BBC Radio 4’s Inside Health is hosting a special debate on the current state of the NHS. Dr Mark Porter and guests discuss what needs to give.
The last few months have seen the service creaking under unprecedented demand, and there is likely to be worse to come. Something needs to give. Is it simply a matter of more resources, or do we also need to change our expectations of what the NHS provides? Is rationalisation and rationing the way forward?
Mark is to discuss the issues with a panel including regular contributor Margaret McCartney GP, Claire Marx, president of the Royal College of Surgeons, and Chris Hopson, chief executive of NHS Providers.
Tickets will be available from the BBC website soon
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Would the panel like to pre-determine their interpretation of the current ideology and philosophy of their NHS, and whether it coincides with Aneurin Bevan’s original article?
In view of this ideology (if they all agree) is it sustainable, given that technology and demographics are advancing faster than our ability to pay, for best and universal health care?
The WHO does not intend to report on the NHS but rather on 4 different systems when it next reports and compares outcomes. In what ways are the Regional Health services, from a patient’s perspective, (in a patient centred NHS) (England, Ireland, Scotland and Wales) still “National”?
Large companies conduct exit interviews on their staff who leave or retire, or get promoted. Is the panel aware that there are very few (if any) Exit Interviews conducted in the Health Trusts (which are much larger organizations)? It is BMA policy (In Wales) to ask for these – would the panel support this? How would you give feedback from these interviews so that it made a difference?
What does the panel think of the language of health? Trusts describe prioritization, restriction and limiting, but not rationing. Is this language honest in a “patient centered” health service?
Do the panel members feel that covert rationing is preferable / more ethical to overt rationing or vice versa? Would it be fairer if patients knew what services they were not entitled to?
The Medical profession believes that the language of health care should be more honest with regard to rationing: do you agree?
If rationing were to be allowed to be debated, where would the panel begin the debate?
How would the panel set about changing the culture of fear in the Health Services of the UK?
Does the panel think that it is right to reject 9:11 applicants to medical school, and then recruit the shortfall from overseas, and countries that can least afford to lose doctors?
Does the panel believe we as taxpayers would get better value from graduate medical students as opposed to undergraduates (as in many other countries)?
In view of the litigation bills: Does the panel believe a “no fault compensation” system would give a payback over time (longer than one term of office)?
How would the panel de-politicize health so that it was not a political football?
Does the panel feel hypothecated taxation, allied to rationing could be a way forward?
What are the arguments against providing patients with the true cost of every good or service they receive, even if there is no charge?
How would the panel design a system that encouraged patient autonomy rather than a paternalistic state?
In a “free” health service (cradle to grave) why is neonatal and maternal health fully funded and yet palliative and terminal care depends on charities?
Are there any goods and services which are so cheap that everyone, whatever their means, should pay for them?
How would the panel address the disengaged, cynical and angry professionals in the medical professions? Given that these real people are in the majority, and they will not be the ones sending questions in to you, and will not be listening to your answers how will you get your new and inspirational message across to them?
Do you think all ministers and health board members should let their citizens know annually whether or not they have Private Medical Insurance?
Would the panel members know of any other country whose funding is open ended? What is their opinion of the New Zealand system which used to be similar to ours? Is there any other country whose system they would hold up as equivalent or better than our own?
How would the panel like to change the dental contract so that, once there are enough Dentists, they will be tempted to have Health Service patients?
Does the panel agree with the 1982 report by Prof Robert Duthrie (1925-2005) of Oxford University: to reduce complications, lower waiting lists and raise standards we need a national network of cold orthopaedic centres. This would reduce infections and complications.
Does the panel think that cold orthopaedic centres should be an option/choice for everyone in the UK Health Services?
Does the panel feel that, with increasing bacterial resistance and cross infections, associated with over occupancy of hospital beds, that patients are more or less likely to choose the private option if they can afford it? What effect does this have on equality?
If you had the power to act, what would the panel members first actions be; in the short term, and then in the long term, to address staff shortages?
Are there some goods and services which are so cheap that everyone, whatever their means should pay for? Eg: 10 paracetamol. Paracetamol liquid. Suppositories for piles.