Once again, a government’s attempts to reform the National Health Service are being attacked from all sides. At every general election we see the childish squabbling by political parties to create fear in the electorate about who is going to dismantle the NHS and who will protect it. The reality is that none seem capable of running it effectively.
Throughout my life I’ve received more than my fair share of treatment via the NHS, some of it good, some of it not so good. On the whole, I have benefited from most treatment and last year emergency surgery saved my life. For that I am very grateful.
I believe the principles on which the NHS is founded are admirable and many of the practitioners working in it are exemplary, but the organisation itself is a disgrace. It lets down many of its dedicated practitioners as well as some of the people it serves.
From a close family member who worked at a NHS stores in the late 1980s and was witness to unforgivably huge waste to friends and family who have suffered recently as a result of inefficiency of the disconnected parts of our health system, I believe much of the problem lies with the NHS organisation itself. I do not think anyone will ever be able to manage the reforms it desperately needs.
I am not often a supporter of name changes for organisations, but in this case I suggest abandoning the NHS name to create a new organisation with a fresh start.
I would like to see general practitioners manage all health and social care: they are the logical people to do so as they are at the centre of the community. Merging the medical aspects of care with the supportive, recuperative aspects would create a holistic service that has not existed previously. It could be called UK Health and Wellbeing.
Such a service could prevent patients remaining in hospital for a week and a half unnecessarily until care professionals can meet to discuss what care is needed on discharge. It could ensure that patients are not discharged after surgery with just a letter to take to their GP if they encounter problems but are provided with care, physiotherapy and the help necessary to recover full health and fitness as soon as possible. It could ensure that patients and relatives do not have to relate the same details to one health professional after another, who write the details down and then ignore them. It could ensure a lot, lot more, but I would have to write thousands more words.
I believe the UK is too sentimental about the NHS. There is much good about it and as much that is bad. There are groups jealous of their power: doctors, nurses, unions, GPs, drug companies and other service providers. They all have a great deal to lose from change, which is why we always see such stiff opposition to any reforms. I want everyone working in the service to be treated fairly and rewarded well, but I also want an organisation that is fit for purpose.
Does it really matter who provides health and care services? I do not think either the public or private sectors can prove they are any better than the other. From what I have read recently (trying to find links) in some other countries a varying mix of private, public and voluntary provision sometimes achieve better performance.
Other complex issues, such as the training of practitioners, also need to be addressed. Recently I received excellent treatment at an old hospital with a genuine and effective community culture where the staff cared. I have also visited relatives in brand new, shiny buildings where there was no such feeling of community and where staff were too busy ticking boxes on their clipboards to listen to patients’ requests.
There used to be talk of the ‘caring’ professions; these days, nursing especially is described in some university prospectuses as a career with no mention of vocation. While specialist training is essential for some positions, the ability to care for the person, not the condition they are suffering from, is critical in many instances. It is dangerous to view nursing as an industry.
So what happens next? I think the present government’s reforms will fail just as all others have. While prestigious projects have provided impressive new hospital buildings, these do not ensure effective treatment: it is the people providing the service who matter.
I would like to see the future of healthcare taken out of the hands of politicians, national and local government and for the community to take more control. Perhaps this is not feasible.
If I were asked where to start, I would set up a commission comprising people with vision and with no specific interest to protect. The names James Dyson, David Attenborough, the Archbishop of York, Joanna Lumley spring to mind; there are more, possibly better qualified people, but I think it is important to bring in a mix of people with varying experience and expertise to examine it from all sides of the community. I would like this independent commission to look at the ideal shape of holistic health and care services. Perhaps this would identify a good starting point. The rest? Well, that would follow on from their findings.
I don’t pretend to know all the answers but what I would like to see is more incidences where we can applaud marvellous care and practitioners and fewer where we are angry about waste, inefficiency and uncaring treatment of individuals.
To progress we have to drop the sentimentality: organisations don’t matter, people do.