Talk:Healthcare in the United Kingdom/Archive 1

Archive 1

old talk page post

An appalling article. Going to take a long time to fix this! 81.159.14.106 14:51, 2 December 2007 (UTC)

Should we strip this article to a simple overview plus information that is in other main articles?

When this article was created, it was intended to provide an overview of the health care system in the UK, and in particular how it looks to the user of the system. That was originally in the header text to the article. This was no accident. The reason for it was two-fold. Firstly it falls into a pattern of other articles such as Health care in the United States and Health care in Canada and Healthcare in The Netherlands which give broad brush descriptions in various countries. The second is that there is already an article National Health Service (England), NHS Scotland and NHS Wales. These articles are perfectly OK as far as they go but they did not actually convey a flavour of what it is like to access and use the services. Also, they ignore other aspects of choice in health care that are not run by the state, e.g. private dentistry, osteopathy, private hospital services, etc..

I see that the text describing this as an overview article focus on usage on choices are no longer in the article and more and more information is being added to this article which is already present in articles such as National Health Service. I think that this is now making this article a replica of those other articles and making it more likely that readers that flit between articles will read the same information all over again. I think that this is unhelpful to the reader, and I would therefore like to suggest that we revert this article back to a core of information that is relevant to health care in the United Kingdom but which is NOT in those other articles. This would make the links to the related articles more prominent and give the reader the choice to hyperlink to that information if they want to delve into it. --Tom (talk) 06:27, 9 July 2008 (UTC)

Please comment on this proposal below.

Support. As proposer of this suggestion I am of course am in favour of making this change--Tom (talk) 06:27, 9 July 2008 (UTC)

I support you intention but since patient experience is now different depending on system, the place to develop about what patients actually experience is in the appropriate article (Healthcare in England etc) I think this article should be stripped down to an overall comparison between the systems to show what they have in common and where there are now differences.

Do you really think that the experience is that different? I could move most of this info to Healthcare in England as you suggest, but I think that there is much more in common than there are differences. But I agree that political devolution is likely to widen the differences over time, but I would think that there is still a long way to go before that happens. Also much of the information in the England article would have to be moved and repeated in the Wales, Scotland an Northern Ireland articles, which seems unecessarily repetetive. --Tom (talk) 10:00, 13 July 2008 (UTC)

Hi there. In terms of actual patient experience, I would suggest that the differences between Scotland and England are now as great as between any other European countries - what they have in common is that the treatment is free, but the differences in experience are now quite considerable...and growing as the NHS in Scotland is moving further away from the private sector whereas the movement is towards the private sector in England. Cheers Fishiehelper2 (talk) 11:23, 13 July 2008 (UTC)

the differences in experience are now quite considerable. That's quite a claim. Would you care to elaborate? Prescription charges is an obvious one but we have covered that already.

The private sector involvement in England is, I think, still relatively small, though the new build program has rather a lot of PFI if that is what you are referring to. But that is not exactly very visible to the patient. --Tom (talk) 22:00, 14 July 2008 (UTC)

the differences in experience are now quite considerable - my understanding supported by articles like | this is that the philosophy of the NHS in England is now emphasising the ideas of choice and competition: the doctor provides a choice of treatment in a range of competing hospitals (including private) from which the patient can choose. In contrast, Scotland provides care based on the idea of co-operation between different parts - no choice, just treatment! Obviously free prescriptions is an easy to spot difference, but this more underlying difference is likely to have greater significance for actual patient experience. Cheers Fishiehelper2 (talk) 22:51, 14 July 2008 (UTC)

Can I add | this article describing the possible effect on patient experience of proposals for 'polyclinics' in England. Cheers Fishiehelper2 (talk) 23:05, 14 July 2008 (UTC)

Layout

I've just restored a WP:MOS compliant lead, but I'm a bit concerned about the layout of the article. I think we need a section (or two) outlining certain (historical?) commonalities of healthcare in the UK (i.e. it has a shared heritage of free healthcare, a system of regional ambulance services, common policies, practitioner standards and management organisation). Then, I think we need to organise the rest of the material according to England, Scotland, Wales and Northern Ireland, with links to the daughter articles. We might want to finish (or at least insert) a section on certain differences within each system. --Jza84 |  Talk  01:03, 26 May 2008 (UTC)

