Rationing is already here Professor, it’s just covert. A health service designed by slogans…

Letters in the Times 11th January, including one from Prof. Sidney Lowry in Co. Down, show the anger, disillusion, disengagement,  of the current Health Service staff. The unreality of the politics is emphasised, and just like flooding, we have a choice. We can do flood repairs and abatement schemes, spending lots of money on short term measures of dubious benefit, or we can look at the cause and prevention. Upland planting, reinvention of meanders, and more hedging and riverside planting is akin to training medical students and nurses. The rewards take longer than one term in office, they win no votes in our system, but they are the appropriate solution. This is why Norman Lamb is right… but Prof Lowry exposes the inevitability of decline. The doctors strike may be a way to get the longer term issues discussed, but in a media led society who focusses on slogans and simplistic language, I am not hopeful…

Sir, The NHS has been a victim of its own success. The demographic change has increased the numbers of frail elderly patients. Expectations have been raised unrealistically by the remarkable scientific advances, from penicillin to DNA. There is also a sense of entitlement. We pay taxes and we want value for our money.

There is another factor: the commercial promotion of a culture of health anxiety, and the pursuit of health at any cost. This week yet another US study has shown we are at increased risk from over-diagnosis and over-treatment.

Politicians are afraid to tell the truth. It would be political suicide. We cannot afford this free-for-all, around the clock for every pain, ache or ailment. Rationing is inevitable. Patients are no longer allowed to die, at least not on stretchers in hospital corridors, and certainly not at weekends.

Professor Sidney Lowry
Bangor, Co Down

Morale is low and medics are fighting for the survival of the health service

Sir, I read Jenni Russell’s article (“Better a decent 5-day NHS than this shambles,” Jan 7) with a mixture of sadness and shame but her “evidence”, based on her conversations with five doctors, came as no surprise to me. My daughter, a registrar anaesthetist, and her husband, a consultant in acute medicine, have worked solely for the NHS for almost 15 years and say that morale is at its lowest, so much so that she has voted for strike action as a last resort. They are both passionate about the NHS and have always said that we will not realise how good a service we have until it has been demolished by the deliberate undermining of the staff by Mr Lansley and now Mr Hunt.

By all means make it more efficient, but please provide sufficient funds to allow them to do their work to the best of their ability and cease the political posturing. The NHS is far too precious to lose.

George Collins
Sutton Coldfield, W Mids
Sir, The greatest frustration experienced by most doctors in our health service is aggressive and incompetent management. Doctors enjoy their work but have lost authority and respect — we seem to have the same status as cleaners in our own hospitals.

The media and government constantly defer to “NHS bosses”. They are not the solution but the fundamental problem. There is an enormous layer of bureaucrats referred to as “nurse managers, clinical managers and medical directors”. Their titles bely the fact that they rarely, if ever, treat patients.

Until this issue, more than any other, is addressed, juniors will continue to strike or emigrate and senior doctors will pursue early retirement leaving a cohort of frustrated and increasingly inexperienced practitioners.

Paul C Nolan
Consultant trauma and orthopaedic spinal surgeon

Dr Bronagh Mcelhenny
Consultant Anaesthetist, Belfast

Sir, A “seven-day NHS” is an attractive slogan for politicians and their advisers but nobody has been able to show what resources, training and staff are required to achieve it, where those resources and personnel are to come from or what benefits they will produce. One must assume that the sums have not been done or published because departmental officials have advised minsters that they do not add up.

Clive Smee
Chief economic adviser and chief analyst, Department of Health, 1984-2002

Constructive deconstruction – of the ischaemic bowel in the UK Health Systems.. Politicians need a duty of candour like Mr Smallwoood

Join the Liberal Democrats now. Change the future for the UK Health Systems!

Why Liberal philosophies are better for the UK. Who will be the first party to re-invent a truly National Health Service?

Local government grants cut to charities which are health related – The pretence that there is no rationing has to be ended, before meaningful debate and cultural change can begin.

Rationing at Commissioning Group level – Aneurin Bevan’s In Place of Fear A Free Health Service becomes a caricature of reality.

The Health Services need a new electoral system – Sudden swings in direction, funding, and organisation are killing health systems..

This entry was posted in A Personal View, Professionals, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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