‘Socialist’ NHS best healthcare system in the world

I am not quite sure, but I don't think the US typically has a body equivalent to N.I.C.E so perhaps business has an upper hand where insurance companies 'rule' ...

 

N.I.C.E.


What is it and what do they do responsibility wise for the UK?

 

The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care.

http://www.nice.org.uk/

NICE publishes guidelines in four areas. The use of health technologies within the NHS (such as the use of new and existing medicines, treatments and procedures), clinical practice (guidance on the appropriate treatment and care of people with specific diseases and conditions), guidance for public sector workers on health promotion and ill-health avoidance, and guidance for social care services and users.These appraisals are based primarily on evaluations of efficacy and cost–effectiveness in various circumstances.

NICE was established in an attempt to defuse the so-called postcode lottery of healthcare in England and Wales, where treatments that were available depended upon the NHS Health Authority area in which the patient happened to live, but it has since acquired a high reputation internationally as a role model for the development of clinical guidelines. One aspect of this is the explicit determination of cost–benefit boundaries for certain technologies that it assesses. NICE also plays an important role in pioneering technology assessment in other healthcare systems through NICE International, established in May 2008 to help cultivate links with foreign governments.

 

Do they hold any legislative or enforcement/executive power as a government agency of the UK?


The closest thing the USA has is the FDA, and US Health Department and the Surgeon General.

But they just release general health advice, and are somewhat bought off.

 

The NHS is legally obliged to provide funding for medicines and treatments recommended by NICE's technology appraisal board.

http://www.scribd.com/mobile/doc/8737637?width=600#fullscreen

In the United Kingdom, non-departmental public body (NDPB) is a classification applied by the Cabinet Office, Treasury, the Scottish Government and the Northern Ireland Executive to quangos (quasi-autonomous non-governmental organisations). NDPBs are not an integral part of any government department and carry out their work at arm's length from ministers, although ministers are ultimately responsible to Parliament for the activities of bodies sponsored by their department.

The term includes the four types of NDPB (executive, advisory, tribunal and independent monitoring boards) but excludes public corporations, National Health Service (NHS) bodies and public broadcasters (BBC, Channel 4 and S4C).

http://en.m.wikipedia.org/wiki/Non-departmental_public_body

In the UK the competent authority is the Medicines and Healthcare products Regulatory Agency (MHRA), an executive agency of the Department of Health.

http://www.mhra.gov.uk/index.htm

 

Yeah that's the closest USA comparison.


The UK's relationship between NICE and NHS, is more legally binding than anything the USA has.

In that sense it's very different and there is no national standard or organization that adheres to what treatments and healthcare products are offered/sold.


There are regulations yes, but they fluctuate based on enforcement, various Congressional laws/acts that are passed and repealed, or interpreted by our court system.

So yeah not as binding , and is much more piecemeal, on a case by case basis.

 

I'm disappointed Japan isn't on the list. They would be first.

 

I dont know much about japan's health system, is it a single payer system?

 

Yep, and they ban profits for insurance companies. As a result healthcare is half as expensive compare to the U.S.

 

Japan's main problems are these 5 things:

1. Cultural shame preventing people from pointing out problems to the corporate and business hierarchy.

2. Overworking workers past the point of exhaustion and into death.

3. An extremely low birth rate

4. Inflation

5. Radiation poisoning a good chunk of their fishing industry, land and therefore their economy.


Healthcare system will be tested in Japan because of all those issues.

 

We'll see. Right now they're way better than us.

 

Monkjr...

No. 1 seems a little too much of a stereotype

No. 2 sounds faintly ridiculous

Not sure about No. 3 Funding/future taxes?