Hi there Jza84. I also don't see the point of this article in its present form - I have been trying to make some changes but it needs a lot of work. However, I think you have to be careful with your suggestion. Firstly the 'shared heritage' of free healthcare is misleading - the situation prior to 1948 was very different to that south of the border. Similarly, separate acts of parliament set up the NHS which has always been organisationally separate despite being called NHS throughout the UK. I don't know where you get the idea of common 'management organisation' - nothing could be further from the truth! My suggestion would be that we take a leaf out of the 'Education in the UK' article, and produce an article that provides some comparison between the different systems. 86.157.202.40 (talk) 18:22, 26 May 2008 (UTC)

I think I agree will you both - in parts! I like the current lead, and as Jza84 suggests, separate sections on each country now makes sense. Cheers Fishiehelper2 (talk) 18:48, 26 May 2008 (UTC)

Can you two guys (who share very comparable editting patterns) please stop reverting my changes without discussion and proper summaries. Every time I look, we have some rather silly wording restored:

• "the NHS " - isn't the title of the article and shouldn't be enboldened
• "However, since Health is a devolved matter, considerable differences are developing between the systems in the different countries" - since when is "Health" a word that deserves capitalisation?
• "countries, countries, countries" - yet more of this splitting of the UK by any means possible in language.
• "Though", should be "although".
• publicly-funded health care deserves a link.

I'm reverting back to the befitting version. Please note that the WP:3RR applies, and using muliple accounts/ips to circumvent it is forbidden. --Jza84 |  Talk  20:17, 26 May 2008 (UTC)

I will assume good faith on your part as I would hope you would assume on mine. If you check back to other occasions when we have disagreed, I have been persuaded by your arguments (I think, for example, of when you removed the subheadings in the United Kingdom article under healthcare and education.) However, you seem to regard the use of the word 'country' to describe Scotland as somehow a threat to the United Kingdom - you should not let your personal feelings affect your editing. If even 10 Downing street describes the UK as a 'country made up of countries', I think you have to accept that country is a valid description, even if you don't like it. Cheers Fishiehelper2 (talk) 20:36, 26 May 2008 (UTC)

Can I add my ten pennyworth? I initiated this article because the other original main article on the NHS is rather focussed on organization and history and did not give a good picture of how health services operate from the point of view of the end user. I edit (for my sins) another article entitled socialized medicine which (under some definitions) is an American term for systems such as exist in the UK or in Finland where I live today. The original socialized medicine article gave an extraordinarily distorted picture of health services in the UK. It has been improved but there are still certain US based editors determined to paint a negative view of publicly managed health care, and the NHS has for a very long time been a target of pressure groups fighting against more democratic control over health care in the U.S. of A. The NHS is painted by right wing pressure groups there as ineffective, gripped by shortages and queues, with users suffering in pain for lack of treatment etc.. Mostly bollocks of course, but there you are. The NHS article was rather technical, and therefore not very readable to an outsider and did not really give an understanding how health care operates in the UK. So the current article was started´to provide a different perspective describing the system from a user perspective. The concept of no billing for services for example is completely out-of-this-world for most Americans.

The purpose of the article I started was to give someone not familiar with health care in the UK a better insight of the service from the user perspective. Therfore it would not really repeat information that was in the NHS article but rather give information that was not there. aSince the article was started, it has of course changed. I know that fishiehelper is keen to emphasise that there is no single NHS, but in reality, the services are very similar in the big scheme of things. I don't mind the mention of differences, but I think it has become a bit overblown and IMHO they now make the article cluttered because frankly, people outside the UK will not be interested in the minutae of differences from one region to another. I think those can be mentioned in the other main articles, or else put together in one small subsection at the end of the current article.

I also want the article to mention private health care which, although small, is part of the wider picture. I have not added much myself on private medicine because I am not overly familiar with the subject area, even though I have had private medical coverage (and occasionally used it) when I was employed in the UK and have occasionally used the services of specialist therapists outside the NHS.--Tom (talk) 22:46, 26 May 2008 (UTC)

Just a note that I've restored a version of the lead that doesn't have lists - it may need some minor tweaks. Every time I visit this page, an experienced ip seems to put these lists back in. See WP:LIST - lists are disouraged. See WP:LEAD - we use summary style. See WP:D - this isn't a disambiguation page. See Healthcare in Europe - we don't split up articles' leads according to perspectives on nationalism. Thank you, --Jza84 |  Talk  18:38, 7 August 2008 (UTC)

