You suggest that having been trained using public money, our doctors and nurses should, despite having their wages frozen/capped, should show a degree of loyalty.
However, loyalty cuts both ways and the relationship between employer and employee has to offer benefits to both sides.
Now, in terms of the NHS, its obvious to see where the benefits are to the employer but, stagnant wages impact negatively on the employee, so where is the loyalty or, should public servants just be "grateful" to have a job.
Also, the state trained staff will be the ones tending to your needs in your private clinic/hospital so, it's ok for them to be "disloyal" if it's helping you personally ???

More double standards ?

Finally, the shortage of "homegrown" doctors and nurses causes a "brain drain" in other countries but, again, this is ok as it's helping people in the UK ??

More double standards ?

How about having well trained staff, working in our NHS (and other local government departments) who feel valued and respected by their employer and those who use the service



Of course we need to try and reduce abuses within the system and there isn't a bottomless pit of cash to just grant pay rises willy nilly but, 7 years of frozen wages plus, no end in sight is taking the pi$$ and you know it.

I am sacrificing my disposable income to pay for health insurance. The double standard here I am paying twice for a service that I should be able to get through my NI contributions.

How have they had a wage freeze - they had two years of wage freeze - very typical of most people after the crash and then they had increases every year since. Do you expect them to receive above inflation increases within the whole public sector. 1% a year is not taking the pi$$ it is pretty normal in the private sector where definite salary increases are seldom written into to contractual arrangements.

Just throwing money at a problem is usually desperation and seldom yields positive long term benefits. There needs to be a debate about what we want from the NHS and huge drive to run it as efficiently as it can be and that includes modifying the behaviour of its patients. Once all that is done then see what the true cost of the NHS is and will guarantee you the monies it currently receives will be more than adequate.

Just think how much it has cost to manage the baby Leo case - the legal cost of defending the clinical expertise that has determined that child will have zero benefit in further treatment is this what the NHS is about. Think about how many cataract ops could be done for that money or meningitis jabs etc. The NHS cannot be all things to all people all the time.

Nice easy question for you.
After a 2 year pay freeze plus, 5 years with a 1% cap, in your opinion, how long is it reasonable to cap any pay increase at 1% ?

Regarding paying twice, that is your own personal choice and you wouldnt want/need to have additional cover if the NHS was equal in quality to your private scheme.
If you dont want to pay twice, then dont, it's your choice.

At a guess, your company will be paying this as a "perk" and you will only be getting "hit" for the "benefit in kind" taxation.

The pay freeze is not strictly true, many workers move up through pay bands as they gain more experience. Also they are paid for training ,if they then pass the relevant tests they are financially rewarded. A friend of mine started work 4 years ago as a trainee para medic. He his now gaining more experience year on year. His pay rates have been substantially higher than one per cent. As mentioned before workers in the private sector have seen pay rates cut, also substantial redundancies have taken place.
This situation is still unfolding. Every week some company or other goes bust. Meanwhile workers in the public sector are safe in the knowledge that they are in safe and relatively well paid jobs. Most decent pension schemes in the private sector have disappeared. The public sector still has excellent pension schemes. It's highly likely due to brexit that further job losses will occur in the private sector. Can't see this happening in the public sector.

I'm loathe to agree with you; but one area we can find some congruence is the burden that self-inflicted ailments puts on the NHS. Obesity, alcohol related shenanigans, smoking - all areas in which self-injurious lifestyle choices are mopped up by the NHS. The problem with that argument of course, is that it could easily be extended to injuries incurred doing sports and outdoor activities - broken legs from skiing trips, 5-a-side football sprains, falling off a horse etc. So the choice to withhold free treatment from people due to lifestyle choices is less simple than it appears.

I know that 999 and A&E are abused by some people - I question if that would reduce were more alternatives available - but I just don't know enough about the root cause to have a strong view.

With regard to your disdain for NHS staff - wake up and think bigger. I also have private health insurance through my company - and I recognise 2 things; firstly, the staff who treat me are trained in the NHS and secondly, when I've needed an actual procedure, it was carried out in an NHS hospital, and I was transferred back to the private one afterwards to recover in nicer surroundings, with better food.

I'm pleased about that; unfortunately, you did.

So, are you saying that the 1% cap should remain indefinitely ?

