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Can the NHS survive?

A report by NHS managers warns the health service will face the worst and most severe and sustained financial shortfall in its history after 2011. How should the NHS be funded?

The BBC has learned the NHS in England is facing a real-terms reduction of between £8 and 10bn in its budget over the three years after 2011.

The shortfall means a cut in staff numbers is unavoidable and it may be time for a cap on the budget for new drugs to be considered, the report adds.

Can the NHS survive unchanged? How can the NHS become efficient and save money? Does there need to be a cap on certain treatments and drugs? Do you work in the NHS?

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Published: Tuesday, 9 June, 2009, 21:33 GMT 22:33 UK

All comments as they come in

Added: Thursday, 11 June, 2009, 09:11 GMT 10:11 UK

I lived in Spain for 12 years and during that time I took ill and was given excellent treatment by the Spanish medical services but, like others, I was required to have what was called, an E111 form issued before emigrating. Tourists have this too and the ones coming here should be required to have them. The NHS had to pay for my treatment and free prescriptions in Spain.
Awesome Geronimo Leds

Awesome Geronimo, Leeds

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Added: Thursday, 11 June, 2009, 09:07 GMT 10:07 UK

It can if the control freaks allow the NHS to do what it is there for , treat patients. The Government treats it as some form of stats generation machine , so that it can make it look good. Less pen pushers , more front line.

Also please get people who know who to set up contracts. Many of the PFI contracts are ticking time bombs which will suck resources away into profit rather than patients. The doctors contract is another fine example of pen pushers who do not understand commercial matters

Chris Parker, Bucks

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Added: Thursday, 11 June, 2009, 09:04 GMT 10:04 UK

The NHS is facing cuts in real terms under Nu Labour. The Conservatives have announced that they would ring fence the NHS and maintain funding in real terms. It all depends on the next general election and how we vote.

[Confuciousfred], DEVON, United Kingdom

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Added: Thursday, 11 June, 2009, 09:04 GMT 10:04 UK

If we can't trust MPs of any party to do their expenses correctly, then why would we trust them to have the NHS working properly?

The NHS has to shed the jobs that the current government have created in order to fools us in to thinking that their is a buoyant jobs market, and I don't mean doctors, surgeons and nurses. Get rid of the tin pot managers who command high wages for achieving & maintaining nothing.

And don't forget - The government have another £70bn to print yet.

Rob Brideson, Salisbury, United Kingdom

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Added: Thursday, 11 June, 2009, 08:59 GMT 09:59 UK

Since our finances will not recover from the banking disaster until at least 2032 the NHS cannot escape from the consequences. Time to review all aspects of cost and concentrate on primary care. Like many others, I'd rather we spend on drugs and operational staff than management and IT. I pity the next Tory Government--they will suffer public anger for the cuts they will have to make to pay for Brown's disaster.

Ralph Cook, Barking, United Kingdom

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Added: Thursday, 11 June, 2009, 08:57 GMT 09:57 UK

The NHS is vital, it's loss would be a devastating blow to our country. Heaven help us if we end up with a system like the US where 40 million don't have healthcare coverage.

To survive, the NHS needs some tough love. Trim the fat, start a comprehensive review of each job to make sure we get value for money, sack the mangers whose job is pointless red tape and make sure we get the best deals from the companies that supply the NHS, perhaps even tax incentives for better deals.

[mars_central], Bedford, United Kingdom

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Added: Thursday, 11 June, 2009, 08:51 GMT 09:51 UK

Bring in regional pay scales so hospitals can pay the local going rate. That way, hospitals in the south east could recuit nurses instead of paying a premium for agency and south eastern nurses could enjoy a similar standard of life to those in (say) the north east.

[MarkGE], Witney, United Kingdom

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Added: Thursday, 11 June, 2009, 08:49 GMT 09:49 UK

It would help if the money spent on illegal wars was spent on the HHS instead and to subsidise other essential public services .and the money saved on the "expenses" of MPs diverted to essential services, too.
Awesome Geronimo Leeds

Awesome Geronimo, Leeds

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Added: Thursday, 11 June, 2009, 08:43 GMT 09:43 UK

Those who say the NHS is the envy of the world have been misled; I have worked overseas and in the UK with foreign ex pats and I have never heard any foreigner, even the most Anglophile, include the NHS among the things they envy most in the UK. Even colleagues from less developed countries don't envy the NHS - they envy countries with good healthcare arrangements.

[MarkGE], Witney, United Kingdom

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Added: Thursday, 11 June, 2009, 08:40 GMT 09:40 UK

"My sister works in a famous West London heart hospital; she used to work in credit control, " - I see your point, but "credit control"? wouldn't it be better if they'd employed nurses to look after patients instead - the NHS was never supposed to be a business!

[numenius], England, United Kingdom

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Added: Thursday, 11 June, 2009, 08:39 GMT 09:39 UK

I'd bet a lot of money that the staff cuts are nurses and health care folks, not clerks and managers. There are excellent front line staff being left struggling understaffed whilst admin sections are bulging at the seams. My wife as a nurse can be run to exhaustion yet 1 floor up there are *hundreds* of office staff who have thier allocated breaks etc whilst below theres 1 nurse & 2 health care assistants trying to look after 30+ very needy ill people. The money has been squandered!

[numenius], England, United Kingdom

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Added: Thursday, 11 June, 2009, 08:35 GMT 09:35 UK

Firstly, I wouldn't believe a word that the NHS managers said. When NuLab came to power there was one NHS manager to every 12 hospital beds, now the ratio is closer to 1:3. At a recent conference the NHS managers suggested they need more admin staff bringing the ratio to 1:1.

What we need is medical staff and NHS employed cleaning staff. That is the only way things will improve. Cut the number of managers back to pre 1995 levels and, hey presto, decent service at a lower cost!

K B, London, United Kingdom

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Added: Thursday, 11 June, 2009, 08:29 GMT 09:29 UK

Given that most new hospitals have been built using PFI we are going to be rooked by the banks and insurance companies for their running costs for years. That's why some PCTs are struggling given the massive guaranteed rates of return the civil servants have been mug enough to agree to.

Colin Shepherd, Farnham, United Kingdom

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Added: Thursday, 11 June, 2009, 08:24 GMT 09:24 UK

Yes, but stop allowing IVF on the NHS having a baby is not an automatic right. If they want one that much they will adopt one or pay for IVF.

Stop treating smokers on the NHS, if they are stupid enoguh to smoke knowing it causes them cancer I don't see why money should be wasted treating them when they'll probably carry on smoking anyway.

Stop treating obesity on the NHS, excercise costs nothing. If they are too lazy or greedy then why should the common man have to fork out for them?

Kevin

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Added: Thursday, 11 June, 2009, 08:08 GMT 09:08 UK

Reduce the managers and all this extra staff, who doesnt work at the bedside. Making some nursing policies simpler would reduce the number of required staff drastically. They should look into other European countries and see how effectively they manage their staffing needs.

Linda, London

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