Euthanasia

The inclusion of this in the links was raised, and I traced it to an unexplained addition in June, which I have now reverted. Nick Cooper (talk) 16:18, 11 September 2009 (UTC)

See also

• Health care compared - tabular comparisons of the UK, Canada, and other countries not shown above.

is rejected by one author because it links to a section and not an article. What possible relevance can that have to anything at all? -74.162.150.124 (talk) 04:36, 5 October 2009 (UTC)

See WP:ALSO: "Contents: A bulleted list, preferably alphabetized, of internal links (wikilinks) to related Wikipedia articles."

It is part of our style guideline that we link to articles, not sections, subsections, redlinks, pictures etc. A link to Health care system would be more appropriate. --Jza84 |  Talk  10:20, 5 October 2009 (UTC)

..."internal links (wikilinks) to related Wikipedia articles" does not preclude linking to a section, esp. when its article, Health care system, is quite long with much that is irrelevant to this one, part that duplicates this one, and one section, in particular, that compares the topic of this one to others. MBHiii (talk) 18:54, 5 October 2009 (UTC)

See Also Section

I actually feel quite strongly that the See Also section should cover the links deleted by User:Jza84. I do not agree that WP:ALSO prevents these links being included. Policy is not so absolutely strict and it says that we s editors should apply common sense to the matter. Common sense to me says that these links belong together and the best together place is the See Also section. I invite comments from other editors.--Hauskalainen (talk) 18:03, 16 October 2009 (UTC)

I agree. We want articles that help readers as much as possible. 86.155.55.251 (talk) 18:55, 16 October 2009 (UTC)

For once, I agree with Tom. It's a helpful set of links that present no fundamental problem. The Squicks (talk) 23:29, 16 October 2009 (UTC)

They are linked several times throughout the article. They are not needed. A Navigation template for healthcare in the UK appended to the end of the article would be more appropriate, tidy, professional and useful. --Jza84 |  Talk  23:39, 16 October 2009 (UTC)

"Per cent"?

This has to be the only page written in British English in which the term "per cent" is preferred, so that what would otherwise be "5%" is changed to "5 per cent".

Is this really the convention in British English? The Squicks (talk) 19:29, 21 October 2009 (UTC)

The BBC style guide prefers per cent,[1] the Economist style guide recommends using %.[2] Pondle (talk) 22:46, 21 October 2009 (UTC)

Isn't % more common? The Squicks (talk) 03:28, 22 October 2009 (UTC)

I would say that % is most often used in column headings and maths classes and that "per cent" is mostly used in texts. The Economist may be a special case because although it is published in the UK most of its readers are in the U.S. The style preference of "The Economist" therefore probably follows the preferred style of its readership. I was taught that "per cent" was the proper way to express it though "percent" seems to have gained ground. Personally I do not get hung up about spelling styles. Its the meaning that is more important than the style. --Hauskalainen (talk) 10:59, 22 October 2009 (UTC)

unbalanced article

I've just come across this article for first time - seems to me that the Healthcare in England subsection is far too detailed when readers can just link to the main Healthcare in England article for more detail. I might try to shorten it a little bit in the time I have before I go to work. 86.155.54.63 (talk) 16:51, 23 October 2009 (UTC)

I've done a bit - got to go! 86.155.54.63 (talk) 17:04, 23 October 2009 (UTC)

This article has much too much detail about healthcare in England - most of this detail should be in the Healthcare in England article, with only a brief summary here. 217.44.32.110 (talk) 23:30, 3 November 2009 (UTC)

The Healthcare in England article needs some work and some of the material in this article would improve it. 86.155.54.6 (talk) 01:33, 4 November 2009 (UTC)

even more 'English' stuff now added!

An editor has just added a huge piece that details the history of healthcare in England - I removed it but was reverted, and I've therefore now moved it to under the healthcare in England section in this article. I still think it shouldn't be added as it makes the article very lopsided, mainly being about England. 86.157.201.31 (talk) 20:18, 10 December 2009 (UTC)

Ambulances

"Each public healthcare system also provides free ambulance services for emergencies,"

Not strictly true any more - there in a small but significant number of situations where you are billed for an ambulance. A major one is road traffic accidents where the person liable is billed (normally their motor insurance picks up the tab). Main article amended accordingly.BaseTurnComplete (talk) 14:34, 5 October 2010 (UTC)

The NHS article has the following text

Since January 2007, the NHS have been able to claim back the cost of treatment, and for ambulance services, for those who have been paid personal injury compensation.

