17 2 mins 15 yrs

nhs23bt.gifWe all know just how GREAT the National Health Service is, right? With £££billions poured into its gaping maw each year, it is proclaimed as the "envy of the world" by politicians holding a straight face! So, comes the news in the Mail on Sunday that record numbers of Britons are travelling abroad for medical treatment to escape the NHS – with 70,000 patients expected to fly out this year. And by the end of the decade 200,000 "health tourists" will fly as far as Malaysa and South Africa for major surgery to avoid long waiting lists and the rising threat of superbugs, according to a new report.

You see the problem, don’t you? The NHS is increasingly seen by those who need to use it as either too dangerous or too inefficient to use. That’s a shame given the huge sums thrown into this neo-Stalinist structure by successive governments, and in particular by Gordon Brown. The problem is that the NHS is disconnected from the needs of patients and the best efforts of medics because of interfering target-obsessed politicians. That’s why it is structurally dysfunctional and best avoided.  

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17 thoughts on “OUR BRILLIANT NHS…

  1. Just how much longer can the NHS as presently constructed survive? Labour, as we know, always gravitates towards the concept of ‘Big is Best’ although the consequencies of size mitigate against flexibility and innovation. The development of large regional centres also health care away from the patient and destroys the sense of ‘ownership’ evident in many communities.

    Health care can be thought of in the following way – low cost procedures/high demand, high cost procedures/high demand, low cost procedures/low demand and high cost procedures/low demand. To me, it appears reasonable for present district general hospitals to be able to deal with all demands made upon them unless they fall into the high cost/low demand category and to do this such hospitals do not to be overlarge regional centres. Regional centres need however, to be there to deal with high cost procedures/low demand situations where a regional response is appropriate.

    This categorisation of medical conditions is not the be all and end all. Clinical evaluation i.e. can the patient wait for treatment, is it reasonable to exspect the patient to travel, do we have the clinical expertise available and so on must also be taken into consideration but all this can be done without concentrating the majority of hospital services in ivory palaces removed from the patient.

    The NHS is suffering at the moment with bureaucratic strangulation. This must be a priority target (I am learning the jargon) but not in the same way that the government means by targeting. Hospitals cannot function effectively in the current top down bureaucratic nightmare. The present tendency or urge to merge with other health care trusts is not the way forward. Smaller can be beautiful. In health care the true measure of efficiency and effectivenes still revolves around patient outcomes rather than cost alone.

  2. Whilst we fail to call politicians on measuring quality and success by input rather than output, nothing will change.

  3. French system: simple, universal, quality choice and bot free at the point of need..the best there is!

    Interesting to learn that Michael Moores Sicko got praise on Fox News.

  4. Alison,

    Todays snippet from your beloved BBC… ‘The French health system is broke, and services are to be restricted, or curtailed’.

    Don’t blame me! – it was on thsi a.m. news….

  5. I’m sure the French system (ie, the level of care, quality of service, cleanliness of hospitals) is probably much better than ours, Alison. It’s probably worth pointing out though, that it does come at a price:
    UK: Employees’ National Insurance 11% / Employers NI 12.8%.
    France: (equivalent of NI): Employees (approx) 20%, Employers (approx) 40%.
    So, in the UK, the cost to the business-owner of employing someone on £25K is their salary plus £2500. In France the cost is the salary plus £8500. (Starting bands are slightly different, not possible to do an exact comparison).
    This MUST have an economic effect in terms of large companies choosing where to locate their premises, in Europe.
    Having said that, if it’s working, it’s working.

  6. Ernest
    I read it and laughed. I had to ask what letters we had missed! Name me a system that isnt

    Yes we underfund and the result is plainly obvious. All health services will come at a price and all are underfunded and struggling. But would i pay for it? Yup because yes its working. And no im not sure it does re companies since large (and small) companies here now offer private healthcare here as a benefit.

  7. A recent Business Week article Ernest!:

    [B]oth data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems. Take Susan M., a 54-year-old human resources executive in New York City. She faithfully makes an appointment for a mammogram every April, knowing the wait will be at least six weeks. She went in for her routine screening at the end of May, then had another because the first wasn’t clear. That second X-ray showed an abnormality, and the doctor wanted to perform a needle biopsy, an outpatient procedure. His first available date: mid-August

    47% of U.S. patients could get a same- or next-day appointment for a medical problem, worse than every other country except Canada.

