So simplistic. Public sector debt has to shoot up without PFI and similar schemes let alone the COST to pay them out. GP cost rent was the first PFI which improved so many surgeries without adding to national debt.
Higher public debt means higher interest rates in the end, or use Labour's favoured scheme to print money, which is so last decade as a solution. In the end it leads to inflation, as shown clearly in Hitchiker's Guide to the Galaxy, so we all pay. Printing money only worked recently because everyone else was in recession, the inflation was in capital costs as in house prices to the delight of the chattering classes.
It wont work again.
There is so much other waste in the NHS to deal with.
You are too pessimistic about chronic pain. It can be resolved, providing the brain's pathways to phase out unpleasant sensations are not blocked by the junk medication. The medication locks people in to permanent pain. Reduce to stop the meds, some CBT and MOVEMENT will rid most people of pain. Those with pure dependency are using these drugs for other effects, nowt to do with pain. Pain that they have to declare to be offered a script.
It is not so much that they are addictive, its that they do not work in the long term. Have you noticed that those with chronic pain are on chronic medication? The medications locks the patients into permanent pain, and give hyperathesia. It blocks the brain from phasing out the pain, a process that must happen in normal people who have avoided such meds. If we look at MRI of people complaining of nothing, their backs look just as terrible as those in agony.
A very useful precedent. I am employed by at a prison whose contract is run by an NHS Trust. They have not confirmed that we are covered by NHS indemnity, which we should be.
What upsets me is the double standards. They should have closed down most London Prison healthcare services. The standards in most local London prisons are orders of magnitude worse than any GP practice I have been to as a locum. I am not sure why CQC accepts the difficulties and excuses in prison and problems there, which are clearly not tolerated in General practice.
Yes. Huge problem in prisons and I suspect they have the same paradoxical aggression effect that benzo's have. Its not just the spice in prison giving us problems but the disinhibition caused by the prescribed gapapentinoids. Back pain is not a licensed indication for these drugs, and nobody on methadone should be offered it. Too risky and its not being used for pain. The pains are hyperasthesia from heroin use.
No, what is needed is the concept of top up. As in Australia, most NHS services are free. The important stuff for the NATIONAL HEALTH, after that the more expensive contraceptives for example, some procedures you pay for or top up the NHS subsidy.
Currently in the UK top-up is regarded as immoral by the standards of the 1940s, at that time it made sense that the limited offering of medicine should be free to all. Now patients understand choice and medicine is not absolute. That with limited evidence or poor value for the health of the nationals should be subject to top-up. No political party could every suggest this. Political suicide... but it is necessary.