So yes in that exceptional area you are right. --Hauskalainen (talk) 17:49, 5 October 2010 (UTC)

References

The problem with splitting the article into countries/NHS

Instead of one or two articles it's fragmented by country and NHS which has meant that there's two large english articles featuring content that applies in general and smaller articles which are empty and miss the general information. The NHS section in http://en.wikipedia.org/wiki/Healthcare_in_England could moved to http://en.wikipedia.org/wiki/National_Health_Service_(England) leaving a link and paragraph in the healthcare article. Health care in these articles looks to be limited to just the NHS and private but don't touch on other issue such as the rise of online pharmacies,legal issues,self treatment, or people abandoning the UK to be treated abroad etc.Pleasetry (talk) 14:09, 5 January 2012 (UTC)

Since there are 4 separate healthcare systems in the UK, it is sensible that there should be an article for each country. The UK article should be little more that a brief summary and link to those articles. There is bound to be overlap between 'health care in England' and the article about England's NHS as most healthcare in England is provided by it's NHS. Fishiehelper2 (talk) 14:23, 5 January 2012 (UTC)

Content to be relocated

The following material has been taken from the article Socialized medicine which now has a tighter focus on the political discussion in the US. The rest of the international material (Canada, Cuba, China, etc) from that article has been moved to Universal health care, which already includes a lot about the UK. The content below needs to be integrated either into the UK section there, or into Universal health coverage by country, or into this article about Healthcare in the United Kingdom, or incorporated into the specific articles such as Healthcare in England, Healthcare in Scotland etc. Whiteghost.ink (talk) 01:56, 28 January 2013 (UTC)

The National Insurance Act 1911 created a system of medical and unemployment insurance for all male workers of 16 years of age or older. The system, funded through four pennies per week from the employee, three from the employer and two from the government (Lloyd George's so-called "ninepence for fourpence") was at first received with some trepidation by the medical profession but was eventually seen to have been a generally good thing. In 1948 the system was extended to the entire population and a new service, the National Health Service or NHS was established. Today it is the world's largest publicly funded health service. It was set up on July 5, 1948 to "provide healthcare for all citizens, based on need, not the ability to pay." It is funded by the taxpayer and in England it is managed by a government department, the Department of Health, which sets overall policy on health issues which, for the English NHS, are summarised in the NHS Constitution for England. There are four separate health services for each of the three constituent nations (England, Scotland, and Wales) and one for Northern Ireland. In practice, they work closely together and provide a seamless service based on the same core principles.

The NHS is committed to providing quality care that meets the needs of everyone, is free at the point of need, and is based on a patient's clinical need, not their ability to pay.

Choice

Every person in the UK has the right to choose to register with any general physician of their choice practising in their area. If the GP has contracted to provide NHS services, as virtually all do, then all consultations with the GP will be free of charge to the patient. An NHS GP is usually not allowed to refuse to register a patient and patients usually choose to maintain a relationship with that GP over a long period in order to maintain continuity. All treatments are offered on the basis on the informed consent of the patient and, when a referral is made to a specialist at a hospital, the patient can choose which hospital to be referred to. A web site informs patients which NHS hospitals in their area offer the referred service and gives details of the quality, service indicators (such as number of procedures each year and percentage of successful outcomes) as well as details of the wait times (if any) for that service. NHS patients have a choice of providers, including at least one private provider, all of which receive the standard NHS fee for the standard NHS level of care. The patient can make the appointment themselves at home using the internet, or obtain assistance from the GP or his staff to make the booking. However, the patient cannot access medical services such as specialists without a referral from the GP.

Some people choose to be treated in private hospitals. Most private treatment options are at the patient's own expense, but sometimes the NHS may sub-contract work to a private operator, in which case the NHS offers to pay for care in a private facility. Patients who choose to go fully private for a particular health care episode must pay for it themselves (including the cost of follow up care and medications) or obtain funding from an insurance policy. An exception has been made for terminal cancer patients who can choose to receive care in both NHS and private settings simultaneously and use the NHS to pay for part of their drug cost themselves if the cost is above a threashold set by the NHS.