What happened to our "strong and stable" economy, with the fastest growth in the EU, was that just an exaggeration.
Also, Brexit is supposed to make Britain prosperous again, without "us" being shackled to the EU.
I think this was just a downright lie but, we're all begining to find out that this was just wishful thinking on a scale that makes Corbyn's ecconomics look understated.

Not sure how the UK will ever totally eliminate the deficit and provide any level of public service on the current trajectory. For example, lets say a care worker funded by the state is paid £10 an hour. As they are all 'out-sourced' the state funds an agency's mark up - let's say they pay the agency £12 per hour, making £2 state funded profit (ignoring other overheads as if the state provided the workers direct there would be overheads too - in fact almost certainly a lot less). So, the state pays £2 and the most it gets back in corporation tax is 20% of £2 or 40p. So, the deficit increases by £1.60 per hour worked. Which of course means the Tory government says we need as a country to tighten our belts further. With the current approach and without further tax rises, the only way to eliminate the deficit totally is to remove the welfare state, NHS, etc, etc completely which is of course their aim.

Although, in one sense, your theory may be on the right lines, the economy should still have some growth in it.
It's extremely defeatist for a capitalist economy to be contemplating stagnation and after all, with a growing population and with record numbers in work, a growing economy and utopia on the horizon following Brexit, we should be able to afford plenty (and that's without our £350 million a week that we will be getting back from the EU, which we could use to help the NHS

)
This is of course assuming that we haven't been sold a pup and surely the majority of the voting population, who bothered to vote, wouldn't have got it wrong, after all they're not thick and most of them had "researched" membership of the EU and decided that it wasn't the way forward.
I'm really upbeat and feel lucky to live in such an outward thinking country, arent you ?

The growing economic is . Small percentage rises in GDP are more or mess inevitable with a growing population but GDP per capita and productivity are falling meaning we are all getting poorer. When QE starts to unwind for real next year there is potential for a major shock. The mastermind being the Leave campaign and the £350m over week bus now thinks Brexit is a huge mistake!

That's one thing we can agree on, Brexit was stupid, no matter who had won the election it's going to be a dogs dinner!

In my view a guaranteed pay increase every year is reasonable - if 1% is what the system can afford then so be it.

So in your company I take it you give pay rises that the company cannot afford because you don't want your staff to be suffering against inflation?

The insurance is not a perk - if the company didn't pay it they would have to pay me more money that's the private sector for you. I only get a salary increase if certain agreed objectives are met by my team it is not a guarantee.

I said this numerous times on this thread the debate for me is not who gets what but what do we want from our NHS and how can we run it as efficiently as possible?

An example - 2 weeks ago a private company contracted to the NHS stored away a load of notes incorrectly. If these notes had been stored electronically you would have no need to outsource this work and you would save millions. This is just scratching the surface of what could be saved in the NHS. Perhaps if the clinical people were prepared to accept mistakes happen and learn from those mistakes hundreds of millions could be saved in legal fees etc.

Nobody on here seems inclined to debate the elephant in the room - what should the NHS offer?

In Norway one of the much mentioned social friendly countries if you want to see your GP its £200 so that a path we should be taking?

First of all, the staff that employ are paid well over the required minimum but, that's due to the size of the business and the fact that it's very well run and can afford to do so.
I dont have any kind of pay cap but, equally, I dont have an automatic year on year increase.

Most private health schemes tend to be given either as a makeweight for salary or, as a "perk", usually done to give employees "added value in their pay package" and usually, you wouldnt quite get the full difference if you were able to opt out but, everyone is different and maybe you actually would ?
It still doesnt change the fact that private health shouldn't be necessary if the NHS was just a little better, although, you would have to mix with the common man in an NHS hospital and that may not suit you.
Regarding waste within the NHS, of course there is plenty which could and should be improved .
In ANY organisation of that size, there will be areas which could be improved. Perhaps this is one of the reasons they employ so many managers ?
Also, the claims culture is huge within the NHS and some of the spurious claims that are made simply shouldn't be allowed.
Apart from the most serious cases of negligence, it's a pity that this culture can be stopped.
I guess we have America to thank for that.

We still come back to whether it's reasonable to cap increases in local government wages, to below than the level of inflation, indefinitely.

It's fundamentally wrong.

If your employer said that your own salary would reduce (in real terms) for the next 10 years, you would look to move on, I know that I would and this may just have an effect on the numbers wanting to join the medical profession, an area that we can not fill with UK trained staff !!

