Is the NHS fit for purpose?

The NHS seems to have accepted the fact that it is no longer the self-proclaimed ‘envy of the World – but now the struggle is on to make it ‘fit for purpose

Whilst we were still in the EU, Minister of Health Andrew Lansley, was asked why the NHS wasn’t taking advantage of strong European ties to learn from its superior health services?  “It’s not the NHS way” was the reply – and that was that.

During the pandemic we were told we had to protect the NHS.  Why?.  Surely a national health service is there to protect the health of the people, not vice versa?

Now, when things surely should be getting back to near-normal, there is a massive backlog of cases, yet there doesn’t seem to be any desire to produce a nation-wide strategy to clear these. Covid is still produced as an excuse for this, but no-one has produced concrete evidence to say if this is really so.

Camilla Tominey writes in the Torygraph “Lest we forget that in the last quarter of 2020 the mean age of those with Covid was estimated to be 82.4 years, while the risk of dying of it if you were under 60 was less than 0.5%  Who wouldn’t take those odds compared to being diagnosed with cancer”

The horrendous numbers of ‘extra’ mortalities “aren’t just statistics – they are people’s husbands, wives, fathers, mothers, brothers, sisters, daughters and sons.  The appalling truth is that a lot of these people would probably still be here today were it not for lockdown… ,

Will the next Prime Minister do anything effective about the NHS?

Or will it be business as usual?  As the  Torygraph’s Leader Comment pointed out “the next Prime Minister will face an urgent question:  what to do about the bureaucratic inertia, the compulsive blame-shifting and the institutional arrogance of the bodies that are meant to be running the NHS on our behalf”. He/She will announce, with a massive fanfare, that they are allocating X amount of extra funds to the NHS (which will boil down to a robbing-Peter-to-pay -Paul scenario).  And, a bit like the promise of ’40 new hospitals’, we will find out actually it is 3 – not 40.  Or something similar.

Why do we need a ‘Minister’ for Health?

A solution might be first to get rid of politicians and put clinicians in charge.  Bring back Matrons for a start (I mean proper Matrons whose job was to run a hospital). A few of the brilliant ones I have known will soon sweep away the army of administrators blocking the efficient running of any hospital.  And I can’t imagine a proper Matron allowing some of the dubious contracts awarded to suppliers, such as loo-roll manufacturers, for a start.  You’d see Matron in the local shops buying loo rolls on special offer if she thought her hospital was being overcharged.

The NHS never was “the envy of the world”.

At its beginning in 1948 Health Ministers, doctors etc. from other countries came to see how the NHS was going to work; in those days the NHS genuinely was ‘the envy of the world’.

In the 1950s I spent over a year in NHS establishments being treated for polio, and every Friday my eminent surgeon’s ward round would be joined by several doctors from abroad;  all sent by their health service (and paying for the privilege) to see what it was all about.

Today, not one country has copied us.

In most countries the State pays out for health care, funded by taxation, but they manage the funding more efficiently in most parts. and don’t scorn private sector involvement.  In most countries you will get basic care, but can opt for tailored insurance packages which cost extra, but might give you a private room, etc.

What happens today?
John Szeremy, a journalist friend who lived in Brussels, tells me ….”Everyone has to have medical insurance – which paid over a lifetime does not come to much, which enables everyone to go to whatever doctor he or she likes.   You usually get a booking pretty quickly to see the doctor – normally this is the following day, except in an emergency, when he/she will see you that very day.
“Yes, one pays him at the end of the consultation or treatment, and one reclaims the cost from the insurance.  The percentage you get back depends on the insurance scheme to which you subscribe…..
“Also the doctors or GPs are far more efficient in Belgium.  Whenever I went to the doctor, he immediately gave me a basic examination – heartbeat, blood pressure, etc., irrespective of what I came to see him about.  (Here, the doctors do not bother to examine patients;  they just talk to them and then prescribe a medicine.   My doctor in Dorridge did not bother to see me for four years after I went onto his list, except for once at the beginning when he asked me a lot of questions.
“Here it is nearly impossible to see a doctor.  The surgery has a rule that patients must phone at 8 a.m. if they have a problem or need to see a doctor.  There is usually a long wait to get through and speak to someone, but if one rings off and tries later, the receptionist says no appointments can be made, except if one phones at 8.  Calls during the day do not result in appointments to see the doctor or to get a message through to him.  I think the point is to avoid the doctor having to see or speak to troublesome patients.  (In Belgium one can phone the doctor at any time.  He listens to your problem and either makes a suggestion of what the patient should do or gives him an appointment to see him within 24 hours.)”
“The only thing they do well here is to automatically renew prescriptions – of course without examining the patient – and writing to a patient if he or she needs a blood test or some other regular examination”.
One thing about the Belgium system stands out for me – if you are wealthy, you probably can’t be bothered to claim for every visit to the GP, so the State makes extra income. Crafty!