In a recent survey, ninety percent of NHS patients and ninety two percent of independent sector patients were able to get to the hospital of their choice for treatment or had no preference of hospital. Only seven percent of NHS and five per cent independent patients had been unable to get to their preferred hospital.

Funding

The estimated cost of the NHS in England (the most populous part of the United Kingdom) in 2008 is £91.7 billion. Funding for the NHS is met from general taxation. Healthcare entitlement is not dependent on a person's citizenship or taxation history but is instead offered to all legal residents. Temporary visitors such as tourists are only entitled to free emergency care, and will be charged by the NHS for all other services.

Quality

In an international comparative study of the health care systems in six countries (Australia, Canada, Germany, New Zealand and the United States), the British health care system was ranked in first place for quality of care. It also gained first rank position for equity and efficiency and a top place ranking for performance overall. Donald Berwick the American Professor of Health Policy and Management at the Harvard School of Public Health and who assisted in the modernization of the NHS begun by Tony Blair was particularly involved in the area of health quality. This was an area he admits that, at that time, he was a novice in, but acknowledged that "in the decade between about 1998 and 2008, the UK accumulated more knowledge and more expertise per capita than almost any other nation I know about how to improve healthcare as a system". He went on to say "In some ways the period between the publication of the Modernisation Plan for the NHS in 2000 and the third election of Tony Blair seems to me a golden era for the pursuit of improvement in the NHS. I daresay that no other country did quite so well at a national scale." Improved services are now being delivered closer to the patients' homes, reducing cost, improving quality, and providing a more convenient patient focused service. The life expectancy at age 65 in the UK is 17.2 years for males and 19.9 years for females, which is almost exactly the same as that for the U.S. (17.2 and 20.0 respectively). A global study of end of life care, conducted by the Economist Intelligence Unit, part of the group that publishes the Economist magazine, published the compared end of life care, ranked UK at the top of the 40 countries studied, receiving along with Australia a rating of 7.9 out of 10 in an analysis of access to services, quality of care and public awareness. The study also noted that "while palliative care is available through public medical insurance," in the U.S., "patients must relinquish curative treatments to be eligible for reimbursements," while in the UK, "both courses of treatment may be pursued" at the same time by patients.

Primary care

At the core of the service are the general practitioners (GPs or family doctors) who are responsible for the care of patients registered with them. GPs are mostly self-employed doctors that choose to contract with the NHS to provide services to patients commissioned by primary care trusts. Some have employment contracts with GP practices and a few are directly employed by the local primary care trust. Self-employed GPs have considerable freedom in the way that they choose to work. Most GPs are therefore paid a capitation fee and certain performance related payments. Patients are free to register with any GP in whose practice catchment area they live. NHS prescribed drugs are subsidized by the taxpayer, in some cases fully subsidized. For example if the person is being treated in medical setting or at home by an NHS medical professional, or if the person is under 18 or over retirement age, or if the patient lives in areas such as Scotland or Wales where the local NHS has decided to meet the cost of all drugs. All cancer drugs will be free of charge from April 2009. In England, people of working age usually pay a fixed price of £7.40 (or about US$11) for each prescribed drug collected from a retail pharmacy. The pharmacy invoices the cost of the drugs (less any fixed price patient contribution) to the NHS.

Hospitals

Only GPS (NHS or private) can refer their patients to a hospital (NHS or private) for acute care. Most patients choose to be treated in NHS run hospitals. Private hospitals mostly specialize in routine surgery and do not have the range of equipment that is available in NHS general hospitals. They do not, for example, provide Accident and Emergency services. In the event of an unforeseen emergency following surgery in a private hospital, a patient might be transferred to the nearest NHS emergency department, and then later moved back again. Some people therefore think it is safer to be in a public hospital for all but the most routine of surgeries. The quality of care in NHS hospitals is comparable to that in private hospitals and the services obtained (medicines, surgeons and other care workers, and even meals) are free of charge to the patient, whereas private hospitals bill for these. Ambulance services, mental health, and ancillary services such as physical and occupational therapy, in-home and in-clinic nursing is met from the NHS budget. GPs do not follow their patients into hospital but each patient is referred to a specialist employed by the hospital. On discharge, the home GP receives a report back of the treatment(s) given and the results with recommendations for any follow up actions to be taken.

