h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

The NHS as it stands is a bottomless pit and it is therefore impossible to fund. Therefore the simple answer is to put a bottom into the pit. Someone needs to draw a line and say what is and isn't covered (just like a regular insurance policy). Then it would be possible to work out how much money needs to be thrown into the pit and everyone would know exactly where they stand.

The NHS is fundamentally a superb idea but the way in which it is working currently is not so good. It is not fair for example that a particular operation is available on the NHS if you live in one particular Healthcare area but move next door into the next area and it's not. The system needs to be fair.

The system can never be perfectly fair. The treatments offered at any given hospital depend on the number, quality and specialisation of staff (who are workers the same as everyone else with the same priorities) and the equipment. I personally don't think you should pay for dentistry or drugs, because that still excludes people.

Yes the treatments offered at each individual hospital will be different but patients will go for treatment at an appropriate hospital. Whilst I agree that nothing can ever be totally fair, things could definitely be a lot fairer than they are at the moment. As an example if you live in an area where there is a large percentage of elderly people you are likely to have to wait longer for a hip replacement than if you live in an area where there aren't so many elderly people. That is not fair and would be fairer if waiting lists for minor operations of this kind were central.

On the NHS we do not pay for drugs, we pay a flat rate tax (the prescription charge) on each item, the vast majority of which cost vastly more than the charge. I disagree with this charge and suspect it actually costs more money than it generates, but it is part of the NHS which is fair.

The current government are introducing more regional specialist centres in the NHS which aims to achieve what you are talking about. It makes sense at one level that where there are a number of hospitals all providing the same range of treatments badly that they split the range between them all and deliver a smaller range better.

Where this is done and travel is a problem it will shift the costs of the NHS around and increase the transport costs. I live in North Wales and the policy might mean that someone elderly in Tywyn (pronounced toe-in (apologies to all you Welsh speakers)) in the West might have to travel over 100 miles for treatment.

More importantly in relation to bottomless pits I believe that there needs to be some rationalisation of policy towards expectations. People expect far more from the public sector that it can realistically provide and if people don't want to pay more taxes then they need to have some sense of proportion and stop demanding the moon and stars without accepting any personal responsibility.

turvy