Good Idea or Dangerous?

Cliff

A Video link is a good idea if it does reduce waiting room appointments.

If it is true that many of the appointments are unnecessary or time wasters, then a charge should be introduced. We already pay for prescriptions so the service is not totally free now. It should be a nominal charge, (£10?)  with the aim to reduce the appointment time.
It would also take the pressure off A&E which has become the first port of call if you need to see a doctor the same day.

Pacifico

theres been a walk-in GP service at victoria Station for about 10 years now - used to be 30 quid a visit.

Jezza99

Oh sure, yeah you have always been able to see a private GP for 100 quid or so, this is a bit different due to only costing 29 quid. I think they can keep the cost down because the appt is limited to 10 minutes, and they are using NHS GPs who are doing private work in their spare time.

GadgetObsessed

As far as I can tell there is not much evidence that immigration is putting much additional load on the NHS as a whole. An extra 300,000 people a year would mean that the population is increasing by less than 0.5% per year.

The main issue for the NHS in terms of increasing demand is the rapidly aging population. There is a strong correlation between age and NHS use. So if the population ages by 1% that will have a much more significant impact than the population increasing by 1%.

Also immigrants have a lower average use of the NHS than the existing population. This isn't anything to do with immigrants being any healthier than the existing population - it simply reflects that immigrants are generally young.

Of course there will be more localised effects of immigration as immigration will be higher in some areas than others. Also there is a disproportionate effect on NHS services more commonly used by the young - such as paediatric and obstetrics services.

So if you want to control the rising demand for NHS services the main focus should be on an aging population than immigration. Although the only real solution for a rapidly aging population (in terms of reducing the average age) is to encourage people to have more children - or to encourage immigration.

Jezza99

I'm sure that will come as a great comfort to people who have to wait two weeks for a GPs appointment, and then sit in the waiting room listening to multiple foreign languages being spoken. Must be a figment of their imagination.

GadgetObsessed

I am not saying that such anecdotes are a figment of their imagination. However, anyone thinking that the main cause of extra strain on the NHS is immigration is not basing their assumption on the available evidence.

For example here is a chart covering relative NHS expenditure by age. An average 85 year old costs the NHS 5.5 times as mucha s the avergae 30 year old.

                                                                                 

And from the Office for National Statistics data I cans see that the percentage of people that have made it to at least 85 (i.e. did not die before they were 85) has grown as follows:

1965 - 11.1%
1975 - 13.9%
1985 - 16.7%
1995 - 23.8%
2005 - 28.5%
2015 - 36.3%

So in that 50 year period the number of people making it to 85 has more than trebbled. If you look at 90 year olds then the picture is even more extreme, with 6 times as many people making it to 90 compared to 50 years earlier.

Issues with the aging population for the NHS are compounded by the fall in the numbers of the elderly being provided with care by their local council - leaving the NHS to pick up the burden.

(A personal anecdote so not statistically relevant but an eye opener for me. I have visited a couple of people in A&E departments recently and was shocked that nearly all the beds were filled not with people with accute injuries/health problems as I expected, but instead with very frail elderly people. Some of them appeared to have mental health issues such as dementia or were at least very confused.)

If you really want to reduce the strain on the NHS then your focus should be on improving council run care for the elderly and not on reducing immigration.

The impacts on the NHS of immigration are rather complex. More people coming into the country will mean more people for the NHS to treat. However, it also means a greater overall size of the economy to provide tax revenue for the government to provide funding for the NHS in the first place.

On the tax front, migrants on average earn more per-hour than UK born workers. (From the Characteristics and outcomes of migrants in the uk labour market 2017 - Oxford University.) This is probably related to migrants having higher rates of the highest rate of educational level than UK born workers. At the same time migrants have higher levels of unemployment. (Actually, male migrants are slightly more likely to be in work than UK born people but employment rates among female migrants are significantly lower than for UK born people.) Migrants also have higher levels of workers in low paid jobs such as nursing. (The NHS employs a large number of migrants.) This indicates that migrants have a more diverse income spread than UK born workers i.e. more at the top and bottom and fewer in the middle.

Combine this income information with migrants average lower use of the NHS (simply because they are generally younger than UK workers) and it is very difficult to draw any strong conclusions on the overall impact of migrants on the NHS.

Jezza99

Must be due to all those Baristas, care workers, fruit pickers and Big Issue sellers.

I think most people have already drawn their own conclusions. And expressed it in the Brexit vote.

EarthRod

Excellent.

Life expectancy has increased. Wonderful news

GadgetObsessed

It certainly is.

Unfortunately, many people get too stuck on the potential negatives - longer period of poor health at the end of life, lower annuity rates for pensions, more demand for the NHS, increase in cancer rates as heart disease used to be the biggest killer and cancer second - reducing heart disease significantly, from 914 per 1000,000 in 1979 to 275 in 2013 meant a corresponding rise in cancer as we all die of something in the end, etc. etc... To some people every silver lining has a cloud.

Jezza99

I can agree with you on that. They are normally remain voters.