No. 4 is possible

No. 5 erm, "according to a report, drafted last year but only recently finalized by the U.N., “The doses to the general public, both those incurred during the first year and estimated for their lifetimes, are generally low or very low. No discernible increased incidence of radiation-related health effects are expected among exposed members of the public or their descendants. The most important health effect is on mental and social well-being, related to the enormous impact of the earthquake, tsunami and nuclear accident, and the fear and stigma related to the perceived risk of exposure to ionizing radiation. Effects such as depression and post-traumatic stress symptoms have already been reported.”




http://www.forbes.com/sites/jamesconca/2014/05/04/cancer-and-death-by-radiation-not-from-fukushima/

 

Did any particular reforms lead to this new ranking?

From what I've been reading on the NHS over the years they seem to have issues related to funding and long wait times.

BBC News - Wales NHS waiting times highest in two years, figures show

 

I was just gonna say "if 11th is last then yes...." because I saw the study too (reprinted in Time).

But yes, about the US... your point? Everyone with a brain knows the healthcare system sucks in this country. People just disagree with how to fix it.

Get rid of chargemaster!!!!!!

 

Why reform the NHS?
Every government has sought with varying degrees of seriousness and success to reform the NHS. New Labour is no exception. It came to power in 1997 promising to overturn the Conservatives' internal market structure, vowing to replace it with a more collaborative, quality-based approach. However, its failure during its first term to radically cut waiting lists and drive up performance has led it to reconsider its approach, believing that without radical change and demonstrable improvement the public will walk away from the NHS. Labour is now pushing towards a more market-orientated strategy: a patient choice-led approach to hospital funding, the removal of ideological barriers preventing the use of private health providers to carry out NHS work, and the devolution of management and budgetary control from Whitehall to local NHS organisations. As the health secretary, Alan Milburn, put it in a speech in April 2003: "We've got to move on from the one size fits all, take it or leave it, top-down health service of the 1940s towards an NHS which embraces devolution, diversity and choice."


Prime Minister Tony Blair has launched a reform programme for the NHS in England that he believes will once again make it “the healthcare system the world most envies.”

The plan proposes changes to consultants' and GPs' contracts; promises more doctors and nurses; sets targets for waiting times for treatment; recommends a concordat between the NHS and the private sector; and aims to reduce inequalities.

Tony Blair criticised consultants' and GPs' contracts, which he said were “outdated and inflexible.” The government has ruled out “buying out” consultants in private practice, which it estimated would cost at least £700m ($1050m). Instead, newly qualified consultants will be contracted to work exclusively for the NHS for “perhaps the first seven years” of their career, providing eight fixed sessions and more of the out of hours service.

The right to undertake private practice will depend on fulfilling job plans and NHS service requirements. If agreement cannot be reached on these changes the government says that it will consider introducing a new specialist grade for newly qualified hospital specialists. In addition, all existing consultants will have to work seven fixed sessions a week.

Distinction awards and discretionary points, which provide £170m a year in superannuable bonus payments for senior doctors, will be merged into a single, more graduated scheme with increased funding. This will enable more awards to be made and ensure that most new awards go to consultants who are making the biggest contribution to the NHS.

GPs will be encouraged to move on to personal medical contracts, which will reward them on the basis of quality of care as well as numbers of patients. The government expects to see an increase in the number of salaried GPs. The prime minister said, “This will be the most significant change to the way GPs operate since 1948 and can literally transform primary care in this country.”

More doctors, more nurses
In March the government announced a real terms increase in spending on the NHS of over 6.3% The plan shows that over the next five years the extra money should provide 7500 more consultants, a rise of 30%; 1000 more specialist registrars; 2000 extra GPs and 450 more trainees; 1000 more medical training places each year, on top of the 1000 already announced; more than 20000 extra qualified nurses; and 6500 more therapists and other health professionals.

There will be 7000 more beds in hospitals and intermediate care and 100 new hospital schemes in the next 10 years. The government plans to modernise 3000 GP premises by 2004 and open 500 new one-stop primary care centres.

By 2005 the maximum waiting time for outpatients will be three months and for inpatients six months. No one should be waiting more than four hours in accident and emergency departments by 2004.

By the end of 2005, waiting lists for hospital appointments and admissions will be abolished and replaced with booking systems designed to give patients a choice of a convenient time within a guaranteed maximum waiting time.

