Saturday, June 25, 2022

WEEKENDER: More on the failing NHS, by Wiggia

There is a certain inevitability about getting old: we need more help on the medical front than of yore, none of us like to admit it but there it is. The argument about whether certain treatments that extend life are really worth the cost in monetary terms or personal life quality is a separate argument.
Still, by its nature the state of our health service does take a very elevated position in our thoughts in everyday life for obvious reasons, so inadequacies in that health service have a serious impact on our lives.

There seem to be endless stories in the press about the NHS on an almost daily basis. None of them put the organisation in a flattering light, which is hardly surprising considering the state it is in,

Nonetheless one would like to think that they were trying to right the wrongs and at least try to serve the public they are there to supposedly look after in times of medical need and not add fuel a fire that just keeps burning.

An example was this week when my wife had to go to the reception at our ‘Medical Centre’ to correct a prescription that had on two occasions been issued with the wrong medication; no good phoning unless you have an afternoon to spare.

On the receptionist's desk was a notice telling those who approached that they had been receiving abuse and threats and anyone who persisted would be de-listed.

Now no one can condone threatening behaviour, yet one would think that the surgery, sorry, Medical Centre would readily admit that people's frustration at not being able to even speak to a doctor (especially if you work for a living) is becoming ever more intolerable and that the centre's policy of working two days a week with ever fewer staff while taking on more paying customers, just might have something to do with it. Tthe threat of de-listing, not that it would make much difference currently, is not a solution; it is a pound shop solution to a problem not of the patient's making, and at surgeries like ours there appears to be no visible effort being made to correct things or redeem the patient's faith in the service, such as it is.

They even shut down routine testing a short while ago, already months behind schedule as the ‘staff’ were busy outside the surgery giving Covid jabs for which they are paid extra. Not bad, working two days a week and then being able to junk even that and go elsewhere to earn more all at the public's expense both in monetary and medical terms.

And now along with much of the public sector they are talking of taking strike action. Much of this comes from a basis that all were heroes during the pandemic and we should just cough up. There is nothing wrong with people wanting a pay rise, but consider two things: the bulk of the NHS was on holiday during the pandemic, so it hardly warrants the hero status; and secondly, the drop in earnings since 2010 of 22 % affects everyone, they fail to realise it is not about ‘cuts’ but a general drop in wages and living standards for many, most without the comfort of public service blanketing. We cannot assume all wages will just go on rising because we want it; economics comes into it and the private sector workers have suffered a lot more than the public sector and they of course provide the funds for the public sector to exist on.

The NHS consumes an awful lot of wonga. They can argue it is not enough but we can say much is badly spent and the figures can be made to show almost anything that is needed either way. When comparing international health spending I see we measure up very badly: infrastructure - poor, beds available - worst, doctor-patient ratio - very poor and many clinical outcomes - poor. Not all of that is because of lack of funds.

There is no way we can claim to be grossly underfunded in health care. Many countries that spend less better outcomes,  better patient to doctor ratios and more hospital beds, as well as better outcomes in the treatment of cancers for instance. Yet many use the US model as the reason not to change; I can only assume they have a socialist agenda and defend their baby regardless of current failings.

Our GPs are the best paid in Europe apart from Germany yet have the worst ratio of doctors to patients and still get paid for not seeing anyone; there is something seriously wrong there for a start.

We have fewer hospital beds per thousand population by a mile, far less than almost any Western country. Fewer beds means fewer patients in care so fewer medical staff needed, yet somehow we are always needing more. I repeat, how can the biggest employer outside the Chinese army be short-staffed? Answers on a postcard please, though I think we know the answer to that.

The chart below shows the decline in available beds, during a period when the population has increased by at least ten million. If anyone can explain the logic of that vis-a-vis other countries I will be astounded.

The NHS trusts should not be personal fiefdoms; all should be under the same umbrella on strategy on spending and structure. Many areas of the NHS still manage to provide decent services; how come others have been allowed to throw the towel in and be unfit for purpose and remain so?

Those who always say we are better off rather than following the US model are not comparing like with like. Why they always bring the US health service into the discussion is strange as there are so many others that have better results than us with similar expenditure. Again, the insurance portion of the cost gives patients the right to choose, something drastically missing here. This is the Danish model: see PT2 for patients' rights and tell me it is not better than our system.

It seems that no matter how many people put forward proposals for improving our NHS nothing of consequence changes. The current waiting lists are so long many will give up and many will die; not a lot of applauding in that sector.

You could almost do a weekly piece on the NHS failings, it just goes on and on. I shall cease for a while. What we see of and get from that organisation stays the same, however much we protest; sometimes it feels as though only a nuclear strike could change it.

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