5th December 2016
Save our NHS, but how?
I had a very interesting discussion over the weekend with a Labour party activist, campaigning under a specially erected party tent in the centre of my hometown, Wokingham.
I was asked if I would sign a petition to support more funding for the NHS and a very interesting discussion ensued.
The female activist was a bit younger than me and was a teacher. She was passionate about the NHS and was of the view that the NHS needed so much more money.
I agree, but having seen in my 65 years how the NHS has evolved, something, in fact most things with the NHS and its management and funding is seriously broken.
The NHS was launched on July 5th 1948 by the then Labour health minister Aneurin Bevan It was based on three core principles:
- that it meet the needs of everyone
- that it be free at the point of delivery
- that it be based on clinical need, not ability to pay
Please note these, and especially those words in the last one around clinical need and the ability to pay.
To most a visit to your GP, a ride in an ambulance to A&E and the ensuing care after an accident or sudden serious illness are rightly considered to be FOC, funded by our taxes.
But we live in a very different world to that of 1948. Health service provisions are more sophisticated, peoples health needs have become very entitlement based indeed and as a result are far more expensive.
For example, in 1948, the following were not available treatments on the NHS:
- Heart and lung transplants
- Liver and kidney transplants
- Gender re-assignment
- IVF
- Womb transplants
- Breast enhancement and reduction
- Tattoo removal
- Critical illness busting treatments such as cancer
- HIV prevention
- Intelligent prosthetics
Whilst many in the UK would cling to the 1948 core principles, the fiscal fuel for delivery of healthcare requires a charging rethink, especially as so much of the NHS service delivery in 2016 is driven more by a clinical want than a clinical need.
Not everything is free anymore in the NHS. With some exceptions we pay for dental care starting at £19.70 prescriptions starting at £8.40 and eye care, excluding contact lenses.
Surely the time has come to apply notional charges for GP visits and non-emergency NHS services that are not currently subject to charges in line with the dental model.
But will politicians be brave enough to change the funding model from all taxation to an element of pay on delivery?
Just a thought
Comments (2)
From personal experience I can vouch (as I know can many others) that the NHS is not even a shadow of its former self.
More often than not a visit to the GP is cursory and time constrained. The ethos is that everything can be fixed with a pill and then the pill prescribed is the cheapest (and not always the best) option. That is of course if you can actually get through on the phone to make an appointment and then if you can actually get one in the same month.
What a difference from (say) 30 years ago!
Being treated in an NHS hospital is now little removed from the old workhouse. Those of us fortunate to have PMI would rather give up almost anything as long as we can afford the premiums. The difference between private treatment and the NHS is just a different world.
Go to France, Germany or Italy and you pay a nominal amount to see a GP. (In France it was €10) and what a difference! A proper examination and no time constraints. You can ring up (as I did) at 14.30 and see the doctor at 16.00 and on time too! Spanish hospitals make our NHS establishments look like slums. Indeed even in Mauritius the hospital was of a better standard. (Visits on holidays for relatively minor incidents).
Unless you are on benefits, a child or a student what is wrong with paying (say) £10 for a GP appointment? (Missed appointments are charged double). When in hospital what is so awful if you pay (say) £2 per day against the cost of food? You eat when you are not in hospital and you are not supposed to be ‘quids in’ if you are in hospital.
The obese and smokers should have to pay a significant contribution for any treatment associated with their self-imposed condition. Anyone playing a sport should have to take compulsory insurance so that sports injuries can be paid for. Those being treated on Friday and Saturday nights (or after football) for drunkenness and affray should meet the full cost of any treatment. And of course before any treatment at all your NHS number has to be presented and verified.
This quasi-religious fervour that the NHS attracts should now be confined to history. As you so rightly said this is not 1948 and the stiff upper lip has since sagged considerably.
Harry Katz 06/12/2016 11:18
Health Spending 2016
% of GDP/Doctors per 1,000/Hospital Beds Per 1,000
UK 9.1%/2.8/2.9
Italy 9.2%/3.8/3.4
Germany 11.3%/3.9/8.2
France 11.5%/3.2/6.4
Spain 9.0%/4.9/3.1
Harry Katz 06/12/2016 11:37
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