Why would you want rack up debt and train for several years to go into that profession/environment.

Except I've already tried to - I reluctantly agreed with part of your argument - and provided some counter to how it's not anywhere near as straightforward as you implied.

With regard to the pay of Dr's and nurses; if as you determinedly insist the problems with the NHS are due to inefficiency - is it their fault, and should they be penalised because of it? I'd suggest that there are probably hospital administrators, NHS England grandees and government ministers who should more reasonably carry the can for that, as they're in a better position to affect it. Was Jeremy Hunt's salary capped?

My absolute belief is that the NHS is struggling to cope because it is being systematically defunded, in preparation for a creeping privatisation; it's started already, with the likes of Branson and many companies with links to Tory MP's benefiting - and Mr Hunt quietly selling NHS buildings to private concerns. It won't affect me too much, but it would be a disaster for the majority of people if we end up with a US style system.

Private, insured healthcare in the UK amounts to getting a nicer room / hospital if you have a stay in hospital and getting seen quicker. The care itself is no better and usually worse eg tests not as well controlled, same doctors, even more time pressure to kick you out early. It's about convenience certainly not quality of care.

Yes, I know that and if, heaven forbid, something goes wrong, it's the NHS that pick up the pieces.
It just allows people who want to and who have plenty of brass or, a generous employer, to queue jump.
Some of them then have the audacity to pretend that they are doing the rest of us a favour



I'm not against private medicine necessarily but, if our health service worked just a little better, and was properly funded, nobody would need it.

It's time that health and education were sorted our on a cross party basis and take the politics out of such fundamental services but, sadly, that will never happen and instead we get a continuous political "measuring" contest.

It's time that collectively, we agreed just what should be expected from the NHS and then get on and deal with it.

The primary factor for me is I get to chose the consultant I want to do the 'work'. One I can research and guarantee a high level of competence and quality. In the NHS there are a lot of trainee Drs learning and that's not happening on my knees!

That is the point my wife was in agony with gall stones which the NHS were reluctant to treat - so I suggested I had private medical insurance it was done the following week by the surgeon of our choice in a private hospital.

The surgeon said after the op there was no way my wife should had suffered for as long she had - small price to pay in my view.

Not once on here has anyone suggested what they think the NHS should offer - so let's get everyone's opinion of what should be covered by NI contributions:

For me it should basic healthcare that maintains a reasonable state of being. It should definitely cover childbirth and free health for children up to 16 including dentistry.

What it shouldn't cover: IVF, gender re-assignment, very expensive cancer treatments, vanity treatments e.g. penis increases, breast augmentation, tummy tucks etc.

It's impossible to have a reasonable discussion with you, when you start from such a ridiculous position; I'm starting to suspect you're a troll. Forget I asked.

Not at all because I don't see things your way - so I ask again what should the NHS offer?

If you want to have a sensible discussion then put your opinions out there for all to read - it isn't difficult even for you

No - because your starting position is to consign people to a life of misery and mental health problems, or a slow painful death, because they don't have the money to fund their own treatment. You are proposing to break a fundamental social contract between the government and the citizens of the UK - and I can't engage with that level of cruelty; or wind up.

NHS ,someone once said it's the only religion we have left in this country. We can never really discuss in depth the problems in the NHS ,mainly because the Labour Party scream that the tories are privatising it. The tories then panic and carry on and the system worsens year on year.
If it's so good how come most of the devolped world have different systems. It's supposed to be a uniform system, yet I know people in Sheffield who have to wait 2 weeks for a doctors appointment. Yet in my semi rural area I can usually fix up an appointment the same day. Two of our friends ,ladies over sixty years of age have had knee replacements on the NHS but undertaken at a private hospital. Everything top class and successful, yet many politicians hate this type of system. Usually because the trade unions are against this system.
The only way for the NHS to improve is a mixture of state and private funding . Another failing of the NHS is this constant bleating that it's got to be free at the point of use. Let's face it not many things in life are free, somebody down the line is paying for it. That's certainly the case with the NHS.

The UKs total spend on education is apparently the highest in proportion to GDP of top 30 world economies. Something is obviously wrong with how the money is spent though.

It s not free. It is paid for by taxation. A much better way of funding than via insurance contracts which only some people can afford or which provide a burden on business and exclude anything complicatated or expensive.