Electronic records

Most doctors and hospitals already keep electronic patient records, but a wide ranging IT upgrade programme is in progress to integrate these systems. Most patients in England can use Choose and Book to arrange their own hospital appointments electronically (either aided at the GP office or elsewhere via the Internet), choosing a hospital and time to suit their needs and some can already access their Summary Care Records electronically. The English NHS was the first G8 country to fully implement a digital Picture Archiving Communications System (PACS) to store and retrieve x-ray and other scans in all of its hospitals nationally.

Future IT developments are primarily about integration synergies, such as data sharing, such as electronic prescriptions (direct to the pharmacy) and quality management recording. Patients can choose to have their personal GP and hospital medical records mirrored centrally. In this way their complete medical history will be fully available at any hospital or doctor's office in the country at any time.

Waiting times

• GP appointments - 41 per cent of UK patients reported being able to get a same day appointment with their GP, with 13 per cent reporting having to wait 6 days or more (2004 data).
• Hospital referrals - For hospital treatment, a timer for Referral to Treatment (RTT) starts running when a GP first agrees to refer a patient to the hospital. A number of steps then typically follow. RTT is often referred to in the press and in politics as "waiting time" but much of the time is dedicated to necessary intermediate steps before treatment can begin. The first hospital appointment must be booked; all tests completed; a diagnosis made; a follow up appointment made (if necessary) to discuss treatment options and obtain consent; an appointment made for inpatient treatment (if appropriate); or the patient prioritized to a waiting list (if there is waiting list for that procedure - only about one third of hospital admissions are from a waiting list). At some point, hospital treatment commences, at which point the RTT clock stops. The hospitals are targeted to complete these steps within 18 weeks. The 18 week RTT targets is met for 90% of patients in England found to need admission (and 95% for those for whom outpatient treatment was sufficient). Two thirds of patients needing a hospital admission experience RTTs of under 12 weeks.

The RTT system was introduced because of faults with the previous wait time recording system. For instance the wait times were sometimes overstated because some patients with multiple health problems made it unwise to treat them. Some may have been grossly overweight and the delay in treating them was more due to the time needed for them to slim down to improve their likely outcome. On the other hand, there were accusations that to meet wait time targets, physicians in some hospital may have been holding back placing patients in true need onto the waiting list, or delaying doing so by calling for more tests, thus making the wait times shorter than they really were. Sometimes patients put off medical procedures for their own reasons (a holiday perhaps, or perhaps until after a family event such as a wedding). For these reasons the government now uses the RTT method of calculation, which allows clock stopping (in the case that the patient could not be treated immediately for on ongoing health reason) or deducting the time if the patient's own choice from a list available admission dates was longer than the first available admission date. The RTT method also prevents the massaging of wait times through tactical behaviours. The effect has been that hospitals have had to become more focused on fixing the causes of delays and ensuring that diagnostic test times are as short as possible. Effective wait times have been drastically reduced, even allowing for the fact that RTT times now include time—such as for diagnostics testing—that was not included in previous statistics.

There is a maximum four-hour wait for treatment in accident and emergency. Patients are triaged and treated according to clinical priority so that those requiring emergency life saving treatment are treated immediately.

The latest patient survey data compares satisfaction levels regarding wait times in NHS and independent (private) sector care. Seventy nine percent of NHS patients were either very satisfied or fairly satisfied with wait times to see a specialist, compared to eighty seven percent of independent sector patients.

Other statistics

NHS hospitals in England carried out almost 13 million inpatient admissions in the NHS reporting year 2006/07. Of these admissions 36% were emergencies, 13% had been deferred for medical or social reasons and 35% were admitted from a waiting list. 15% were admitted for other reasons (such as maternity care or childbirth. 99.6% of hospital admissions took place on time as planned. Only 0.02% of all planned admissions were cancelled and not subsequently admitted within the following 28 days. Performance data for all hospitals for all common procedures (such as number of similar operations per year, clinical and patient ratings, wait times, re-admission rate) are publicly available on-line at the main NHS web site.

There is popular support for the NHS. The Healthcare Commission also undertakes regular surveys of patients' opinions of the NHS. In its most recent survey (2007), the experience of hospitals in England was rated by inpatients as follows: excellent (42%), very good (35%), good(14%), fair (6%) and poor (2%).

