Friday, 14 August 2009

NHS In Free For All?

Poor old NHS, a creaking giant born of good intentions, the saviour of many, the tormentor of some. Say what you will, a service where everyone payed in to provide health care for all seemed to be a good idea at the time. Or was it? According to critics both here and in America, the National Health Service of Great Britain is a disgrace. They say we are subjected to governmental control and tyranny in order to access basic health care for which, they say, we wait and wait for no good reason. And what's more we have awful teeth. Nice. How kind of them to mention it.

I've worked in the NHS all my adult life, and quite frankly despite all the negative press I'm proud of what can be achieved, although I'm the first to agree it isn't all good news. That much is obvious. Since 1969 I've seen many changes, many different incentives and initiatives relentlessly pursued only to be abdandoned and tried again years later with the same disappointing results. I've witnessed the rise and rise of superbugs, the lowering of cleaning standards, the out-sourcing of basic services which are often substandard, the ridiculous obsession with producing statistics rather than genuine improvements in patient care. Whole hospital departments exist merely to collect raw and sometimes inaccurate data, mould it into the required good news format to be used in the never ending game of ping-pong politics in which the NHS has become the continually battered ball. Point scoring results can be manipulated to order, depending on who's asking the question and what they want the answer to convey. Legions of career focused hospital managers now spend their time in meetings about finances, targets and cuts whereas at one time they used to know more about patients' needs, the local population, the value of their staff. Sadly, that's all in the past.

Yes, there's plenty to be negative about if we want to look and look and look for it, but whilst we're having such a close look I'd urge anyone who's at all interested in fair play and a balanced argument to take care not to ignore the tremendous good that is also achieved.

In the years I've worked in the health service, I've seen kids who would never have previously survived into adulthood given transplant surgery which has provided them and their families with a future. There are chronically ill people in the UK who are being kept alive by combinations of drugs/therapy/care, all free at point of delivery. What would happen to them if it wasn't for the NHS? Babies smaller than bags of sugar (much smaller, actually) are now routinely cared for in amazingly expensive high-tech units until they're big enough to go home, when the nursing staff joyfully hand the parents a baby, not a bill. Every day we can freely go to our GP's surgery, or take part in some sort of health screening, or be seen by a consultant without taking a credit card with us (although change for the carpark would be handy), but these treatments come at a cost and these costs come from our contributions, and we who contribute do so on behalf of everyone. I think we can be proud of that.

I'll not try to pretend that there isn't massive room for improvement in the NHS and admit that there are very, very many cash-strapped services which are not up to a good enough standard, and yes, our demands for health services outstrip the available supply because there simply isn't enough to do everything everyone wants, so yes, we sometimes have to wait. And sadly, yes, some people have been very badly let down by the NHS for many different reasons. But please don't forget the millions and millions of people who owe their health and wellbeing to it, who have been treated successfully and well and are living proof that when the National Health Service is allowed to work, it works. It may be a long way from perfect, but at least you can rest assured that the first question a patient is asked before treatment in a British A and E Department is never going to be "who will pay?"

For me, the sight of people in the US with no health insurance queueing up before dawn in order to see a doctor, certainly vindicates our NHS warts and all.

And yes, in this country you can get those treated for free too.