Improving Healthcare In 2005

Contrary to its cheerleaders’ increasingly desperate claims, Britain’s National Health Service is not the envy of the world. Evidence enough for this proposition is in the number of British people who choose (and pay twice over to exercise that choice) to have private healthcare. Many others choose to go abroad for their treatment.

On the other hand we manage to provide “free” healthcare for every person who comes into this country with an acute medical condition, whether or not they have contributed in any way to the NHS. That is the nature of a system that is “free to all at the point of delivery”.

Sadly, with human nature as it is, people do not properly value that which is provided “free”. In spite of this I detect that many British people increasingly feel cheated that after a lifetime of paying into the system they get short-changed when they would like to see some return for their money.

A great sadness for this country is the way that many of our brightest and best people are not being attracted to work in the medical profession as they have been in decades past. Similarly many of our best medical technicians are taking their skills abroad for better pay and conditions. What is to be done about it? Few seem to accept the reality that the NHS is a financial black hole and that funding is not at the root of all the medical problems in this country.

There are too many anecdotes from around the country for us not to realise that cleanliness in hospitals has been a major problem; NHS dentistry especially here in London is virtually a thing of the past and patients wilfully misuse doctor’s appointments because there is no fee for turning up and no penalty for not turning up. None of these issues really concern investment but clearly many continue to believe that money and money alone is the answer.

My contention is that it is not. Big is not always beautiful and medical care is at its best when carried out by motivated professionals who take a pride in what they do and receive the respect their efforts and expertise are due.

Take one example of the new developments in the NHS. Far fewer GPs are now able to offer a service which will see patients out of hours. So these patients present themselves at the local hospital’s Accident and Emergency (A&E) Department. The impact of that on the local health economy is immense. The cost to the taxpayer of each GP consultation has been calculated at £17. By contrast, each A&E attendance is estimated to cost £77. Throughout the country A&E attendances continue to rise while the policy of the NHS is to close many of them and rationalise. This clearly makes no sense.

I believe we should allow the medical professionals to make the key decisions about patient care. Equally consultants must take responsibility in our hospitals – they cannot throw up their hands and complain about political interference or administrative meddling. If they want control of their day-to day professional lives, they must also manage budgets properly: once again the fallacy of “healthcare being free” works against the best interests of patients. Nursing must once more be regarded as a caring profession, not simply an element of the public sector workforce.

This country should have a heathcare system which will benefit all who live here. Choice will be an important factor. Patients have the right to clean and safe hospitals. But patients also need to act responsibility towards their own health and towards the professionals in the medical world. No one should be allowed to misuse GP surgery appointments and similarly all our medical care establishments, both within and outside the NHS, should concentrate on rebuilding the public’s confedence in hygiene standards which were once taken for granted.