UK Petition to maintain healthcare reciprocal arrangements.

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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby flyeogh » Thu Sep 01, 2016 12:05 pm

Well in 6 days less than 200 more signatures. Looks like a dead duck.

I wonder if someone launched a sensible balanced petition there might be a better response? Might be worth a try if it invited potential EU people who may want in the future to be, or who already are, based in the UK to support it.

Even though I do not agree with the petition I am surprised that it didn't do better based on the number of expat pensioners living in the non UK EU.
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby ChrisM » Thu Sep 01, 2016 5:33 pm

GerryinCajiz wrote:
peteroldracer wrote:Until the Tories find a PM with cojones there will not be a politician in parliament that would dare tackle the mess that is the NHS. Laudable though their aim is, they stop any reforms to move it towards living within its means.


I manage a large GP surgery. Living within it's means?! There is no other business model in the world predicated on an unconstrained demand side (unfettered patient access) set against a constrained supply side (budgets). This is compounded by a huge demand created by lifestyle issues e.g. obesity = type 2 diabetes, strokes/heart attacks, diabetic amputations etc etc, plus skyrocketing pharmaceutical costs as medicines become 'smarter' yet more expensive to produce.

Funding per patient has fallen 7% in real terms in just under four years, despite the fact primary care takes 90% of NHS patient contacts. In addition, our net margin will fall by 37% by April 2020.

GP numbers will fall by 1/3 within 4 years based on current demographic data. Yet they're insisting on 7 day access.

The maths don't add up.

The system is unravelling and until these issues are addressed head on, the NHS as we knew it will cease to exit within 10 years at the very outside.

Living within means cuts both ways.
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby flyeogh » Thu Sep 01, 2016 7:04 pm

Well said ChrisM :thumbup:
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby TorreDelAguila » Thu Sep 01, 2016 9:35 pm

Chris, that is indeed an appalling but likely prospect. I understand the point you make about the mismatch between supply-side and demand.

One could be forgiven for thinking that the Tories, behind closed doors, are not totally unhappy with the situation.
If left unresolved, modern and effective health care will become a commodity only available for the rich.

The push towards "7-day hospital service" (which is actually there already), is only accelerating the problem, and even the statistics which Hunt and others have used have been seriously questioned. Medical training is being starved of funds and numbers, and students now expected to pay yet more.

The private health providers and big pharma are rubbing their hands with glee at the prospect of all this. Their lobbying of selected politicians over many years is now paying off handsomely. Escalating drug costs, which are extraordinarily high in the UK, need to be seriously examined. Just look at the retail (non-prescription) prices of drugs in Spain, for example.

There is absolutely no sign that the present Tory government will change direction on all this. J.Hunt is left in post, while patently incompetent, and obviously prefers to stoke a constant battle with junior doctors (he's chosen not to take on the consultants, so far), rather than achieve a productive outcome. I guess he's under instructions in this matter.

It is becoming increasingly difficult to take the words of current senior politicians, T.May in particular, at face value. Speeches and actions just do not match up. The recent referendum has now been roundly condemned by a detailed report, highlighting how the population was comprehensively misled by politicians on both sides who were willing to say absolutely anything to achieve their ends.

So, all this being the case, when assurances are delivered that 'The NHS is safe in our hands', 'We are committed to raising standards' (Education), 'We are narrowing the gap between rich and poor', 'Our aim is to equip consumers with the best possible choices' (energy costs) . . . . . . We now know that all this is simply, absolutely, untrue.

It will take some radical rethinking and public education to turn this around. The current Tory government will do its best to make sure this doesn't happen.
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby flyeogh » Fri Sep 02, 2016 9:04 am

TorreDelAguila can go along with most of that but it is not the fault of the tories that there is no sensible and organised opposition. And without such I think the gloomy predicitions of Chris and yourself may well come true.

But just a thought on the drug companies. These companies have helped push life expectancy and quality of life to extremes in my life time. And many of us, directly or indirectly share in the profits they make (if not as shareholders through pension/investment funds and via the tax they pay and the employment they create. I do think that while many things could be improved, including transparency and ownership, that they are often seen as an easy target.
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby TorreDelAguila » Fri Sep 02, 2016 11:02 am

You are right about the need for an organised and sensible opposition. It has never been needed more. In its absence, the gates are wide open for a damaging agenda. The press and BBC are under attack from right-wing groups (Trump too), and we've never needed a vigilant media more now either.

