What am I afraid of? More and more… Bringing back fear..

In the original description of the former NHS, In Place of Fear A Free Health Service 1952 Chapter 5, a reader would have been reassured by the “universal” nature of the health service. The equality in access to specialist services, surgery and other specialities.

So what am I afraid of?

Firstly the quality of emergency and out of hours services. Casualty department staff are overstretched and undervalued, and there is a shortage of applicants. This is partly due to the gender bias in medical recruitment, but also due to long term rationing of medical places. The most likely acute scenarios for me are a heart attack or a stroke. For the first a stent treatment is 90 minutes away. For the second there is no fully staffed stroke unit with psychologist etc. The Western Mail 19th Jan 2016 reports: Hospital emergency departments in Wales are ‘on the edge’, leading doctor admits

Secondly I am afraid of being excluded from choice. Some conditions are relatively rare, such as thyroid cancer, but I have no choice, and will have to be treated in my own Welsh Trust even if the treatment is only done once or twice a year by the specialist. This exclusion also applies to more common cancers, where advanced  treatments, such as for prostate and breast, have been shunned by a government more keen on reducing inequalities than raising standards.

Thirdly, I am afraid there will not be capacity to look after me in my old age. The “cradle to grave” nature of the health services is only free at one end..  Bed blocking and families where all children have to work are actually in a worse place than those with under or unemployed, as they can often cope somehow. Saving for old age has not been done by most of us. What was National is now “post Coded”.

Fourthly, I am fearful of the structure of the UK, and particularly the Health Services. It has been a mistake to devolve Welsh health, and the figures will be out in the end. Deliberately different performance indicators will hide the situation for so long, until the WHO does it’s international comparators… I believe civil unrest could follow.. The public have been sold a pup: larger mutuals are better.

Fifthly, I am afraid for my profession, and for nursing and midwifery. The cynical approach to recruitment, and rationing of much needed places, brutalising the youth of the country where so many are disappointed, is responsible. Unethically recruiting doctors and even worse nurses, from other countries perpetuates the situation. Graduate entry to medical school would help correct the gender bias. It appears that politicians believe in nothing. NHS reality does.

Sixth, I am afraid for the politics in Wales, where a new hospital in my own area should have been started 7 years ago in a geographically central situation. Without the political will to see through “utilitarian” changes and to debate and explain why they are needed, we can end up  with wrong decisions. Expanding Carmarthen Hospital is wrong. Carmarthen is only 30 miles from Swansea, (which needs a new Hospital) and has good transport links. We are 35 miles from Carmarthen on slow roads, and have 4 times the population in summer. We have had not had enough infrastructure invested. Good communications to West Wale and Ireland are paramount if rural areas are to have the same life expectancy as the cities.

Seventh. I am afraid that the word “duty” in Health policy does not arise. Patient rights and reparation are more important. Litigation results. No-fault compensation has been ignored as an option. The obesity tsunami coming slowly on us is a case in point. Deserts based rationing is one solution, but it has to be overt.

In summary – I am afraid of bringing back fear.

A new philosophy, what I believe: allow Trust Board members to use the language of rationing in media press releases

Devolution of health to Wales was a mistake?

Financial Reality – The Health and Social Security budget will break us by 2020. We need to focus on duties rather than rights in healthcare..







This entry was posted in A Personal View, Community Health Councils, Patient representatives, Political Representatives and activists, 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.

One thought on “What am I afraid of? More and more… Bringing back fear..

  1. Pingback: The BMA Hustings – an uninformed line up of hopeful politicians. Withybush Hospital degenerates further. | NHS reality. An NHS soapbox. Speakers' corner for the NHS.

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