What the GP did best: used time as a diagnostic tool. The “failiing fiasco” of health care in the UK.

I was trained with and by the same teams as Nick Norwell whose letter points out the perverse incentives ever present in medicine. The dissonance is between over-treatment and investigation in the private system, or under-treatment and waiting lists in the state system. Elderly people are usually uninsurable, and so they have little choice. Thus they fall victim of any delay. The access to diagnostics is very important:

PET scans (positron emission tomography scans) are often done in conjunction with CT scans (computerized tomography scans) or MRI scans (magnetic resonance imaging scans). … An MRI scan can be used when your organ shape or blood vessels are in question, whereas PET scans will be used to see your body’s function.

But the relative number of these machines is very low in the UK, and often they are old and break down. There is not only a shortage of speedy access to imaging, but also a shortage of radiologists.

There will always be over-treatment, but what UK health service dependent patients are experiencing is slow, or under treatment, post code lottery of access, (even to private provision) and a failing fiasco of a broken down unfair system.

What better incentive to go privately if you know a delay could make your condition untreatable? Perhaps I need to drop the crusade? Legalising pot will be easier than reforming the (N) HS.

See the source image

INSURERS IN CHARGE – The Times 18th November 2019
Sir, The article on health insurers overruling consultants on the best treatment for patients (news, Nov 18) illustrates the fundamental problem with private practice in the NHS. In private health insurance, money (and profit) is king. In private practice money, if not king, is at least prince regent. The health insurers take the money and hope to do nothing, while private doctors take the money, and attempt to show patients that they are getting value for their money.

When I lived in France many expat Brits would tell me, with wide-eyed wonder, of the speed with which their various ailments were dealt with, surgically or otherwise, under the French mixed private/insurance/state-funded healthcare system.

As a retired doctor I could not help wondering how many ohttps://www.thetimes.co.uk/article/insurers-overrule-consultants-on-best-treatment-for-patients-5g0tdmdvtf those treatments were really necessary. I remembered the advice of one of my teachers at medical school: use time as a therapeutic tool. For all its faults, the NHS is good at doing this, albeit usually by default not design.
Nicholas Norwell
Newbury, Berks

The NHS does not have enough radiologists to keep patients safe, say three-in-four hospital imaging bosses  – Royal College of Radiologists

Andrew Ellson in the Times 18th November 2019: Insurers overrule consultants on best treatment for patients

Image result for failiing fiasco cartoon

This entry was posted in A Personal View, Stories in the Media, Trust Board Directors 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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