Agree on the drug companies: clinical advances have been impressive, but their eye is also firmly on corporate profits. Their use of tax havens is rife. Several years ago, one UK pharma company was claiming multimillion pound payments (against UK tax) to a South Amercian company, for the use of its own registered drug labels/names, which it had sold to them earlier. The SA company was set up and operated by the drug company in question! I have not heard that the arrangement has been stopped.

There is also the question, healthwise as well as ethical, about drug dependency. Nothing would suit the companies more than to have a sizable proportion of the population taking its product daily, for the rest of their lives. I have not noticed the food industry being criticised by pharma as part of its "relentless drive towards improved health".

A similar agenda is pursued by the agro-chemical industry (pretty much the same folk as pharma). The aim is product dependence. Even Countryfile is now reporting on this.

I'm all for improved health, but there are other agendas at work, too, which need watching.
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby flyeogh » Sun Sep 04, 2016 8:29 am

This might be of interest within the context of this thread. http://www.elconfidencial.com/espana/an ... s_1254792/

In particular I noted: Con todo, el sistema público sigue siendo muy demandado en los jubilados extranjeros como los 80.000 británicos que residen en Andalucía. En Reino Unido tienen que pagar sus medicinas. Aquí se les regala a los pensionistas. Susana Díaz ya advirtió que tras el Brexit la sanidad andaluza dejará de ser gratis para los residentes británicos. Entre las 120.730 asistencias a pacientes extranjeros desplazados temporalmente a la Comunidad andaluza en 2015, el 48% procedía del Reino Unido.

However, the public system is still much in demand by foreign retirees with 80,000 Britons residing in Andalusia. In the United Kingdom they have to pay for their medicines. Here we give them to the pensioners. Susana Díaz has warned that after the Brexit the Andalusian health will no longer be free to British residents. Of the 120.730 foreign patients in the Andalusian region in 2015, 48% came from the United Kingdom.

First I believe it is a good example of miss information. "En Reino Unido tienen que pagar sus medicinas.". In the UK very few retired pay for medicenes, if any. Even my Spanish wife, who is no where near retirement age, when resident in the UK received her medecines free as they were regularly prescribed (2015). Her medicenes cost far more in Spain than they did in the UK.

But if you read the article (those who read spanish, sorry haven't time to translate it) it raises some interesting concerns. Makes you wonder if the withdrawal of a collapsing health service here (in Andalucia) will be of any great concern to many.
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bigal
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby bigal » Sun Sep 04, 2016 11:13 am

"Aquí se les regala a los pensionistas" (Here we give them to the pensioners).

Not true, recently we had to pay for medicines on prescription for my wife who is retired, as am I.
More scaremongering, methinks.

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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby El Cid » Sun Sep 04, 2016 11:24 am

They are also getting confused between residents and holidaymakers using EHIC. They talk about reimbursement from the UK, but that only applies to the latter. Pensioner residents are paid for under a reciprocal arrangement, in advance on an annual basis with a payment that does not reflect on the services used (it's around €3000pa).

In another article they talk about having to renegotiate the residents deal after Brexit, either with the whole of the EU or on a bilateral arrangement which seems more likely as it can be done very quickly.

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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby Lavanda » Mon Sep 05, 2016 12:14 pm

The news yesterday was that obese people and smokers were going to be denied routine NHS surgery in the UK. I didn't read the detail as it was in the Daily Mail and sure to be waffle but, what happens when one day the NHS does limit its provision to selected groups? I supposed our response will depend on where we fall in the groups. I'm not a smoker but it was once calculated that smokers pay enough in taxes on tobacco every year to keep the NHS solvent.

The NHS was never set up to cope with vanity surgery, body enhancements and gender adjustments. nor was it set up for endless fertility options for people who already have families. Nor was it supposed to pay huge salaries to managers, followed by golden handshakes and pensions between successive NHS appointments.