Internal Linking

The wikilink to 'publicly funded healthcare system' in the first sentence of the first paragraph directs the Socialised Health Care article within Wikipedia. This is a political term of use only in the United States currently, which disambiguates to the more global article on Universal health care. It is more encyclopedic to link first to the latter and then readers may go on to the former if they're interested in the health care debate in the US. I have corrected this. JDnCoke (talk) 14:46, 2 November 2013 (UTC)

References

The skyrocketing costs

The UK increase in costs was a deliberate policy action by the Blair Admininstration to bring UK spending close to Euro average.

(a)The UK's increase in costs is more than the increase by other European nations. I's even higher than the United States!

(b)If this context is being neglected, than why on earth would the solution to that problem be censoring the article? Add the context to the rest of the information. The Squicks (talk) 22:14, 27 August 2009 (UTC)

I added This has occured due to a policy of greater spending in the Labour Party's platform for the context, although I cannot find a ref for the statement. Can Islander Wikipedians help? The Squicks (talk) 22:20, 27 August 2009 (UTC)

I am an islander and the Blair policy was to rectify the starvation of the NHS by the conservatives over the years from 1979-1997. At the end of the Thatcher/Major era British spending was then about 5.7 per cent of GDP. All that Blair did was to bring spending on health up to about 8 per cent which is a tad BELOW the European average. The way the article has been edited makes it sound like costs have gone out of control e.g. "through the roof". If you think that taking it to 8 per cent of GDP is "through the roof" where is U.S. spending right now? On Mars maybe?

In fact the spending was mostly planned and was made clear to the electorate before the election. It was a policy that the British public voted for in droves. The first Blair administration had the highest landslide victory in parliament since the war (when the population voted against churchill and voted for the creation of a welfare state (which ultimately included the NHS).

The edit you have made is politiking because it seeks to imply that UK spending is out of control, which, in the broad scheme of things, it is not. --Hauskalainen (talk) 16:59, 28 August 2009 (UTC)

If you think that taking it to 8 per cent of GDP is "through the roof" where is U.S. spending right now? On Mars maybe? Actually, the increase by the U.K. is- as the original ref pointed out- greater than that for the U.S.

Thank you for finding the references, although I wish that you had brought those up in the first place instead of you insisting that other people should just take your word for it. The Squicks (talk) 19:02, 28 August 2009 (UTC)

Much of the increasing costs of the NHS is due to it being used as political football over the preceding forty years, the Conservatives attempting to sabotage the service in order to allow it to get to the point where the service is so poor they can abolish it.

When speaking of the 'skyrocketing costs' of the NHS one should bear in mind the following.

• one of the biggest costs for the NHS is for drugs and pharmaceuticals. Throughout its history the NHS - which is the world's largest single purchaser of drugs - negotiated bulk prices for medical supplies that kept costs much lower than if they had had to pay the going market rate. Mrs Thatcher ended this in the 1980s, she thought the NHS should pay full prices. This greatly increased the cost of the NHS to the taxpayer.

• throughout the Cold War the NHS maintained numerous hospitals thought necessary should war break out which would be needed to treat the large numbers of civilian casualties anticipated. In the 1990s after the Fall of the Berlin Wall many of these were closed, and the costs eliminated - a result of the so-called 'peace dividend'. This closure of hospitals was vast, and probably amounted to around a third of all UK NHS hospitals being closed. These hospitals had all been bought and paid-for by the UK taxpayer many years previously. In many cases the land was then sold for redevelopment. Despite the growing numbers of elderly today the excuse that they are an increasing drain on the NHS is absurd when you consider the cost reductions produced by these closures and the revenue that should have been obtained from the sales of the land.

• the introduction of the 'internal market' is absolutely at variance with the ethos around-which the NHS was founded. This has raised costs astronomically, and is one of the reasons why you cannot get an MRI or CAT scan after hours. Previously the scanner operators were flexible on hours and some departments were open til late in the evening. Now they have to account for costs and shuffle paper around such that administrative staff have now doubled or trebled in numbers. These staff - no doubt admirable in their own way - do not contribute one iota to patient care.

• I won't mention the cleaning of hospitals, as the majority of the unfortunates now having to carry out this task are no doubt subcontracted and on the minimum wage, and have probably taken enough undeserved criticism. Simply to say that UK hospitals prior to this had their own cleaning staff and the hospitals were clean and smelled predominately of disinfectant.