    The Commonwealth survey did find that U.S. patients had the second-shortest wait times if they wished to see a specialist or have nonemergency surgery, such as a hip replacement or cataract operation (Germany, which has national health care, came in first on both measures). But Gerard F. Anderson, a health policy expert at Johns Hopkins University, says doctors in countries where there are lengthy queues for elective surgeries put at-risk patients on the list long before their need is critical. "Their wait might be uncomfortable, but it makes very little clinical difference,"

  8. Is underfunding the problem though? I’m not sure. We now pay record amounts (via taxes) into the NHS in real terms, yet the huge MRSA/C-diff infection rates were not this much of a problem back in the 60’s/70’s.
    I think mismanagement and too much state interference is the real problem. The NHS has become a huge political tool. As it is state-controlled and publicly funded, it has to be "seen" to be meeting all sorts of targets. It’s a vote-winner (or loser) and no political party has the courage to ever radically change it, for fear of accusations of scrapping it or whatever.
    I would favour privatising the NHS, but with certain regulations imposed by law upon the business-owners and financial backers. Just like say, the banking sector. Our banks are all private-sector global companies, but in the UK a bank must have a certain percentage of its working capital deposited with the Bank of England as a safety-net. No tin-pot trader can just start a bank up, willy-nilly.
    Why not sell the NHS off to the private sector, with certain conditions attached to all bidders (eg, they must have assets worth a certain minimum, they must pool a certain amount of their investment into a welfare fund so, that those who cannot afford private medical plans can still get an adequate basic level of emergency care, etc).

  9. We spend less than any other nation on healthcare and operate one of the cheapest systems in the world. Why not just for the French public private hybrid? Or the German hybrid system? All infinitely better than the US or UK models. The Germans have as much invested in new technology as the US also so they arent losing out there either. I think privatising the NHS would be a disaster. The idea that insurance firms making money, would be better is just plain odd to me. eg The differences – vast enough that "those in the top education and income level in the U.S. had similar rates of diabetes and heart disease as those in the bottom education and income level in Great Britain." That sort of a disaster.

  10. Alison, the example you quoted – I’m not sure I understand your point – what has that got to do with the performance of a health service? I thought the NHS (or any other foreign health service) existed to cure people’s illnesses, not to try and tell people how to live their lives so as to prevent those illnesses? What does it matter how many people from such-and-such a social class develop certain illnesses in certain countries? How is that the fault of their health service? For example, If I develop lung cancer then on the one hand I’ve got no-one but myself to blame, but on the other side of the coin, I ought to demand the top treatment off the NHS, as I’ve contributed £3 more per day to the treasury than non-smokers. I’m just saying, its none of the NHS’s business making any sort of distinction or comparison of why I get ill. The NHS is there to treat me, nothing more.

  11. What I’m saying is, at least in a private medical plan, they do the questionaires, take the tests, weigh up your lifestyle and quote you an individual premium based on your lifestyle and habits. Fair enough. But on the "one size fits all" NHS, it’s all supposed to be "free for all", yet they’re trying to impose restrictions on smokers etc, without allowing them to reduce their contributions via taxation. That’s not fair.

  12. Alison,

    Sorry, but I never mentioned the US health service. So why the lengthy ‘cut and paste’? – to prove you know how to do a search? Well done, – have a gold star, – you have now done what any pre-teen can do…

  13. Apologies Ernest – i realise it was Davids post that had this in there. It was late. No need to be so rude.

  14. Tom – The comparisons cited were from an American study not the NHS, if that is what you meant.
    Its related to the service provision and overall state of peoples health. Isnt that what the provision is supposed to be for whether private or ‘socialised’? If its failing on any level then that is not a good enough reason to switch to privatised healthcare. Why exchange one bunch of problems for another?

    The point of the French system is that it doesnt discriminate, it is not free at the point of need either. Like all othert systems it has to examine costs and efficiency. For them the issue is tied into the dispensation of medication. They hand out pills like theyre going out of fashion and given the expense it will be this area that sees more cost efficiency. They wont discriminate with peoples health. That said with the posts above it is very interesting to read the privatised american system has waiting lists on basic health care.

    Surely the idea is to establish which system of all the global, struggling and westernised health care systems best meets patients needs and is the most efficient – especially given the cost of medicine and the longer life expectancy. At the end of the day I shouldnt really care less. We are lucky enough to have access to the French system and its been a huge benefit to us, especially this year. But Id like to see a better debate on the subject though rather than see the NHS used as a political football to dismiss ‘socialised’ healthcare as a non starter. Instead of the lurch to one or the other, I think the hybrid option they have in place is smart and effective and full of choice and worth the review.

    Like a good "pre-teen" (? – i still dont get that, why bother commenting ona blog if you arent interested in the research and content Ernest), Ive just finished a post on comparisons with other health systems. Ill stick it up and we can have a look at the German, Canadian and Japanese also fwiw. Be interesting to get your input Tom.

  15. Alison,

    Well, if you will tread on my corn, – what do you expect! – it’s just as well I am gout free at the moment…

  16. Alison,

    Re the cut and paste posts. Fair enough to do the research, – to read and inwardly digest, but to just post large screeds from other sources doesn’t show much imagination, does it?

    Quote the sources, by all means, but your input should be your thoughts and ideas, not a consensus of web opinion.

    Sources are easily quoted, no need for masses of electronic bumpf – after all it your ideas that should be of interest to others….

    I agree with your take on DT and CL – reading a lot but not thinking a lot. I am sure you would not want to be tarred with the same brush.

  17. Alison,

    p.s. Re the Canadian system – total crap! which is why the savvy Canucks always go ‘south of the border’ for their essential medical needs…

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