This type of social revolution brings some good thoughts from our media correspondents. Whether their thoughts are translated into action is another matter. Populism, embraced by leadership in the UK, is aware that by changing the services so that they are founded on a rock will be traumatic, controversial, and lose them votes because the opposition will pounce on them. Co-payments – no way. Rationing – never happens, Standards – always rise! These are lies that need to be exposed and debated in an open society.
Lets start with standards. In a short article hidden in a small side column on the Times 4th April, and not on line, :
Medics’ Extra Insurance: Doctors have been given extra government assurance for lower care standards and a commitment that regulators will be lenient on failures at the height of the pandemic. In a letter to medics, seen by The Times, health authorities acknowledged that satff may “need to work in different ways”, adding “We do not want indemnity to be a barrier to delay to such changes”.
Well let me tell you that not only hospital doctors, but also GPs are taking extra risks. For a start not examining the patient and relying on phone and video calls raises the risk. I wonder if GPs, already in meltdown before the crisis, are going to be absolved if they make the inevitable error. We should go the whole way and have no fault compensation.
Co payments. Well Janice Turner on 4th April in the Times in This fad for fitness could last a lifetime – All the generations are coping with their fears by trying to improve their health, which will be good news for the NHS
….The one notable downside of the NHS is it leads to physical complacency. If we get obese, diabetic, develop joint problems or high blood pressure we just see a GP and are treated “for free”. No need to change your lifestyle: pop a statin. An NHS physio told me patients expect to be fixed in a single appointment, rarely doing the therapeutic exercises at home. Writing about diabetic amputations, I met nurses begging high-risk patients not to live on chocolate bars, and a surgeon who eventually cut the limbs off patients who’d carried on smoking even after losing several toes.
Ms Turner exposes the achilles heel of the paternal society that is the 4 UK health systems. One that even Anneurin Bevan recognised, but felt he had to put up with to get his bill through. We do not encourage people by stick, as well as carrot, to look after themselves.
And rationing: In Paul Nurse opinion in the Times 4th April: ‘Boris knows he’s out of his depth. Suddenly experts are useful again’
…The country is, he warns, paying the price for ten years of austerity. “If you’re always strapped for cash, you will invest in what’s going to be needed next week, and not what might be needed in ten years.” Too often, the political debate about the NHS “focused too much on short-termism — what money can be saved here — and you do have to have a longer-term perspective,” he says. The calculation that “we’re tying up money in something that is unlikely to be used . . . is OK if you’re running a business, but it isn’t so OK if you’re running a healthcare system”.
The pandemic also, he argues, proves the importance of “left-field” scientific research that may not be immediately useful. “I work with yeast, and people think that’s utterly useless. But what we discovered some years ago is what controls how a yeast cell divides . . . and then we showed that’s the same in humans. That is absolutely critical for cancer.”
The next big challenge is to create a coronavirus vaccine.
It needs more money, resources, people and plant. But we cannot afford it if “Everything is free for everyone for ever”.
Kat Lay in the same paper thinks that the Pandemic is set to future-proof the NHS
but NHSreality would contend that is only if we face the issues above honestly.
…New ways of working, including centralised hubs co-ordinating cancer care, are likely to persist even after the pandemic has passed, experts say…..
…He estimated that even after the pandemic, up to half of GP appointments would be online or by telephone.
Efforts are focused on how GPs can access patient records securely from home, with many having to travel to surgeries to conduct remote appointments…
Hospitals, too, have moved outpatient appointments online. The move ties in with a pre-pandemic ambition to reduce travel and thus air pollution.
Pando, a communications app for healthcare workers, is being downloaded by more than 1,000 doctors daily.
Last week, Matt Hancock, the health secretary, wrote to all NHS organisations giving them legal backing to set aside the normal confidentiality for patients until at least September if sharing patient data was deemed relevant in helping the fight against Covid-19.