The UK Health services are facing a “dead end” – both literally and figuratively if we don’t accept rationing.

Britain’s Rubicon in the Brexit debate could also be one for the 4 Health Services. The trouble is that politicians are judged on 4-5 year cycles by a population who expect instant hedonism, and who don’t expect to wait for anything, and lacking honest leaders. The population also voted against proportional representation very recently: the one change which could have led to more long termism. Chris Smyth’s article (below) reveals how disconnected from reality the cancer charities, the RCGP and MacMillan nurses pretend to be – actually it’s not true since most monies for all three are not from taxation, but from gifts from the public. If we wish to ration fairly we need to think about ID cards and different scales of subsidy/co-payment, but before this we need short waiting lists (Wales is worst)…..  and will be getting even worse. Without quality those who can afford it will get better, faster treatment in a two tier service. And why should psychiatric patients suffer more than cancer from covert rationing – because they don’t influence elections? They have more life years ahead of them! Mr Stevens suggestions are rational, pragmatic and overt…lets have more, and avoid the “dead end” we are heading for.

Image result for crossing the riubicon cartoon

Britain’s Rubicon is the Times leader 28th March 2017, and the arguments against short-termism apply equally to health – Negotiators on all sides in the Brexit process that starts today must put short-termism aside and think of the future generations that will judge them.

Chris Smyth reports 28th March 2017: Cancer patients ‘will suffer in NHS war on waste’

Cancer patients will die in pain because of NHS cost-cutting plans, charities have warned.

Scrapping prescriptions for “low-value” medicines would also harm people with coeliac disease and those in chronic pain, the campaigners claimed.

Simon Stevens, the head of NHS England, outlined his proposals to cut waste in the health service yesterday when he said that common painkillers, gluten-free foods and travel vaccines should no longer be available on prescription when patients could buy such products for themselves. Medicines that have cheaper alternatives should also not be prescribed.

NHS bosses have identified ten products, costing £128 million a year, that they want doctors to stop prescribing, with further restrictions on other items being considered.

Suncream, cold remedies and heartburn treatment could be restricted under a review to cut £400 million of NHS spending.

“There’s £114 million being spent on medicines for upset tummies, haemorrhoids, travel sickness, indigestion. That’s even before you get on to the £22 million-plus on gluten-free that you can also now get at Morrisons, Lidl or Tesco,” Mr Stevens told the Daily Mail. “Part of what we are trying to do is make sure that we make enough headroom to spend money on the innovative new drugs by not wasting it on these kind of items.”

Helen Stokes-Lampard, chairwoman of the Royal College of General Practitioners, said doctors must not be banned from prescribing paracetamol in quantities not available over the counter or offering powerful sunscreen to people at risk of melanoma.

“If patients are in a position that they can afford to buy over-the-counter medicines and products, then we would encourage them to do so without a prescription, but this isn’t the case for everyone,” she said.

“Imposing blanket policies on GPs that don’t take into account demographic differences across the country or allowing flexibility for a patient’s individual circumstances risks alienating the most vulnerable in society.”

Rosie Loftus, chief medical officer at Macmillan Cancer Support, criticised the decision to single out fentanyl — a painkiller that costs the NHS £10 million a year — on the ground that morphine is cheaper.

“It is a drug often given to cancer patients to provide crucial pain relief at the end of their life. This move would signal a step back in how we manage people’s care when they’re dying,” she said. “We understand the financial pressure the NHS is under, but for some patients it might be the only or best medication that can help ease discomfort in their final days.”

Sarah Sleet, chief executive of Coeliac UK, attacked Mr Stevens for saying that people with the auto-immune disease could get their gluten-free foods at the supermarket.

“Budget and convenience stores, which are relied upon by the most vulnerable, such as the elderly, those with disabilities and on low incomes, have virtually no provision,” she said.

Identity Cards could help, addressing inequality in health, and helping younger families.. Bring back the guillotine for Mr Hunt?

What a pity that mental health stats are not universal and comparative. The limitations of the smaller mutuals (Wales Scotland and N Ireland) are exposed…. What can save the services?

A two tier primary care (General Practice) service is evolving, like in Dentistry, by neglect…

 Rationing by waiting, and insufficient staff. Wales is worst…

Betsi Cadwaladr waiting times ‘getting worse’ since Welsh Government stepped in to rescue health board

David Williamson for Walesonloine reports 23rd March 2017; Wales’ Health Secretary refused twice to guarantee that NHS services will not face cuts

If we go on like this the housing debt will be as nothing to the health debt in 10 years time.

There is no sustainable ideology – so leaders find their staff disengaged and that their job is impossible..

This entry was posted in A Personal View, 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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