Could private top-up insurance fund the (failing) NHS? Jumping into the abyss of denial..

BMJ editor, Richard Hurley has to hark back to 1948 to find “reasons to be proud” of the UK Health service (NHS that was). He admits it is buckling, and offers a head to head between Christopher Smallwood (a former Trust Chair) and David Wrigley who derides the pragmatism suggested by an insurance based scheme. Neither points out that the WHO does not recognise and will not report on, an NHS any longer.

Read Chris Smallwood’s argument here: bmj-i5424-full

Image result for  nhs cartoon

When I became a GP in 1979 there were state run nursing homes. These were closed and provided by the private sector, doubtless much more efficiently, but now, owing to bed blocking and undercapacity rationing, Hospital trusts are having to “open own care homes to tackle beds crisis” (Chris Smyth 15th October 2016). Full circle? But the money should have been spent in primary care, drip fed over many years. Instead it is effectively spent on the “black hole” Hospital budget..

The pharmacist is an essential member of the primary care team. How many times has a minor error been correctly questioned or politely pointed out to a GP (like myself) – but cutting 3000 pharmacies, especially if they are in rural areas, is madness. Chris Smyth reports again on this “incoherent policy”..  On 30th May NHSreality posted “Cutting pharmacists may be possible in cities, but it will be very inconvenient in rural areas. Who is off their trolley? “.

Increasing Medical Students by 1500 per annum when so many (42%) want to leave the UK after 9 years qualified, means we need to do more. If 2 out of 11 applicants got places in the past, and we increase by 25%, this means approximately 3 out of 11 applicants will get jobs. 8 rather than 9 will be rejected. Over the years I have witnessed the rejection of very suitable applicants and this will continue, whilst we import from poorer countries with lesser training standards, to our shame. (Health services are “vacant” – and have many GP vacancies despite oversubscription to Medical School over many years ) This year, for the first time, there were places in Medicine through clearing! (Medical Schools: your chances – applications-to-acceptance ratio was 11.2. May 2014.)

As for whistleblowing and morale – Sathnam Sanghera opined in The Times on 14th October “NHS staff need funding, not trite advice based on a terrible movie” and his comments are exactly what the profession feel…

“It’s only October, but we have a winner already. The 2016 Award for Most Inane Management Remark of the Year must surely go to Dr Henrietta Hughes, the new whistleblowing chief for the NHS, who argued out loud this week that low-level grumpiness among staff was creating a mistrustful, “toxic environment” in which staff were reluctant to speak out, and that the answer was for them to gain inspiration from the happy embraces of reunited families at the start of the Hugh Grant film Love Actually. “If you think about that scene in Love Actually where everybody is meeting at the airport, that’s the oxytocin feeling,” she said, according to a story on the front of The Times this week. “So wouldn’t it be better if oxytocin was the predominant neurotransmitter in the NHS?”

Dear Lord. Leaving aside the fact that this a) sounds exactly like something David Brent would say and that b) the more immediate problem with whistleblowing in the NHS is that her office has no formal investigatory powers and that c) this particular scene, which also features a voice-over grotesquely linking bland romantic comedy sentiments to the 9/11 attacks on the World Trade Centre, is one of the most cringe-making in the history of British cinema, she couldn’t have picked a worse film for a workplace allusion…..

Add to all this “Burnout” and the need to fund a service more and more..

and saving money on Training inappropriately for short term gain

and reduction of standards, especially around death and dying, but also around cancer, and the demographics would cause Apple jealousy in their rate of expansion if they represented business opportunity (Half a million will get cancer every year)

and if you thought you would be OK in an emergency, think again. There are too few doctors willing to work the shift patterns of A&E for their lives, and “Abandoned pensioners are swamping A&E” departments across the country. NHSreality predicts private A&E in cities, and then across the country.

Mistakes do happen (David Rankin reported October 12 “Mother died after hospital blood mix-up”), and my own family were victim to the giving of a wrong X ray recently. Aside from the cost the issues are confidentiality to both parties, and wasted time as the results were unavailable for the consultant. More importantly, did the health service staff concerned fill out a “critical incident”? Were my family member’s X rays seen and given to someone else? Everyone tries their best but no fault compensation makes sense…

Litigation – The rising tsunami is swamping us all.. NHSreality lists all the posts on litigation in the two years of existence. NFC (No fault compensation) is essential.

NHSreality agrees with The Times leader October 11th “The (presumably England, Wales, Scotland and Ireland) more money.”

 

 

 

 

 

 

 

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