There is plenty of money available via general taxation for the NHS provided it is spent wisely and the point is that prior to comparatively recently it was. The NHS just needs to be back in the hands of politicians who care, and who know more than the price of everything, and the value of nothing. Otherwise you'll get the NHS you deserve - and politicians who can afford to go private and don't give a damn what the rest of us get. The result of having these people running things should by now be obvious.

BTW, before she became a full-time politician Mrs Thatcher was a chemist by training. — Preceding unsigned comment added by 2.24.216.123 (talk) 10:23, 16 June 2014 (UTC)

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Prescription Prepayment Certificate

It seems, from the NHSBSA website, that purchasers will no longer get a tangible certificate; but there appears to be no easy way of telling what one might actually get without paying for the service. Certainly a very non-indigenous friend has a Prescription Prepayment card; but it seems that a pharmacy would not accept it recently. Someone who knows should consider updating that part of the Article. 94.30.84.71 (talk) 13:13, 12 November 2018 (UTC)

Statements re: UK quality of healthcare and rankings

An anonymous editor has made changes to this article that clearly seem to be subjective in nature, not supported by fact (or without proper disclaimers), and not relevant to the topic at hand. The editor is making two claims overall: 1) That despite other UK healthcare system quality reports, the UK's healthcare system cancer survival rates rank the lowest in Europe; 2) The Commonwealth Fund's reporting of first-world nation healthcare systems is flawed and emphasized too heavily in the article.

Starting with #1 above, the editor relies upon a science blog from the Cancer Research UK Organization website. The editor presents the information in such a way as to imply that the low cancer survival performance is based on objective and equal data from all of Europe - This is not true. The blog itself states clearly that there is a "large caveat" with regard to the rankings because the data used to generate the ranking was not based on the same set of data as used for the rest of Europe. This is a HUGE distinction. Further, the editor neglects to mention that the data used is at least 7 years old - a huge amount of time when discussing something like cancer mortality.

Moving to #2, the primary reason stated for the edits is that the article places "too much emphasis" on published reports from The Commonwealth Fund including it's most recent rankings from 2014. This claim is hard to justify given that the report is referenced just one time in the entire article (excluding the references section) which happens to be the same emphasis placed upon the World Health Organization yet the editor seems to not be concerned about emphasis there. Next, the editor states that the CommonWealth Fund report in question does not focus on patient outcomes apparently thinking that only reports focussing on patient outcomes are relevant to the article. Again, this claim is hard to justify - it should be self-evident to any reasonable person that any and all reliable reports focussing on a given topic are relevant to that topic. The Commonwealth report in question discusses research that the organization performed regarding the overall quality of healthcare systems in the top-11 first world nations. This is a factual statement and it is up to the reader - NOT THE EDITORS - to decide if the data contained in that report is accurate. Our job as editors is to put forth objective factual content (the report makes X claim) and not to censor content according to balance (the report is over-emphasized and therefore should be mitigated) nor to spin the content to put forth a given subjective opinion (the report is inaccurate because a phone was used).

Finally, the editor states in the article that the Commonwealth report was done via a telephone survey yet fails to document where he\she discovered this insight. In searching the entire report, the word "telephone" is found exactly two times and in both instances, it is referencing the patient's experience in terms of having their questions answered via telephone on the same day that they called. This is starkly different from the actual data being collected via telephone. And all this aside, the fact that a telephone may have been used for data-gathering is not at all relevant and seems to be an attempt to undermine the validity\quality of the Commonwealth report.

If there is relevant objective factual data supporting the claims made by the editor (i.e. the Commonwealth report is flawed, cancer survival rates in the UK are low when measured equally, etc), then that should definitely be included BUT ONLY when including the proper disclaimers as outlined above.Aleding (talk) 19:13, 21 October 2014 (UTC)

Agreed. The anon IP seems to be pushing an unsupported viewpoint that certainly shouldn't be in the lead paragraph. Nick Cooper (talk) 09:48, 22 October 2014 (UTC)

This article needs flagging for biased content - painting one of the worse developed healthcare systems in the world as one of the best. It's run by doctors for doctors and it shows. Evidence of this shouldn't come from a *commonwealth* funded study, but by looking at median cancer survival statistics, the UK's lowering mean life expectancy, and the number of full time doctors available per citizen. Djp~enwiki (talk) 21:03, 15 January 2021 (UTC)