By the end of this year NHS Direct, the 24 hour telephone helpline, will cover the whole of England, and by 2004 a single phone call to NHS Direct will be a one-stop gateway to out of hours care, with calls being passed on, where necessary, to the appropriate GP cooperative or deputising service. Also by 2004 all patients should be able to see a GP within 48 hours.

By 2004 most NHS staff will be working under agreed protocols identifying how common conditions should be handled and which staff can best handle them. The government believes this will help to remove the demarcations that have held back staff and slowed down care.

Bigger role for nurses
By 2001 around 23000 nurses will be able to prescribe a limited range of medicines, and by 2004 a majority of nurses should be able to prescribe, working to protocols authorised by a doctor and a pharmacist.

The public consultation called for a “modern matron figure” in hospitals, and ward sisters or charge nurses will be given authority to resolve clinical issues. By April 2002 every hospital will have senior sisters and charge nurses who are easily identifiable to patients and will be accountable for a group of wards. By 2004 there will be around 1000 nurse consultants in the NHS.

The NHS Plan: A Plan for Investment, a Plan for Reform is available from the Stationery Office, price £15, and is at www.nhs.uk/nhsplan






http://www.bmj.com/content/321/7257/317.1


http://www.theguardian.com/society/2003/may/07/health.theissuesexplained



What does the NHS plan promise to do?
Lots. The 143-page document establishes a set a "core principles" for the NHS. These reaffirm the NHS traditions of free access to services on the basis of clinical need, funded by the state. They also enshrine commitments to:
· improved standards of care and an end to the "postcode lottery" of care;
· more investment in staff development;
· increased partnership working between the NHS and social care;
· and a renewed commitment to improving the health of the nation.

All of this through an ambitious "modernisation" programme involving the recruitment of thousands more nurses, doctors and other health professionals, and hundreds of millions of pounds of investment in new hospitals, GP surgeries, and medical equipment.

What has happened since the NHS plan was published?
The independent inquiry into the Bristol children's heart surgery scandal in July 2001 made several recommendations about patient involvement and healthcare regulation which have been adopted by the government. In the same month, ministers set out their detailed plans to take forward the NHS plan and devolve resources to local level in a document Shifting the Balance of Power - Securing Delivery. The Wanless report into the future funding of the NHS, published in April 2002, provided the intellectual underpinning for the government's decision to invest an extra £40bn in the NHS between 2003 and 2008. As the government refined its plans in 2002, its proposals for foundation hospitals, and for a new system of financing hospitals (called financial flows) emerged.

 

I can't find the original documentary I watched to support #2, but I can provide this link to say the problem does exist.


https://www.youtube.com/watch?v=6kdzPOp6yik"]Meet Shiho Fukada: Japan's Poor, Homeless, Outcasted and Forgotten Workers - YouTube

 

I think 'waiting times' will always be an issue to those within the media and politicians.
It's a soft target.
If the figures are not exactly the same in one January than another January then obviously the NHS is in crisis.
It is also complicated when they compare NHS Wales with NHS with NHS England - which have the added factor of Wales being governed by Labour and England not by Labour...
Complicated even further that 'waiting times' are separated into approx' 3000 categories (ok, maybe a little bit of an exaggeration)
So, at some time somewhere a certain waiting time target isn't being met.



https://www.gov.uk/devolution-of-powers-to-scotland-wales-and-northern-ireland

 

I understand where you are coming from.
What about the other 4?

 

Well #3 is easily checkable if you lookup Japan's birthdate or how many children each couple is having.

Mathematically most couples are stopping at 1 child , so there's a decline in youth.

Combine that with the high suicide rates, of which have been a stereotype, but no less originating from a real problem.


The other #'s I can't support at this time. I have to go and find the name of that documentary I watched as it cited that among the developed nations Japan's happiness and life satisfactory levels were the lowest.

 

This is a little bit alarming. Maybe it's right, maybe not. Time will tell.

http://www.bbc.co.uk/news/health-28235850