Root and branch salary and pension caps for every person that works across the public sector is long overdue. If a manager cannot manage on £100,00 a year then perhaps they should not be in the public sector but go and work for a bank instead? There is HUGE waste across the entire system but no one wants to tackle the problem. It seems that politicians would rather see the whole thing collapse rather than take action. In any case action would require teams and teams of very expensive people spending years and years investigating the NHS and putting forward proposals for reform. Think how much all that would cost. I feel quite pessimistic.

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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby Miro » Mon Sep 05, 2016 12:39 pm

It would be very interesting to know exactly how much the Spanish system receives from the UK for resident pensioners, compared to how much it costs to administer to them. I wonder if such a figure is even possible to work out. The article mentions a very vague approx. figure of €10m to cover treating around 60,000 Brits, which would mean an average of €166k per Brit treated - many of whom probably had a stubbed toe! (I'm not actually sure from the article if these figures refer to payments for resident Brits or reimbursements under the EHIC). How many British pensioners return to the UK before or when serious illness looms? Does the current system give Spain a net gain or loss? Does anyone really know? Anyway, it's clear to me that all those who sing the praises of the Spanish health system and slag off the NHS, don't read the Spanish press! I've fortunately never had a bad experience with either country's health service (not that any encounter with hospitals can be deemed "good"!) so I'll reserve my judgement.
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby El Cid » Mon Sep 05, 2016 1:01 pm

The UK government subsidise pensioner healthcare across the EU. The calculation is a simple one. Take the total cost of the individual country's healthcare bill and divide it by the total population of that country. That gives a per capita figure which is paid for each and every pensioner who has submitted an S1 or E121 form (including dependants).

In the case of Spain that figure is approx €3500 pa.

As for any other treatment given to other Brits, usually via the EHIC, the actual cost is charged to the UK and any costs incurred by Spaniards in the UK is deducted and a net figure paid to the country with a positive balance. Of course, the UK usually ends up with a big bill purely because they do not seem to make charges that they are entitled to make.

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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby Miro » Mon Sep 05, 2016 1:55 pm

I understand that simple calculation gives an average cost of providing healthcare to the total population, but that doesn't answer the question of how much it costs, for example, Spain, to treat British pensioners. I would imagine pensioners in general cost more than the average, younger people less - so, it would be reasonable to assume that it costs more for Spain to treat it's foreign pensioners than it receives from their home countries. But I doubt it's that simple.
Just out of interest, I wonder what the per capita figure for the NHS is?
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby Lavanda » Mon Sep 05, 2016 2:06 pm

If it helps, Miro, the bill to care for my OH five years ago was over €120,000 give or take a few centimos. A more interesting comparison might be the cost of, I.e. a liver transplant in both countries, a course of antibiotics, a flu jab, a mammogram, etc. I think it's the cost-efficiency and value-for-money that is also a factor. Fat lot of good the UK paying X per Brit if all that could be got for that is four aspirins.

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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby flyeogh » Mon Sep 05, 2016 7:19 pm

My concern when looking at costs is that very soon you spend 10 million Euros to discover there is an error of 5 million Euros. I don't actually think any detailed analysis is necessary. If one side thinks it is missing out because all the brits in spain are old and all the spanish in the UK are young just get an independent board to make an adjustment. Money should be spent on healthcare and not administration where ever possible IMHO. It's a win win :)

For one thing the old Brits are spending in Spain and sending VAT to the Spanish government. The spaniards in the UK are benefitting from lower UK taxes and often sending money home. It is just too complex to untangle in any confident way. So let's do it the cheapest way. As Miro said "But I doubt it's that simple." and it certainly isn't.

I note still no one can be bothered to do a sensible balanced petition on petition.parliament.uk. Odd when so many offer such strong views :wink:
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Re: UK Petition to maintain healthcare reciprocal arrangements.

Postby El Cid » Mon Sep 05, 2016 7:25 pm

flyeogh wrote: If one side thinks it is missing out because all the brits in spain are old and all the spanish in the UK are young just get an independent board to make an adjustment.


The reciprocal annual payment only covers pensioners, so there is no difference as they are all over 65.

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