at least the 1980s the expectation genuinely seemed to be that everyone would get healthier and support would be needed less. But that's not been the case.

 

[kebabking]

God me and you really should meet we definitely see eye to eye even about National Service and phys Ed

LynnDoyleCooper and I, in our (mostly) benevolent dictatorship, will have the fittest, healthiest, most disease resistant workforce, err... I mean population the world has ever seen.

Our education program for anti-vaxxers would make Dr Mengele vommit.

 

[MickiQ]

Every developed country bar one glaring exception has some form of free or heavily subsidised healthcare system, which makes me wonder why the Yanks defending their shitty system point at the NHS as an example as why they should stay with theirs. My own experiences of the NHS have been entirely positive but hey if they don't want our system there are plenty of other perfectly good ones they could model theirs on.
Perhaps the German, Canadian or Australian systems are fundamentally better than ours but we have what we have and that doesn't mean our way is wrong,
The NHS could do a LOT BETTER than what it is now given a) sufficient funding and b) re-organisation with the aim of serving patients, All the major changes to the NHS don't seem to be aimed at doing that, they've either been in support of a largely pointless idealogy like the internal market that costs money and adds no actual values. Or we have the PFI initiatives which enabled a short term injection of resources at an excessive long term cost. It's main achievement seemed to be to allow the Blair-Brown Govt to kick the can down the road when it comes to paying for stuff.

 

[Athos]

Also worth pointing out that the health service is far from basic and most people including the very wealthy do rely on it for most of their care. I’d much much rather be ill there than here...

It's bound to be better, because they spend a lot more on it. For now.

 

[Cid]

It’s always worth remembering how unstable our political system is... any government can essentially do what it feels like with a sufficient majority. To me that makes allowing degrees of insurance more risky, especially with close ideological ties to the US.

 

[kalidarkone]

Funded through insurance like germany or from central revenue like NHS is irrelevant to how the service is delivered though

1) There is not enough staff to deliver safe and quality care all of the time currently. This issue needs to be addressed and it probably is but the shortfall is so great that it will take a really long time if ever for appropriate and safe staffing levels to be restored.

2) Management needs to be addressed.
Someone mentioned middle management not being an issue. It is a major issue in my department because we have ONE band 7 (Senior sister ) managing a work force of 113 people (obviously not managing anything, every day treading water) so the staff are unsupported apart from on a peer day to day level. Then there are a few band 7's for the theatre side and ONE band 8 (matron) for about 300 people + that is the theatre side and the recovery side. So management are totally limited within their roles despite their capabilities.

3) We workers have no voice. There is no one listening. I have no actual idea what is going on in my hospital or department except at a very local level. The best I can do is to refuse to carry out unsafe but time saving actions and stand my ground when I am being rushed to discharge my patient despite it not being safe. The big picture is only being thought about afaik in terms of getting through all the surgery lists and trying not to cancel patients (because of safety and because of being fined for breaching the 18 week limit for elective surgery) They ask all the time why they are not able to retain staff but they are not listening. .....
4) Everyone is exhausted.

 

[kalidarkone]

Oh god... I've been meaning to write something on this topic for ages. I'll take a deep breath and start with a few things here, but first I think in this discussion it might be useful to lay out a couple of things...

I work in the NHS and have done on and off for about 9 years, a few years working on ambulances and then a few in an acute medical walk-in department. I've also worked a bit in healthcare in a few other countries for short periods of time.

I am 100% committed to free healthcare as a universal service to all.

Right, the NHS is fucked, and we can probably all repeat a whole load of experiences, statistics, and newspaper articles to show this, the questions are what are the problems and how do they get fixed.

I might say more on the problems in another post, but for the moment I find it depressing and incredibly narrow minded that the arguments about the NHS pretty much start and finish with funding. Of course this is a (massive) issue, but it's far from the only one, and I think you could probably continue to throw increasingly large amounts of money at the NHS as it is now and it would happily swallow them up and I seriously doubt you'd see that much of an improvement without some massive structural changes - within the NHS and within society.

There's no way of fixing healthcare in this country without a huge restructuring of how we live and work. Where we get our food, how we work, housing, etc. all need to be under the microscope and sorted out. Focusing on healthcare for the moment though, how would I start to fix these problems?

In no particular order...

Flatten out the wage differentials within healthcare. Doctors, especially consultants and above need to take a pay cut. (I know, goes against worker's stuff right, but fuck them, they can just not send their kids to private school to save money...) and nurses, healthcare assistants, ward clerks, etc. need a rise. Becoming a doctor needs to be opened up to people beyond the (upper) middle classes, and all healthcare related training should be free (including medical degrees) to balance this wage cut for them out a bit. Get rid of massive amounts of the management. Cut the working week hourly length, and shifts need to be shorter and with more flexible working options.

Bring all services back under the NHS umbrella. Start a national drug manufacturing program making all the drugs we need. Abolish prescription charges. Bring dentistry back under the NHS too and abolish all dental charges.

Start a national ambulance service. It's fucking ridiculous it's split the way it is. You could get rid of fuck loads of management and save millions in all sorts of areas. They could be offered free re-training as nurses or healthcare assistants or whatever they want as we'd be having...

A massive program of recruitment to all healthcare professions across the board. Alongside this a program to wind down using any agency staff, and especially locum doctors (one I know is on £250,000 a year through an agency ffs.) And with this would come a huge new program of employing community healthcare workers (or some sexy title) that would work in neighborhood clinics that are popping up when we....

Totally re-structure healthcare provision. Open up a health clinic in every neighborhood. It would have a skill mix of nurses, doctors, dentists, psychologists, some alternative healthcare types, advanced practitioners, physios, sexual health folks, and diet and exercise advice people. They'd know their patients. The centres would be nice welcoming places you could drop in to or get an appointment at easily. They'd do all the normal GP surgery stuff, plus minor injuries (x-rays) and maybe some minor ops, and they might even have a very small ward for overnight stays. The other side of this would be having some massive specialist hospitals covering larger geographical areas and that deal with complex medical problems like cancer, renal, serious trauma, etc etc.

Introduce basic healthcare classes at school for all ages taught by those community healthcare workers we've recruited. They'd be weekly and you'd cover different topics as you got older until you were 16. Teach healthy eating, how to exercise, sexual health, dealing with simple ailments, what is and isn't an emergency, stress management, first aid, dealing with grief, expectations of death, and how to exercise. And on that topic....

Compulsory twice weekly PE classes at all schools including teaching everyone to swim. Yup, read it and weep you weedy anarchists....

On that note if I was benevolent dictator I'd probably start a compulsory national service year for everyone when they hit 18, they'd be living in a hut in Scotland/Lakes/wherever working on a massive nation wide tree planting project, but that's another post...

Anyway, that will do for starters.

LynnDoyleCooper for president! (I'm not even being sarcastic)

 

[kabbes]

A really great social care system and elderly support system would relieve a lot of pressure. We could do so much better for so much less.

 

[Manter]

It's bound to be better, because they spend a lot more on it. For now.

It’s much more difficult to change their system (selling bits of it off etc) as it’s not a top down structure like ours. And the differences are not just money.

 

[Athos]

It’s much more difficult to change their system (selling bits of it off etc) as it’s not a top down structure like ours. And the differences are not just money.

Rest assured that, once it has a sufficient foothold in healthcare, capital will find a way.

You can't knows whether or not UK health outcomes would be better than Germany's with equal spending.